Thursday, November 3, 2016
Thailand - Civil service plan ‘risky for health schemes’
A solution is needed to reduce civil servants’ medical expenses: NLA whip
THE FINANCE Ministry’s plan to buy healthcare insurance for civil servants and their family members threatens to take a toll on beneficiaries of other health schemes across the country.
Designed to control the budget for civil servants’ and their family members’ medical benefits, the plan recommends that the government spend Bt60 billion on purchasing health insurance from private firms instead of shouldering the actual cost of treatment.
“But when insurance firms are in charge, they may not provide coverage for all types of treatment. Civil servants and their family members will be the first to suffer an impact,” Sureerat Treemankha, who works for the People’s Network for Welfare State, said.
The medical benefit scheme for civil servants and family members is one of Thailand’s key healthcare programmes.
Sureerat also said that beneficiaries of the universal healthcare scheme and social security would also suffer.
She pointed out that insurance firms mostly work with private hospitals, which will then try to attract more medical workers to their fold by offering better pay.
“State hospitals that are mainly in charge of the country’s two other major healthcare schemes will risk facing an even graver shortage of staff,” she pointed out. The Finance Ministry has been considering the plan to purchase health insurance now that the medical benefit scheme has been found to be eating more state budget each year.
The government had hoped to fix the budget at no more than Bt60 billion per year, but during the 2015 fiscal year, the scheme cost Bt66 billion.
“Apart from the imminent adverse impact on the country’s healthcare sector, the plan will also widen the inequality gap among beneficiaries of the three healthcare schemes,” Sureerat said.
According to her, the plan covers just 6 million beneficiaries but uses a state budget of around Bt60 billion. At present, the government has allocated Bt3,000 per head in the universal healthcare scheme, which covers about 48 million people.
“The government should combine the total Bt200 billion spent on the three major healthcare schemes and manage the resources equally,” Sureerat said. “By doing this, the government can ensure that the management power is in its hands, and not with the private sector.”
Last Friday, her network submitted a petition to Prime Minister Prayut Chan-o-cha asking him to put the brakes on the plan to buy health insurance for civil servants and their families and also scrap the plan to spend Bt800 million on buying accident coverage for 8 million registered low-income earners.
The petition pointed out that the National Health Security Office had successfully boosted health benefits for local administrative bodies’ officials at the rate of Bt7,000 per head a year, when the Interior Ministry called on it to help run the healthcare sector.
‘High management cost’
“If the government decides to purchase health insurance for civil servants and their families, then the rate should be no higher than Bt7,000 per head,” the petition read.
As for accident coverage, the petition pointed out that the money spent would not be worthwhile given that the clear beneficiaries would be insurance firms.
“Consider the mandatory auto insurance, the rate of compensation claims is less than 50 per cent,” the petition said.
It also pointed out that while the fund from the mandatory auto insurance handed out Bt4.53 billion in compensation, its management cost was as high as Bt4.78 billion.
Worawan Chandoevwit, a lecturer at Faculty of Economics in Khon Kaen University and adviser to Thailand Development Research Institute, said she did not believe that the plan to purchase health insurance for civil servants and their families would aggravate inequality.
“Inequality exists even now. Civil servants and their families enjoy better medical benefits anyway [in comparison to the other two schemes],” she said.
She went on to say that if the private sector was in charge, it would control the cost that the government has long been unable to do.
So far, Worawan said she was not sure how the health insurance would impact on state hospitals, which have often said that they need to use income from other sources to support the universal healthcare scheme.
This researcher, however, believes the government will not be able to purchase private health insurance for civil servants and their families due to stiff opposition from the civil servants themselves.
“I heard about this idea a long time ago”
“Every time the medical benefits scheme for civil servants and their families uses up too much budget, this idea comes up for discussion. This is not the first time,” Worawan said.
Jetn Sirathranont, chairman of the National Legislative Assembly's Committee for Public Health, said the Comptroller General’s Department allowing an insurance company to manage money for civil servants' healthcare was just one proposal.
He said it was time for a serious and thorough study to find any solution that could best control Civil Servant Medical Benefit Scheme expenses which kept increasing every year. However, he urged that any solution should also minimise the impact on civil servants' rights.