Thailand - Many people fear losing access to free healthcare

Wording of charter spurs concern right to free care may be limited

AS THE REFERENDUM on the charter draft draws nearer, people are concerned their right to free state healthcare services will be lost if the document is adopted.

Their concern centres on the draft's Section 47, which states that "the poor" will get free medical services but does not refer to other groups.

At first glance, the clause sounds good because it would benefit the poor. But as the charter draft comes under closer scrutiny ahead of the August 7 referendum, critics have pointed out that the next government could effectively receive a blank cheque to redesign the universal healthcare scheme if the charter passes.

Launched 14 years ago, the scheme offers most types of medical services to most people in Thailand for free. At present, the scheme covers 48.7 million people.

As a result, most people no longer have to worry about medical bankruptcies. They can walk into hospitals and ask for treatment, even in the case of medical emergencies, without having to worry about the cost.

People not covered by the social security scheme or the health scheme for civil servants and their family members are entitled to the universal healthcare scheme's services. Before the launch of the universal scheme, only poor people were entitled free medical treatment. But to access free treatment, they had to ask for help from medical service providers.

Many paying people complained that hospital staff demanded money in advance before providing care in medical emergencies.

That is why the charter drafters' decision to specify that "the poor" will receive free medical services without mentioning other groups has become a contentious issue.

Critics have warned that the charter would set Thailand's healthcare system backwards. They believe it would undo the efforts achieved by the 1997 and the 2007 constitutions, which supported the universal healthcare scheme for the benefit of most citizens.

Many critics also remain unappeased by the charter draft's promise of free preventive healthcare and disease prevention during outbreaks of dangerous diseases such as severe acute respiratory syndrome (Sars), or the commitment to the welfare of the elderly and pregnant women.

Sarcastic comments about the draft have been proliferating particularly on social media. Critics have insisted that people should have a right to free state medical services and not have to beg for it. Dr Mongkol Na Songkhla, a former public health minister and permanent secretary for Public Health, posted on Facebook: "We won't want to see Thai people coming to hospitals, sweating and using loans to pay for their treatment. We won't want to see people coming to hospitals so depressed as they hold low-income-earner cards and have to beg for medical services."

There has been a proposal to categorise some people as low income, entitling them to the free care. Other prominent figures have also questioned the draft.

However, Constitution Drafting Commission (CDC) chairman Meechai Ruchuphan has said the charter would not deprive the public of the right to free state medical services. "We didn't mention anything about cancelling the rights. We didn't touch on the universal healthcare scheme either. You can check our draft," he said.

He added that the decision to enshrine the rights of poor people in regards to receiving free medical care only aimed to ensure the care of them. "We add what the country has not yet had. We hope to promote equality and eradicate inequalities," he said.

CDC spokesman Udom Rathamarit also insisted the charter draft would not strip people of their right to free medical services.

Nimit Tien-udom, of the AIDS Access Foundation, said: "Through state mechanisms, the government has informed people that the current charter draft seeks to give complete healthcare to people from birth until death. But the problem is the government has provided just some of the facts."

Nimit said he and representatives from several healthcare groups in the non-governmental sector believed the charter draft would destroy equality in the healthcare system. "We have such a concern |and we have tried to communicate that with the public. So far, though, our voice hasn't been as loud as the government's," he said.

Chularat Saengpassa

nationmultimedia

You can find older posts regarding ASEAN politics and economics news at SBC blog, and older posts regarding health and healthcare at IIMS blog. I thank you.