Solutions offered for inequality in state healthcare schemes Jun 11, 2015

Solutions offered for inequality in state healthcare schemes

A meeting led by the Thailand Development Research Institute Foundation (TDRI) was told that the government should establish a National Council on Health Insurance (NCHI) and pass a new law on national healthcare management to tackle the chronic problem of inequality in the national healthcare system. 

This proposal aims to resolve inequality between the Universal Coverage Scheme (UC), Social Security Scheme (SS) and Civil Servant Medical Benefit Scheme (CSMBS).

This proposal was offered by a sub-committee that had been set up by the government to study the problem. 

The meeting was attended by related agencies and subscribers' representatives yesterday. 

Dr Suwit Wibulpolprasert, who leads the subcommittee, said a central agency that can coordinate between the three national healthcare schemes was necessary as it could negotiate between social security agencies, healthcare providers and beneficiaries.

"The NCHI would be under the Prime Minister's Office with the main objective of managing the operation among three social security schemes and cutting down on inequality among subscribers," Suwit said. 

NCHI would be comprised of 18 representatives of the stakeholders to ensure participation from all parties. 

"The new law on national healthcare management will also regulate the agency's work," he added. 

Worawan Chandoevwit, a TDRI specialist on social security, blamed the inequality among these three schemes on different management and operation procedures as they come under the jurisdiction of different agencies. 

"Statistics of the per-head cost of medical care for beneficiaries under different schemes from 2008 to 2013 revealed that the per-head cost under CSMBS was six times higher than the other two schemes," Worawan said. "The beneficiaries of CSMBS received up to Bt12,589 per head in 2013, compared to Bt 2,509 per head of SS beneficiaries and Bt2,245 per head for UC beneficiaries, which means those under CSMBS have access to better medical care."

Representatives of social security agencies, healthcare providers and beneficiaries reacted to the proposal by voicing concern about their representation at the NCHI. Many believe the council would have too few representatives and that they could not represent their respective group properly. 

Many also asked for clarification about the new law, pointing out that punishment for violators still had to be debated. They also asked about the budget for the new agency. 

All comments from yesterday's meeting will be presented to the panel charged with coordinating between the three schemes on Wednesday before passing it on to the Cabinet for consideration, Suwit said.