While countries around the world heap praise on Thailand for its universal healthcare coverage, Prime Minister Prayut Chan-o-cha attacks it as a populist policy that will bankrupt state hospitals. This cannot be further from the truth.
Universal healthcare is not populism. It is a state welfare system. In a country with glaring and worsening disparity such as Thailand, it helps save ordinary people from financial bankrupcy and unnecessary deaths.
It is also an important economic investment, enabling the country to reap economic returns from its human resources investment.
The military said it had seized power to return happiness to the people. Gen Prayut's virulent attack on universal health care on Wednesday has fuelled widespread concerns. If universal health care is affected, the majority of people will certainly suffer.
Lack of money is often cited as the reason against universal health care. Now in its 14th year since it was launched by the Thaksin government, the system has proved this is not the case. The problem is not lack of money, but fierce power struggles between the Public Health Ministry and the National Health Security Office (NHSO).
In a nutshell, the ministry wants to take over the 141-billion-baht universal healthcare system now managed by the NHSO. Allowing that to happen, however, means going back to the old system that fosters inefficiency and corruption when healthcare service purchasers and providers are in one agency.
One of the main allegations against the NHSO is it has put many hospitals in the red. However, a committee led by prominent economist Ammar Siamwalla has looked into the matter and found the claim most possibly overblown since state hospitals' accounting systems are inconsistent and flawed without external auditing.
While it is true that several hospitals in border areas need more financial support, the ministry has been equipped with a 4 billion baht budget to intervene. The question here is not lack of money, but mismanagement.
Instead of attacking the universal healthcare system, the PM should look into the country's other healthcare systems and fix their glaring disparities.
At present, there are three separate systems with different benefits, service quality, and fees. The government now pays 60 billion baht for 4.4 million civil servants, or 14,000 baht per head, as their welfare benefits.
Since the government pays for all their actual costs, this expenditure is steadily rising.
Meanwhile, the 141-billion-baht universal healthcare coverage serves 48 million citizens, or about 2,900 baht per head.
The outrageous differences make the PM's complaints against a "heavy financial burden" from universal healthcare system unconvincing.
Furthermore, members of the social security system, which covers 10 million people, are unhappy because they are the only group forced to pay monthly fees. In return, they receive inferior services and the benefits end when they reach retirement, when they start to need more healthcare services.
Despite his frustrations rooted in anti-Thaksin sentiments, Gen Prayut admitted he could not dismantle the popular universal healthcare system.
His challenge is therefore to improve and standardise healthcare services across the three systems and put a lid on civil servants' unlimited healthcare expenses.
He must also ensure management of taxpayers' money for both the Public Health Ministry and NHSO are transparent with external oversight.
This is why he must not relent to the Public Health Ministry's push to take control of universal healthcare money.