Clear up cuts to 30-baht scheme
Confusion appears to reign supreme over the budget for the universal healthcare or 30-baht card scheme. Activists have complained that the Prayut Chan-o-cha government, which is about to go on a heavy spending spree on populist policies, is excluding sick people who depend on the universal healthcare scheme (UHC) to meet their needs.
According to local media reports, health activists have complained that the UHC fund has shrunk as the Budget Bureau quietly cut 680 million baht from its funding. The scheme benefits some 48 million people or 70% of the population across the country.
These are the people not covered by civil servant welfare fund or the Social Security Fund (SSF). Shortly after activists made the complaints, the government argued the UHC budget was in fact on the increase.
Narumon Pinyosinwat, a government spokeswoman, branded the activists' remarks as "fake news", saying the Prayut government has allocated some 191 billion baht to the universal health coverage fund for the 2020 fiscal year, which is a 6.5 billion baht increase from this year's UHC budget.
However, health activist Nimit Tian-udom insisted the budget under certain areas especially for chronic diseases has dwindled.
The decrease, he said, would deal a heavy blow to those suffering from kidney diseases as well as bed-ridden patients and other vulnerable groups.
Initially, he said, the budget for chronic diseases was set at 9.4 billion baht before the Budget Bureau chopped off 300 million baht, while the fund for bed-ridden patients went down to 975 million baht, from 1.1 billion baht.
The activist said he had a detailed note from the Budget Bureau that shows the hole in the fund.
The cut is a nasty surprise for activists and members of the National Health Security Office (NHSO). They are seeking a meeting with Public Health Minister Anutin Charnvirakul on the matter in the next two weeks before the Budget Act enters parliament next month.
During a press conference on Aug 15, Yupadee Sirisinsuk, an NHSO member, said some elements had tried to cut the UHC budget, but former public health minister Piyasakol Sakolsatayadorn staunchly defended it, so the fund had escaped the Budget Bureau's knife. But not for long.
This upsets the activists since Mr Anutin, Dr Piyasakol's successor has also promised the fund would remain safe.
The minister also ruled out a move to co-payments, or user-pays charges, in which UHC beneficiaries would have to bear partial responsibility for their medical bills.
The activists, in particular, have lambasted government plans to use a huge budget totalling 10 billion baht to promote local tourism.
The plan covers a 1,000-baht giveaway for 10 million Thai tourists who visit destinations outside their home provinces and a 15% cash rebate of up to 30,000 baht on their tourism spending. It is part of a 316-billion-baht stimulus package which includes cash handouts for welfare cardholders, approved by the cabinet on Tuesday.
The activists made a good point in warning about using taxpayers' money to boost tourism, even if the intention is stimulating the sluggish economy.
In his previous tenure, Gen Prayut implemented a tourism measure by offering tax cuts for local holidaymakers. This measure seemed not to bear fruit, as no spectacular results were achieved in boosting revenues.
Public Health Minister Anutin must also clarify the UHC budget cut. It should be noted that Gen Prayut, during his previous tenure, made it clear he regarded the UHC scheme, which has provided health care for Thais since 2002, as a burden on the state coffers and showed an intention to put in place a co-payments system, so the government would have more money for other activities.
While he wanted to restructure the scheme in the name of saving money, he had no intention to cut back military spending.
Such anti-UHC statements -- without regard for the fact the scheme has earned Thailand a prominent place in the global community for the quality of its publicly-funded health care -- prompted harsh public criticism that forced the prime minister to swallow his dislike of the scheme.
It did, after all, give him, through the Palang Pracharath Party, a chance to claim credit for its success during the election campaign.
It's true the UHC fund requires an enormous budget, but it's one of a few schemes that truly benefits a large number of people.
The scheme, if implemented in full, with a focus on health promotion rather than cure as well as decentralisation of health providers and improvements to efficiency, could be a phenomenal success that helps ushers the country a step closer towards being a welfare state which takes proper, comprehensive care of its citizens.
Bangkok Post editorial column
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