By Chularat Saengpassa
“State welfare should be universal,” said Dr Thorn Pitidol, a lecturer at the Thammasat University’s Faculty of Economics. A recent forum held by his faculty addressed the challenges facing the country’s welfare system.
He said a focus limited to the poor would weaken state-welfare systems in the long run, because the government would then become accustomed to providing help and support for just a section of the Thai population.
Thorn said overseas research had found that a country that focused on universal welfare would be more successful in closing gaps within its society.
The lecturer suspected that the current government had launched the welfare-card scheme for low-income earners in the hope of spurring grassroots economy and avoiding funding problems that might arise under universal welfare options.
“But problems may simply arise out of inefficient policies,” Thorn countered.
He said several welfare projects in Thailand overlapped, complicating the provision of state welfare and unnecessarily raising expenses. Several projects were also populist in nature and instigated or pushed by politicians or political-office holders to make clear to voters what they could deliver.
Professor Euamporn Phijaisanit, who teaches at the same institute, said Swedish tax rates had minimised income distribution problems and Sweden arguably had the world’s best welfare system.
“It’s not out of luck that Swedish people get comprehensive basic welfare from their government. Such a level of welfare is available to them because of collaboration between the government, the private sector and the people,” she said. She pointed out that Swedish people’s tax rates were as high as 56.86 per cent.
Euamporn said it was understandable that Thais would love to enjoy the same level of welfare, but it would take time to implement the several measures needed to achieve that goal.
“We will have to expand the country’s tax base, collect higher taxes from the rich and increase labour wages etc,” she said.
She also noted that Thailand suffered many challenges, including a relatively low level of education, rising public healthcare costs and a greying population.
In her opinion, Thailand should tackle its challenges by offering welfare that drove economic output. For example, the country should create job opportunities and suitable work conditions for people aged 60 to 70 years old. If they worked beyond the current age limit of 60, the country’s gross domestic products would rise by between 4.74 and 9.35 per cent. They would also be able to pay on average Bt4,000 extra annual income tax to the government, which would then have more money to finance state welfare for the elderly.
Dr Viroj Naranong, a research director of health economics and agriculture at the Thailand Development Research Institute, said studies showed welfare states materialised only in a society with little inequality.
“Welfare states are the result of people paying taxes for their welfare. It’s not the other way around,” he said.
He is now especially worried about the 20-year national strategy, which prescribes policies for the country’s development over the next two decades.
“This means we can’t change direction midway even if new governments are formed. Who knows if current policies will not kill us in the future?” he said.
Viroj noted that problems are caused by policies that limit help to only the poor. It could cause even more problems to arise as some impoverished people might not be able to access it, and other not-so-poor people might use connections to portray themselves as poor in order to claim benefits.
“Everyone knows medical bills may easily drive one into bankruptcy,” he added.
Even the middle class could quickly become poor when their families were forced to pay hefty medical costs, said Thorn. He and Viroj agreed that universal welfare was better than selective aid.
The chairwoman of the Healthcare Workforce of Thailand argued that the universal healthcare scheme, which now offers most types of medical services for free to 48 million Thais, would end up lowering the quality of medical services.
“For how long will the government be able to shoulder the financial cost of the scheme?” asked Dr Churdchoo Ariyasriwatana.
Churdchoo said that with budget constraints, doctors would also find it more difficult to work because the list of medicines for prescription would become very limited.
Medical Council’s board member Orapan Mathadilokkul said the offer of free medical services could also promote unhealthy behaviour among people who might think that in the end they could still get help from the universal healthcare scheme.