Bring back Bt30 fee and boost staff and awareness of health
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TDRI health expert says security schemes 'need more money' in order to survive, but a doctor says the govt should bring back Bt30 fee and boost staff and health awareness.
THE rural doctor behind the famous Facebook page “Drama Addict” says the country would be heading down the wrong path if it introduces a co-payment method to fix the funding problem faced by the three major health schemes. He says the government would be better placed to promote prevention and fix other problems.
Having worked for nine years as a doctor on Lanta Island in Krabi, former Koh Lanta Hospital director Wittawat Siriprachai, or “Ja Phichit”, said co-payment would not solve problems in the Universal Health Coverage Scheme (UC) – if other major problems in the system were not fixed.
Those problems include a lack of health knowledge and shortage of medical personnel, he said.
“We need to solve problems in the system as a whole. It will not help anything if we only focus on the budget because every problem is related to each other,” Wittawat said.
The focus should be on cutting costs of the system, he said, by by encouraging people to adopt a healthy lifestyle.
“Currently, the UC scheme is overloaded with patients. Thailand is going to become an ageing society. So we are facing an increase in many chronic diseases such as heart disease, diabetes and hypertension, which will increase budget expenses,” he said.
“Moreover, there is more illness among youths because of the dietary change, as we can see that the age of diabetes patients is getting younger. This is also increasing the financial burden on the scheme.”
Witawat said the total failure of health education was a major reason for the patient overload, as many people go to hospitals with only minor illnesses such as a common cold when there was no need to.
“Before talking about co-payment, it is necessary to educate the people to know how to take care of themselves if they feel unwell and when they should visit a doctor. This would help a lot,” he said.
He stressed that the government should bring back the Bt30 co-payment when seeing a doctor under the UC scheme because this amount was not too much for poor people and it would show that healthcare had a cost, so people would think more before going to hospital.
But he added: “I want to inform that the most serious problem in our healthcare system is the lack of medical personnel, which not many people have revealed to the public. This problem is closely related to the problems in the health security schemes.
“Overcrowded hospitals add more expense to the health security fund and the budget deficit results in less spending on medical personnel, which finally results in doctors not wanting to work in rural hospitals – and that causes a doctor shortage [in those hospitals]. “All this is linked together. That’s why we have to look at the wide picture of the problem.”
