A co-payment scheme combined with the universal coverage (UC) scheme will improve the healthcare service, experts say.
Co-payments became a hot topic of discussion after the idea was raised in a meeting between the Public Health Ministry and the National Council for Peace and Order (NCPO) on May 31.
Information from the meeting was leaked indicating that the public may be asked to pay for some of their treatment under the UC scheme.
The experts said the current free UC scheme encourages people to make many visits to state hospitals which puts a strain on hospital staff and doctors.
A co-payment scheme will encourage more people to take better care of themselves because they won't want to make unnecessary trips to the hospital if they have to pay some of the bill.
Tawatchai Kamoltham, director-general of the Department for Development of Thai Traditional Medicine and Alternative Medicine, admitted he raised the issue in the meeting.
Dr Tawatchai believes co-payment will see patients take better care of their health and will reduce the possibility that people who urgently need care might not be able to receive the treatment they need because their doctors are busy.
He estimated that of all the patients who visit hospitals, about 30-40% have minor ailments that do not need to be treated there, such as dizziness, common flu and indigestion.
As a former health inspector-general, Dr Tawatchai said he encountered financial problems, hospital management difficulties and overuse of health services because of the free UC scheme.
Under the UC scheme, run by the National Health Security Office (NHSO), hospitals are reimbursed about 300 baht for an outpatient visit.
But Dr Tawatchai claimed the true cost is about 600 baht.
About 6,000 baht is reimbursed for an inpatient admission, but the true cost is between 10,000-12,000 baht.
"This means the scheme isn't covering the full cost of each case," said Dr Tawatchai.
He added the hospitals have to seek a subsidy from other sources such as taking funds from other healthcare schemes, including the civil servants welfare and social security scheme, to help cover the costs.
The Provincial Health Offices tends to allocate more money to bigger hospitals compared to smaller ones.
This results in about 400 to 1,000 state hospitals struggling with debt.
