Patients 'should help pay some of the cost'

Change to health scheme urged

Patients 'should help pay some of the cost'

APIRADEE TREERUTKUARKUL

Public Health Minister Mongkol na Songkhla is proposing a scheme which would require patients under the 30-baht health care system to pay some of the cost of medical services beyond primary treatment. Dr Mongkol will seek approval from the National Health Security Office (NHSO) board, which he chairs, at a two-day meeting starting on Thursday in Phetchabun province.

The minister said he hopes to see the new policy implemented before the expiration of the military-appointed government's term.

''Co-payment is a sensible and reasonable solution to the problems troubling the state health care system,'' Dr Mongkol said.

''People should take some responsibility for their own health. People are using medication wastefully now because they think they are getting it for free.''

NHSO secretary-general Sa-nguan Nityarampong said the proposal would be closely examined.

Sharing the cost burden was not an immediate issue because the interim government had already allocated sufficient funds to run the health programme. However, a co-payment scheme would bring immediate benefits to large hospitals and medical schools providing secondary and tertiary care.

The universal health care system covers about 48 million people _ children, the poor, the elderly and the unemployed. Each are entitled to 2,100 baht in medical treatment per year.

Many civil servants, with approval from their doctors on a case-by-case basis, are also benefiting from the policy. Left out are office workers and labourers covered by the other health care programme, run by the Social Security Office.

Dr Sa-nguan said many points in the proposal still had to be ironed out.

How patients should pay had yet to be discussed in detail, as well as the issues of special rooms and nursing care charges, he said.

Ammar Siamwalla, a health economist at the Thailand Development and Research Institute, disagreed with the payment sharing proposal, saying the government needed to first come up with a proper system to run the universal health care scheme. Lack of funds was no longer a problem for the universal scheme, but the shortage of medical staff was crippling the system, he said. The government should focus on fixing this nagging problem, instead of asking patients to share the treatment costs.

Mr Ammar said collecting a medical tax from foreign patients seeking treatment at private hospitals was a possible option the government could use to prop up the universal health care scheme.