For over two weeks, Thailand’s daily caseload of new cases has been above 2,000. More than half of the confirmed cases are in Bangkok and its suburbs, where health authorities have discovered new clusters and the highly contagious UK strain since early April.
This has resulted in a hike in demand for hospital beds and Covid-19 testing services.
The capital is presenting the biggest challenge for us. Private hospitals dominate Bangkok’s health system, unlike the provinces, where public hospitals are the primary health providers.
Thus, the only way to fight the pandemic in Bangkok will be by engaging the private sector.
There is also a huge disparity in healthcare access in Bangkok. Though the wealthy and middle-class people can afford high-quality care in private facilities, there are also many vulnerable groups, like the homeless, migrants, prisoners and poor people, who are struggling to reach out to primary care. They rely on public health facilities, which provide free healthcare services under Universal Health Coverage (UHC) run by the government.
Under normal circumstances, this disparity would not be felt as public healthcare facilities can easily meet the needs of the population, including those from the underserved communities.
However, during the pandemic, public healthcare resources are stretched tight due to the rising number of Covid-19 patients, who need to be isolated. Calling on the private sector for help is unavoidable, including profit-making hospitals and hotels, which have the resources necessary for fighting the pandemic.
The National Health Security Office (NHSO) is collaborating with the private sector to run the Universal Coverage Scheme (UCS), one of the three tax-funded healthcare schemes under UHC. The other two are the Social Security Scheme and Civil Servant Medical Benefits Scheme. These ensure healthcare access for more than 99 per cent of the Thai population, including free Covid-19 testing and treatment.
Many private hospitals have been providing health services and emergency care to beneficiaries of these schemes, especially in Bangkok.
After these services have been provided, managers of the three healthcare schemes – NHSO, Social Security Office, and the Comptroller General's Department – will reimburse the hospitals.
This public-private partnership gives us the advantage of tackling Covid-19 while closing the disparity gap in Bangkok.
Many private hospitals have also agreed to provide medical care to Covid-19 patients regardless of their financial status and registered healthcare schemes. This has been made possible by the Private Hospital Association Thailand, which is led by Dr Chalerm Hanpanich.
In a bid to support hospitals, the NHSO has recently amended its reimbursement regulation to improve hospitals’ liquidity and their ability to cope better with the pandemic. Previously, the NHSO allowed healthcare providers to submit claims for reimbursement once a month but has now changed it to every 15 days.
Meanwhile, some hotel operators have agreed to turn their properties into temporary quarantine facilities, or "hospitels", to meet the high demand for hospital beds and isolation rooms in the recent outbreak. The NHSO has been covering the operational cost for these.
Thailand is not unique. Public-private partnerships have helped many countries improve their health systems and boost their capacity to handle the pandemic.
Taiwan is one of the prominent examples. Its health system is dominated by private hospitals that work closely with the Taiwanese government under the National Health Insurance, a single-payer compulsory social insurance plan, by sharing data and driving health innovations to protect people from Covid-19.
As testimony to the benefits of public-private partnerships, the World Economic Forum hosted the UHC2030 Private Sector Constituency in September 2019 to bring together private sector actors and promote collaboration across them and with other partners outside their circle.
The UHC2030 Private Sector Constituency launched its statement on UHC ahead of the UN High-Level Meeting that year. It highlighted how the private sector can work with other stakeholders to achieve better health and well-being for all people of all ages, calling the governments to strengthen partnerships with the private sector and encourage all players to progress towards UHC.
The private sector involves a wide variety of players, including health providers, insurance companies, health innovation developers, manufacturers and distributors of medicines and health products.
They can affect the health systems in many ways. For example, hospitals can incorporate the UHC principles in their business model by offering high-quality and affordable healthcare. Innovation companies can create health products that improve people's lives and increase the efficiency of health workforces.
Despite the challenges presented by the pandemic, it has provided opportunities for the public and private sectors to work together to improve health systems and ensure people’s good health.
The NHSO will continue strengthening this partnership, as we are aware that all players are essential to the health system.
Published : May 28, 2021
By : Dr Jadej Thammatach-aree Secretary-general National Health Security Office