While Thais may be familiar with overcrowded state hospitals, that familiarity should not be grounds for dismissing political parties’ policies on public health in campaigning for the May 14 election.
Shaped by the parties who win seats in government, public health schemes are a matter of life and death in so many cases.
In mid-2022, 55-year-old Rabiab was rushed to a major state hospital in her home province of Khon Kaen with life-threatening diarrhea. There, she waited patiently in the long queue. After several hours, she finally saw a doctor and was told she needed a better-equipped hospital. But by the time she was transferred, it was too late. Rabiab died of her condition the following day.
“Had I known her condition was so serious, I would have not let her wait,” said her grieving husband.
Tai, who spoke on condition that he and his wife’s surname was withheld, complained that if the hospital staff had been more attentive, he would not have lost his wife. She succumbed to acidosis and kidney failure.
Sumon (surname also withheld) said she had repeatedly checked into the hospital in her district over several years because of a severe stomachache. Every time, she was diagnosed with gastritis. But in 2021, her condition worsened to the point that she could not accept the same old diagnosis anymore.
“I tried to queue up at a provincial state hospital but the queue was so long,” she recounted. “Fortunately, my family advised against waiting. I was taken to a private hospital in Phitsanulok province where I was diagnosed with a swollen liver.”
After spending two days in the intensive care unit, Sumon was released with medications to treat her condition. Had she not switched her course of treatment, she felt she might have suffered the same fate as Rabiab.
“I don’t say the universal healthcare scheme is not good. But really, I almost died because the hospital did not give me a thorough check-up,” the 52-year-old commented.
Thailand’s healthcare schemes
The majority of Thais are entitled to free treatment under Thailand’s universal healthcare scheme. Managed by the National Health Security Office (NHSO), it covers about 47 million people in a population of around 66 million. Under this scheme, patients must seek treatment at their assigned state hospital or clinic. Treatment at other medical facilities is only free in life-saving emergencies or when the patient is referred by their designated hospital. Beneficiaries do not have to pay to join this scheme. On average, it shells out about 3,000 baht worth of medical treatment per person every year.
The second of Thailand’s major health-related programs is the social-security scheme, which covers 12-13 million people. Members of this scheme need to pay monthly contributions to claim benefits, which include medical cover. If they fall ill, they can seek free treatment at their designated hospital – which can be a private hospital. The Social Security Scheme spends an average 3,000 baht to 4,000 baht per head each year.
The other major scheme is for civil servants and their family members. Covering more than five million people, it averages 12,000 to 15,000 baht per member each year.
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Gaps and more
Somchai Krajangsang, a member of the Thailand Consumers Council’s health service subcommittee, said the difference in per-head spending in each scheme indicates the country does not take care of its citizens equally.
“Comparing all three, the social security scheme offers the least to its members,” he said. “The social security scheme sets monthly price ceilings on treatment for members. That’s a problem because the cost of treatment can rise above the limit in some months.”
Moreover, the social security scheme has very little budget for health promotion. And it offers nothing to protect members whose right to treatment is denied.
“That’s unfair given that they also make monthly contributions to the scheme on top of taxes,” Somchai said.
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What are political parties promising?
The Pheu Thai Party, whose predecessor Thai Rak Thai introduced universal healthcare in Thailand with the 30 baht-per-medical-visit scheme 22 years ago, has promised to ensure people can be treated at any hospital or clinic by just showing their national ID card.
“We will make sure that the database is linked so people can seek medical treatment conveniently. We should share the resources of both private and public hospitals, clinics, pharmacies, and labs. When we do that, queues will automatically get shorter,” Pheu Thai leader Cholnan Srikaew said.
The Thai Sang Thai Party, meanwhile, is promoting a “30 baht-Plus” scheme in pursuit of what it calls a well-being society. The 30 baht-Plus concept would integrate advanced technology into public health, with artificial intelligence leveraged to serve as a “personal mobile doctor”. Patients who need to consult a medic could talk to the Mobile Doctor via the ChatGPT chatbot.
The Move Forward Party is seeking to reduce medics’ workload and the number of patients by promoting good health and disease prevention. It also plans to offer rewards to people who take good care of their health and stay healthy.
The Democrat Party has simply highlighted its idea to offer free health checks and free treatments, while the Bhumjaithai Party, whose leader is the public health minister, has vowed to expand the provision of free radiation therapy from the current 22 provinces to every province within the next four years. It also pledged to set up dialysis centers in every district to deliver free services.
Failing to meet expectations
Nimit Tienudom, director of the AIDS Access Foundation and the civil society representative on the NHSO board, complained that he has not seen any revolutionary ideas from political parties campaigning for the election.
“This shows that parties have not done their homework,” he said. “Instead, I expected them to talk about equality and the need to merge all three major healthcare schemes to ensure Thais have equal access to medical services.
At the very least, he said, members of the social security scheme should be allowed to claim healthcare benefits from the universal healthcare scheme instead.
“The portion of their social security monthly contributions that are used to fund medical benefits could then be reallocated to retirement benefits instead,” he suggested.
By Thai PBS World
