When the 2011 Central Plains flood crisis ravaged industrial estates in Ayutthaya and destroyed the country's biggest dialysis solution production plant, more than 40,000 patients' lives were endangered.
Tanapol Dokkaew was among them. "We frantically searched for hospitals which could clean our kidneys," he said. "We also desperately needed dialysis solution. Without the services and the solution, we would have surely died."
Fortunately, the Government Pharmaceutical Organisation (GPO) imported the solution in time, sold it cheaply to the patients, and saved lives.
Meanwhile, dialysis centres at community hospitals funded by the National Health Security Office (NHSO) saved countless lives of kidney patients fleeing the devastating flood.
"During emergencies, the rich can still seek treatments from private hospitals, but poor patients cannot," Mr Tanapol said. "That's why we must keep the health systems that care for the poor.
"We are joining the rural doctors' protest against the Public Health Ministry's efforts to undermine the universal healthcare system in order to promote the private hospital industry at the cost of the public."
Mr Tanapol is vice-president of the Friends of Kidney Patients of Thailand group, which has more than 30,000 members nationwide. His organisation is joining hands with cancer, heart and HIV/Aids patients' networks to back the rural doctors in their bid to oust Public Health Minister Pradit Sintawanarong.
As they see it, the various policies initiated by the health minister are part of a larger scheme to benefit private hospitals and the pharmaceutical industry.
At a glance, these policies may look unrelated: Stopping hardship allowances for rural doctors, subjecting them to a rigorous assembly-line style of performance evaluation, putting Dr Pradit's own people on the GPO board, interfering with universal healthcare budgets at regional levels, trying to introduce a co-payment system in the universal healthcare scheme, attacking and discrediting the GPO, and firing GPO boss Witit Artavatkun.
"If you look at the blueprint of the private hospitals' policies, [Dr Pradit's] policies fall into place," Mr Tanapol said.
According to the Private Hospital Association's policy blueprint, the government should:
- Reduce the government's role in health care, from providing 70-80% of health services currently, to just 30-40% within 10 years.
- Support private health insurance.
- Promote private hospital businesses by giving them investment and tax deduction incentives.
- Support private hospitals to produce their own medical doctors through financial support from the government.
- Allow private hospitals to carry out clinical trials on humans with support from the pharmaceutical industry.
- Support the medical hub policy.
- Allow hospitals to advertise.
- Allow fast-track imports for brand-name medicines.
- Abolish price ceilings on medical treatments and allow private hospitals to charge what they like.
- Stop state hospitals from competing with private hospitals.
- Make state hospitals serve only the poor and private hospitals serve the middle classes and above.
These goals cannot be achieved if there are not enough doctors to work in private hospitals, nor if the NHSO and universal healthcare scheme continue to operate as they do now. Nor is it possible when the GPO is determined to manufacture generic drugs. When the GPO can produce a generic medicine which costs the patient only 1 baht a tablet, compared with the 70-baht price tag of an imported brand-name drug, it appears clear why Dr Witit had to go, and who was behind his sacking.
The government also faces pressure from the European Union and the United States to use a stricter copyright regime than the World Trade Organisation system in exchange for export privileges. That makes it clearer still why the GPO's compulsory licensing policy to save lives must stop and why Dr Witit was given the boot.
"When I suffered renal failure in 2005, I had to spend up to 40,000 baht a month for treatment," Mr Tanapol said.
"Back then, most patients died because they couldn't afford to clean their kidneys, or went bankrupt because of the expense.
"The NHSO listened to our needs. The costs for dialysis went down until it became free. The NHSO has done the same thing with many other treatments and the GPO has finally made drugs affordable," he added.
"These systems save lives. It's a matter of life and death for us if they're destroyed.
"We must fight to keep them free from political interference at all costs."
Sanitsuda Ekachai is Editorial Pages Editor, Bangkok Post.
About the author
- Writer: Sanitsuda Ekachai
Position: Assistant Editor