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.
Chularat Saengpassa
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