Merging the government’s three healthcare programmes into one will tackle inequalities in the system but poses an uphill task, the Public Health Minister has said.
Speaking at seminar on public health and insurance reform on Saturday, Rajata Rajatanavin said efforts to combine the three systems are being hindered by the fact they were established for different purposes and have different budgets.
The three systems are the Civil Service Welfare scheme for civil servants and their families, the Social Security scheme for private employees, and the Universal Coverage scheme for all other citizens.
Dr Rajata cited the example of the civil service scheme, arguing that state employees usually earn less than private sector workers, so should continue to enjoy a better package of healthcare benefits to compensate.
The cabinet has recently approved additional funding of 10 billion baht to all three systems, bringing the total healthcare budget to 163 billion baht this fiscal year, Dr Rajata said.
However the additional money came on the condition the budget must be managed as if the three schemes were a single system.
This is because the cabinet believes an integrated approach to budget management is the key to eliminating inequalities between the schemes, the minister said.
Winai Sawasdivorn, secretary-general of the National Health Security Office (NHSO), which operates the Universal Coverage scheme, said government must merge the schemes into one if it intends to provide equal care for all.
Similar mergers have already happened in South Korea and Taiwan, but Dr Winai said Thailand faces a bigger challenge, because the three existing systems are so different.
He added there is still a severe lack of understanding about the three healthcare systems among members of the public.
Dr Winai said the three systems have starkly different approaches to the treatment of diseases such as HIV/Aids, chronic kidney failure and cancer.
Dr Rajata said a royal decree to establish a new office to manage data for all three schemes is being drafted. The cabinet will be asked to approve the proposal. The new office will support efforts to integrate the management of all three systems, he said, since policymakers will be able to get a clearer picture of how the different schemes can be streamlined together.
The Universal Coverage scheme has faced controversy over the past few months, with the NHSO accused of sending state hospitals into a financial tailspin through poor management of the programme.
Among other allegations, the NHSO is accused of spending its budget on private instead of state hospitals. The office has denied the claims.