Today, Thailand celebrates UN-designated Universal Health Coverage (UHC) Day with a success story to share with other countries, near and far.
Thailand took the lead with its universal health coverage (UHC) in past decades.
Thailand's UHC was put in place in 2002 -- after being piloted for one year-- by the Thaksin Shinawatra government. It was then known as the 30-baht healthcare scheme and launched amid caution.
Some even mislabelled it as a populist scheme and there were fears it would bankrupt the government. It took some time before UHC was recognised as a welfare system that benefits 48 million people.
In recent years, universal health coverage has gained momentum across the globe as the United Nations began promoting the concept as one of its health targets under Sustainable Development Goals to be achieved by 2030.
This year, Thailand was ranked as having the world's sixth best healthcare system by Ceoworld in accordance with a healthcare index.
With international recognition, Thailand's UHC serves as an example to other countries, among them Vietnam and Kenya, of how to provide low-cost and easy-to-access treatment.
The UHC scheme is financially managed through "capitation" -- a healthcare payment method in which hospital operators are paid a fixed amount, based on the number of people living in hospital districts. The state budget for the UHC has increased year on year. The government spent around 56 billion baht, equivalent to 1,202 baht per head, to fund the UHC in the 2003. This year, the scheme's budget tripled, climbing to 166 billion baht or equivalent to 3,427 baht per head. Yet the UHC fund still accounts for less than 1% of GDP. Health economists believe the budget is still reasonable.
The Ministry of Public Health has introduced policies to improve the healthcare system. Since Oct 1, the latest project allows patients to pick up medicine at their local drugstore instead of the hospital pharmacy.
This initiative involves 50 hospitals and 500 pharmacies. In Bangkok, Lerdsin, Rajavithi and Nopparat Rajathanee hospitals are pioneers, while in the provinces, participating hospitals can be found in Ratchaburi, Rayong, Nakhon Sawan, Uttaradit, Chiang Rai, Trang and Phuket, to name a few.
There are shortcomings that need to be addressed especially relating to the core concept of free medical care that may be a pull factor for some people to seek treatment for mild illnesses. Such practices lead to overcrowding and burden medical personnel.
To get out of that quagmire, health agencies must do their best to make the system complete under UHC principles. Instead of focusing on medical treatment for patients, health authorities should attach importance to health promotion based on the idea that prevention is better than cure. They must work harder to push for a family-doctor system -- a shift from hospital-based to community-based care. With such a change, the workload at major hospitals is likely to fall, and doctors will have more time for research of difficult diseases.
To achieve that, health authorities must boost public confidence in community health institutions, such as community or tambon health stations. With such a system, patients will be screened by general practitioners and only necessary cases will be referred to large hospitals, while health promotion work can help people practise a healthy lifestyle. This will help weed out unnecessary hospital visits, leaving the whole system in better health.