The Yingluck Shinawatra government's healthcare policy has been given a narrow pass grade, one year after her government took office.
However, health activists and experts say the government loses points for reintroducing the 30-baht mandatory payment for medical treatment.
The fee, which was first introduced by the Thaksin Shinawatra government in 2001 and abolished by the Surayud Chulanont administration following the 2006 coup that ousted Thaksin, will be brought back on Sept 1. "In my view, the government should have scored seven points [for its healthcare performance], but when they brought back the 30-baht collection under the Universal Healthcare Scheme (UHS), which currently is free of charge, their score went down to five points," Nimit Thien-udom, secretary-general of a social security members' rights protection club, said in his review of the government's first-year performance on health.
"They cannot explain why they have to collect this money again," he said.
"People in the healthcare field see this policy as a backwards step."
However, he still senses a determined effort by Prime Minister Yingluck and Public Health Minister Witthaya Buranasiri to push for an integrated standard between the country's three main health-care schemes _ the Civil Servant's Welfare Fund, the Social Security Fund and the UHS.
Vichai Chokewiwat, a member of National Health Security Office Board (NHSO), said the government has shown the intention to make the country's health-care system equal by initiating a policy to merge the three schemes and allow emergency patients to receive emergency treatment at any hospital regardless of which scheme they pay in to.
But Dr Vichai said he is disappointed by the government's decision to reinstate the 30-baht payments under the UHS.
The 30-baht collection will not lead to any substantial change in public benefits, he said.
Dr Vichai claimed it is merely a ''rebranding'' effort to make people aware that the UHS was initiated by the Thai Rak Thai-led government of Thaksin. It was then referred to as the 30-baht universal healthcare scheme.
Dr Vichai said he gave the government a score of 59 out of 100 for its first-year healthcare performance.
''Where the government failed was in its attempt to increase its power in the UHS by sending more representatives to sit on the scheme's board even though several of them came from the private sector,'' Dr Vichai said.
He said the key principles of the government's healthcare policy have been equality of access, improved service and more efficient treatment, but there has not yet been any clear sign that those targets have been met.
On the other hand, the government has allowed private hospitals to bargain for greater reimbursement for emergency treatments on a per-case basis. It has set a maximum rate of 10,500 baht a case, he said.
''If private hospitals are permitted reimbursement based on the actual costs they claim, the healthcare schemes would collapse,'' Dr Vichai said.
According to the NHSO, from April 1, when the new emergency system began, until July 31, the agency paid 57.4 million baht reimbursements to private hospitals which submitted claims for 2,982 emergency cases.
The Yingluck administration recently adjusted a regulation to allow people to change their subscribed hospitals up to four times a year.
Cherdchoo Ariyasriwattana, chief of Federation of Medical and Public Health Practitioners of Thailand, said this would allow patients to change to hospitals which better suit their needs.
However, if patients start changing hospitals several times a year, he doubted that the NHSO would be able to reimburse every hospital in a timely manner as the administrative process would then become too complicated.
Dr Cherdchoo also expressed concern about the government's attempt to cut its budget for the UHS.
The new budget allocation under the UHS was slashed from 2,895.60 baht a person this year to 2,755.60 baht next year, Dr Cherdchoo said.