Chiang Mai: Smart ID cards are helping ease patient worries about their ability to meet the cost of treatment, especially if they cannot find ready cash to pay up front as they had to do in the past.
Now, state employees merely present their smart ID cards when they go for treatment and hospitals provide them with service without the need for the total payment to change hands.
The cards effectively act as a form of credit guaranteeing the hospital will be reimbursed from a central budget where treatment funds are kept. Previously, state sector employees had to pay first and take their chances applying for reimbursement later. The payment method change shifts the onus on the state to care for people first rather than asking patients to provide for themselves.
A recent interview by the Bangkok Post with state employees working for local administration organisations found they are using the chip-embedded identification cards to arrange payment for health care, with few worries now compared to the past.
The technology of the chips not only speeds up access to a patient database but also eases the payment process, said employee Hathairat Khattari.
The 54-year-old director of Umong municipality's social welfare division in Lamphun said she is happy to see the ID card eliminating her family's long-running concerns over medical bills incurred both by herself and her mother, who is being treated for a blood pressure disorder.
As an employee of a local administration organisation, Ms Hathairat, together with her parents, spouse and children, is granted the right to claim money for treatment.
In the past, many organisations only made partial payments and told their employees to pay the rest in advance.
That caused a headache for low-income staff and forced many to seek loans from non-bank lenders.
The problems continued until authorities introduced a new budget management system in 2013 and have facilitated medical payments with the use of smart ID cards since Aug 1. The cards solved the advanced payment issue as they serve as "cash" for patients while better budget allocation, overseen by National Health Security Office (NHSC), removes hindrances to money flow.
Before 2013, each local administrative body had to manage money for this medical welfare itself under a ceiling of 40% of its entire budget. This caused problems for small agencies such as Umong municipality because they have a limited budget and cannot earn much revenue.
The municipality once struggled to afford more than three million baht billed in one year for cancer treatment and was almost at its wits' end. "We had to take money from other development projects and delay their implementation," Umong mayor Khayan Wiphromchai said, adding illness is always considered an emergency case. However, this method was not a complete success. His municipality staff were still required to pay for the rest with some desperately resorting to money from loan sharks.
The government later solved this budget constraint by merging money allocated for medical welfare into a single budget and using it for 7,851 local administration organisations nationwide -- local agencies at the provincial and tambon levels as well as municipalities.
It turned out the government had to pay more under this new management, deputy NHSC secretary-general Karun Khunthiranon said. The budget request rose from 3.4 billion baht for 590,000 claimants in 2014 to 6.2 billion baht for 620,000 people last year.
This means the government tended to bear more financial burden. In fact, the money was even not enough last year when officials requested additional budget of 2.5 billion baht for emergency purposes. But from a medical point of view, "I'm satisfied with the figures," Dr Karun said. "The numbers tell more people have come under doctors' care."
In the past, some state employees avoided seeing doctors because they could not afford to pay their bills. One result was their illnesses became more complicated, were rarely treated and needed a more expensive cure, he said. With the smart ID cards, the staff's lives are happier. There is no longer a need to pay in advance. Simply show the cards and the payment process is done. "Now everything is easy and convenient," Ms Hathairat said.
Previously, state employees were allowed to use services at hospitals where they were registered. But with the smart cards, they are free to visit hospitals of their choice.