'Personal contribution leads to better healthcare'
Contributing to medical procedures by patients who are insured through the universal healthcare coverage national insurance (UC), leads to improvements in health care, experts say.
The current free program encourages people to visit state hospitals too often. All those visits put a strain on hospital staff and doctors. When people have to pay, they take better care of themselves and do not have to pay unnecessary visits to the hospital.
Increasing the personal contribution (currently patients pay only 30 baht per consultation) has been a hot topic since it was leaked that the idea was launched during a meeting of the Ministry of Health and the NCPO (junta).
The proposal was made by Tawatchai Kamoltham, Director General of the Department for Development of Thai Traditional Medicine and Alternative Medicine. It reduces the likelihood that people who need urgent medical attention will have to wait because doctors are busy, he says. Tawatchai estimates that 30 to 40 percent of hospital visitors have simple complaints that do not require treatment. He mentions dizziness, common flu and indigestion.
Tawatchai, in his previous position as Inspector General of health care, encountered the effects of UC insurance: financial and management problems of hospitals and overuse of health services. The hospitals receive 300 baht for an outpatient visit through the UC insurance, while the actual costs are 600 baht, according to Tawatchai. 6.000 baht is paid for hospitalization; the actual cost is 10.000 to 12.000 baht.
'This means that the insurance does not cover the full costs,' is Twatchai's [quite obvious] conclusion. In order to make ends meet, the hospitals have to rely on the two other insurance policies, the civil servants welfare en social security insurance. Another problem is that the provincial health services channel more money to large than to small hospitals. As a result, some XNUMX to XNUMX state hospitals are facing shortages. (Source: Bangkok Post, July 17, 2014)
Some data:
Thailand currently has three health insurance plans:
- Civil Service Medical Benefits Scheme, which covers the medical costs of 5 million civil servants, wives, parents and the first three children. Budget (baht/head/year): Open-ended, average 12.600 baht.
- Social Security Fund for 10 million private sector employees registered with the Social Security Office. Employers/employees (67 pc) and government (33 pc) contribute to the fund. Budget (baht/head/year): 2.050 baht.
- Universal Healthcare Coverage Scheme (gold card) for 48 million people. Budget (baht/head/year) 2.755 baht. Accidents are not covered. [I don't mean childbirth either.] Operator: National Health Security Office.
Nurses
The ratio of nurses per capita in Thailand is 1:700; in the US and Japan it is 1:200. In Singapore 1:250 and in Malaysia 1:300.
Thailand is not only short of 30.000 nurses, but also has 12.000 nurses in government hospitals, who have a temporary contract and earn less than the permanent staff. Some hospitals have had to close wards because they are short of nurses.
According to the National Nurses Council, the ratio in Bangkok is 1:285; in the Central Plains 1:562; in the North 1:621; in the South 1:622 and in the Northeast 1:968. (Source: Bangkok Post, 21 November 2012)
See also: Statement of the week: Thai people take medicines like sweets
Interesting article and I think that many people from NL/B would like to insure themselves for medical costs in Thailand for the average costs which are less than 30 euros per year.
“…Copaying for medical procedures by patients insured through the universal healthcare coverage national insurance (UC) leads to an improvement in healthcare, experts say…”
Completely correct. But not as the experts think.
80 percent of this country is poor and the poorest of them cannot afford healthcare. Healthcare as it is today did not come about for nothing. She provided and meets a need, because otherwise the poorest people would no longer go to good care but to the 'wizards' in the remote villages who can also cure ailments, but then cure between " and " written... Yes, they are still there in the periphery of this country
If you introduce a general personal contribution, you will miss a group in the state hospitals and because of the contribution of the people who can afford it, you can do more, add more care to the package and yes, the care will improve. Well, that's how I can make it up.
Why is the current health care short of money? It's better to look at that. The 'swallow like candy' is one of the causes but more, and it has been written about for years in the press, a big hole has been created by the frontier workers, often illegal, who are helped (you don't let anyone die as a doctor) but who cannot pay. And a group of farang white noses who have caused a few million losses.
What they want to do now is to put the blinders on the backs of the poorest. I hope this ill-advised proposal will be scrapped.
Well responded Eric.
That's how I think about it myself.
Especially the group of Farang white noses.
I have also met them a few times in a regular state hospital near me.
Was in a bed in a room with 40 patients next to my Thai father-in-law.
While there are good private hospitals close by.
But yes, Cheap Charlies live here without money and any form of insurance whatsoever.
And when the hospital bill has to be paid, they won't have a single cent.
Know the Story.
That is why more Thai hospitals will ask for financial guarantees upon arrival at the hospital.
It may seem and be customer unfriendly, but it ultimately arose out of necessity and learning from trial and error.
Therefore , also think of the poorest .
And there are still some here in Thailand.
Jan Beute.
“Tawatchai estimates that 30 to 40 percent of hospital visitors have simple complaints that do not require treatment. He mentions dizziness, common flu and indigestion.”
Solution seems simple to me.
Nothing changes except for 1 thing:
As soon as the diagnosis of dizziness, common flu and indigestion is made, you will have to pay a personal contribution of 300 Baht instead of 30 Baht.
Then people think twice before they go to the hospital, and you immediately reduce the number of hospital visitors.
I don't think there is much abuse of care by the poorest people.
You don't spend a few hours waiting in the hospital waiting room for fun.
Incidentally, most people in the village first buy a handful of antibiotics in the minimart before going to the doctor.
The shortages will arise because money is not collected properly.
I always have to insist on being allowed to pay at the doctor's office in the village.
(the only time I get there…
For example, to bandage my hand after a village dog showed me a radiant smile).
Unfortunately I had to go to the city for the injections.
My girlfriend's family has to arrange a taxi to go to the hospital. She costs 600 baht there and back. They therefore wait too long rather than go too often.
How do you re-educate a country?
I have to think about that when I read about the costs of healthcare in this country. Even when I hear how in the Western world especially new fellow countrymen report to the care for a wet nose, and that also outside normal hours.
Thais and fellow citizens? Could it be their nationality or their background?
I come from a working-class family. People of the mashed pot and greasy gravy. The minced meat ball or the smoked sausage from the butcher on the corner.
Don't say 'ouch' and not at all as a young man and I was also the oldest at home and had to set an example. Saying ouch is for sissies. "It comes by itself and goes away by itself." At home, mother had a pot of pasta lassar (zinc ointment) and a pot of drawing ointment, as well as a meter of plaster, which was cut to size and properly smeared. And don't whine if we fell off a scooter or bicycle again. A slap on the buttocks if the clothes were also broken.
Do you gain experience with that? Did mom and dad from home, church-going families with 15 and more kids, have that hard experience? No one suffered and the doctor was only visited if there was really something. And we're still here, all the kids.
But in Thailand?
The level of education is different here, let me put it neatly. The general knowledge about health is not nearly what Western people know about it. They don't know anything!
I see it at my wife's house. A wet nose at our 11-year-old foster son leads to panic. That brings the paracetamol on the table; I brush it off the table immediately and put down a jar of Vicks and go buy Strepsils. (While I'm gone, the paracetamol comes on the table...)
If my wife thinks I won't be able to pass wind tomorrow, I have to go to the doctor today. Misunderstanding when I say 'Just watch it'.
That's the mentality, a right word, or should I say: that's the knowledge, here? Lack of ? Or is it laziness?
Do something about it, government!
Scrap that pointless parade in the schoolyard before school with the decibels at max! Delete or cut short in the lessons on the composition of a sure house. Supplement the curriculum with lessons on personal and nutritional hygiene and do the same on national TV for the adults.
Apply the laws to local markets where meat and fish are stewing in the blazing sun on sheets of cardboard that are placed under the table after the market and reused tomorrow. Long live the ABC bacteria!
The Thai, generally speaking, knows nothing about body, hygiene and health. In addition, the doctor comes straight from the Lord God and the pills have been sent to him. Respect OK, but worship is wrong.
The masses, spoken with respect, have been kept ignorant. Then you shouldn't come and complain that they go to the doctor and put a personal contribution on it. Address the problem at the source. Education.