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Fri, April 7, 2006 : Last updated 22:30 pm (Thai local time)



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Home > Opinion > Start the cure with Bt30 health plan





EDITORIAL
Start the cure with Bt30 health plan

New Thai Rak Thai-led govt would show a change for the better by being honest about costs of the scheme

 As caretaker Prime Minister Thaksin Shinawatra prepares to leave the political centre-stage temporarily to pave the way for constitutional reform designed to do away with the dirty politics that his Thai Rak Thai Party has left behind, it must be pointed out that there is a need to clean up the mess in other areas as well.

Chief among them is the gross mishandling of the hugely popular universal healthcare programme, which has been starved of funds from the moment it was introduced in October 2001.

No one can accuse Thaksin and his Thai Rak Thai Party of lacking bold ideas or the willingness to exploit them to gain a political advantage over their more conventional-thinking rivals. The Bt30-per-hospital-visit scheme is arguably the single most important populist policy to explain Thaksin's enduring and genuine popularity among the poor rural masses.

Before the universal healthcare scheme was introduced, the typical poverty-stricken household would likely face financial ruin if any member of the family was afflicted with a serious disease or an accident that required costly medical treatment. This virtually free healthcare programme changed all that.

The healthcare scheme, one of the world's most generous as it covers such complicated and costly treatments as brain surgery and Aids, could have been the best thing that Thaksin and his Thai Rak Thai Party ever did for the country since they came to power five years ago, if only they had done it in a responsible and honest manner.

The problem is that responsibility and honesty have never been Thaksin or the Thai Rak Thai Party's strong suit, as the irrepressible urge to cynically manipulate the masses to score quick political points always got in the way.

The Thaksin government has consistently failed to provide adequate funding for universal healthcare, which explains why many government hospitals are teetering on the brink of bankruptcy. Government hospitals, which are exclusive healthcare providers of the universal medical service, often had difficulty getting reimbursed for costly medical treatments provided and medication dispensed.

A large number of public healthcare providers now cannot afford to pay their utility bills and some are being threatened with water and power cuts. The quality of healthcare is being compromised, and the morale of doctors and nurses at state hospitals is at an all-time low.

Thaksin has been withholding the truth about the real costs of universal healthcare and how those costs escalate over time. If he had been honest from the beginning, he would have told the public that this programme would not be sustainable in its current form.

Any conscientious politician would let the public in on the rising costs, which constitute a long-term financial liability, and would try to look for more viable financing options. Not Thaksin and his Thai Rak Thai Party; they continue even now to lull the public into a false sense of security by withholding the grim realities of this costly entitlement.

The government has just fired a group of researchers led by a respected economist, which it assigned to explore ways to improve the administration and financing of the universal healthcare scheme, for telling the public the truth about its lack of financial discipline in running the programme. In 2003, the government earmarked only Bt1,202 for each person covered by the scheme, instead of Bt1,414 as needed; only Bt1,308 in 2004 instead of the proposed Bt1,447; and Bt1,510 in 2005 instead of the real cost of Bt1,700. The funding shortfall will likely continue this year.

To say that universal healthcare coverage is financially draining would be a gross understatement. Some of the more cautious economists and health experts have warned that unless it is properly managed, which would either require a judicious cut in the benefits on offer, or a sizeable increase in co-payments from the current Bt30, the system could face financial ruin over the long term.

Once a prime minister is elected to lead the Thai Rak Thai Party-led government in place of Thaksin, the new leader's handling of the universal healthcare scheme will be as good a test as any for the public to decide whether the Thai Rak Thai Party is prepared to abandon its old manipulative ways and start acting responsibly as it should.







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