Invalid healthcare

General News - Wednesday December 19, 2007

COMMENTARY

Invalid healthcare

BOONSONG KOSITCHOTETHANA

I was seriously ill the other week. Not because of some virus, but because I realised that I, and probably millions of others like me, have been fed a terrible diet of junk information about our healthcare system.

For so many years I had been comfortable in the knowledge that Thailand's health system, for all its shortcomings, was still one of the world's better ones. Then I read a series of full-page information ads citing data from the United Nations World Health Organisation showing that, in fact, our country is ranked behind countries like Cambodia, Mongolia, Vietnam, and Sri Lanka in the percentage of its GDP being spent on healthcare. And that we had fewer doctors as a proportion of our population than Laos, Vietnam and the Philippines! What a shocking eye-opener it was!

The strangest thing is that our standing is not just behind advanced, developed nations, but behind even the least developed nations! I went into the WHO's website to find out more. I saw that, in fact, while the most developed nations such as the US, France and Germany were spending around 10-15% of their huge GDPs on health, even Bangladesh and Afganistan, as well as countries in Africa, like Liberia, Mozambique, Rwanda, Sudan and Senegal, were allocating a higher proportion of their GDP to health than Thailand's meagre 3.3%. It's even worse than what the advertorial indicated!

Countries like Pakistan, Malaysia and Iraq did not just have more doctors as a proportion of their population than Thailand; they had almost twice as many!

Algeria, Ecuador, and Mexico had more than three times as many! We were there on the list shamefully sitting on a par with Burma, Botswana, Tonga and Yemen at fewer than four doctors per 10,000 people. And our political leaders still keep nurturing pipe-dreams of Thailand becoming a medical hub. What medication have they been taking?

It's time for us, as individuals, to actively care about our health because it's clear that our politicians do not. We have been fooled by them for years and people need to speak up and demand better healthcare.

The universal healthcare scheme has done a lot to extend the reach of healthcare. You only need to look at the political popularity of the people who introduced the scheme to know that it provided something important to the public. What we need to do next, though, is improve the quality of the services and medicines provided. We need to improve our country's infrastructure so that the neediest in the remotest parts of our country can find a doctor, and that those doctors are supported by a high quality healthcare infrastructure to provide quality treatment.

I am tired of taking bad prescriptions from wayward politicians. So, today, for a change, I want to be the one writing a prescription for them:

During your tenure in office, you have to move Thailand up the rankings to be among the top 25 countries in the world in terms of the proportion of GDP being spent on healthcare.

It does not take a lot to figure out where there might be some unnecessary spending going on elsewhere in the national budget which could be allocated to healthcare! You have to move Thailand up the ranking of doctor-to-patient ratios to be among the top 25 countries in the world. It is not acceptable to be ranked alongside the poorest of African countries, especially when our country's economy is already the 33rd largest in the world. [World Bank, July 1, 2007]The private sector needs to be told to do more. Once in a while, I read about the charitable deeds of pharmaceutical companies but, frankly, I don't think these really fool anybody. Let's see you big corporations do real corporate social responsibility programmes on a par with the banks and other major industries in Thailand.

The biggest among you need to be helping the poor with hundreds of millions of baht in assistance, not just hundreds of thousands!

Remove the taxation on medicines. Why are drugs taxed when we know how inefficiently politicians are using our tax money? I don't want to pay import duty on medicines, nor do I understand why I should pay VAT on life-saving or other treatments. I also want my doctor to be able to prescribe whatever he thinks is best for me.

I would urge any new administration to think about the health of the nation. It is probably one of the most important and sustainable ways to make a fundamental change to our economic indices.

Boonsong Kositchotethana is Deputy Assignment Editor (Business), Bangkok Post.

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