When I heard Public Health Minister Anutin Charnvirakul say he would make it possible for members of the Universal Health Care (UC) scheme, better known as the "30 baht scheme", to get treatment anywhere, I was optimistic.
I felt it could be the best news to come out of the ministry in a long time. I was wrong.
I've always appreciated how the government has maintained the UC scheme for Thais, even though our leaders don't understand the principle.
Prime Minister Prayut Chan-o-cha, for example, gives the impression that UC is a charity! He always complains about how the scheme is a burden on the budget.
I believe health personnel deserve credit for a scheme which has gained recognition all over the world ... but there's still room for improvement.
To begin with, I'm afraid that Mr Anutin has no idea about how inaccessible the current scheme is, especially for newcomers.
I'm saying this from first-hand experience. For more than 20 years I used to be a member of the Social Security Fund (SSF), paying monthly contributions, which in turn gave me the right to medical treatment in hospitals that were part of the scheme.
I recently resigned from the SSF, and would like to switch to the UC. Here's the problem. The hospitals in my neighbourhood turned me down, all saying there was no room for me.
Instead, I was told to go to far-off hospitals -- one is 15km from my house and the other 28km. That is not practical. It actually defies logic.
My concern is for people who retire from the SSF. Do they know what they will have to encounter in their retirement? Whatever they want in their old age, it is definitely not what they are going to get. I know some workers who quit their jobs but maintained their SSF membership. They could be spared problems -- but how many will do that?
I also fear for those who are newcomers by age. If they register for treatment today, they may get the same answer I did. Go to some distant hospital because there is no room for you here.
But in principle, Thai workers, especially those employed at private firms, should be able to choose which scheme they want to belong to, be it the SSF or UC, since they are also taxpayers in one way or another. Moreover, it's well known that the SSF offers the least medical benefits.
But the NHSO, which allows for direct registration, makes the system so inefficient and unfair for those registering later in life and doctors in major hospitals are exhausted.
I know policy-makers will not agree with this. They will surely insist that state hospitals are already overcrowded but they should find ways to accommodate workers who leave their jobs and are forced to switch to UC.
It's time they thought about solutions for those registering for the UC scheme today, so that they can get the treatment they need nearby. Some may say that's impossible. Let me explain.
Policy-makers should complete UC by introducing a family doctor referral system. This is a system that is in use in most advanced countries in Europe.
For example, in Belgium, each patient visits a family doctor who later verifies if the patient needs a reference letter to see a specialist or not. If needed, the patient may choose whichever hospital is most convenient to them. All hospitals are private and a patient will have to contribute a certain amount of the bill, depending on their income (the higher the income, the higher the contribution).
A similar system is also adopted in many European countries, where a referral by a family doctor is needed to prevent hospitals becoming overcrowded. Everyone, regardless of their age, gets similar treatment.
The government should try to find a way to improve the system and make it fair for those coming later by making every member get referred by a general practice GP. Otherwise, hospitals will always be overcrowded, overloading medical staff. That is not likely to be good for anyone's happiness or health.