Minister: 30-baht scheme unsustainable

Minister: 30-baht scheme unsustainable

The public health minister has hinted the universal healthcare scheme in its current form might not be sustainable and contributions apart from the state budget are necessary.

The programme, widely known as the 30-baht programme, has been applauded by international communities for its efficient use of the budgets to take care of all people, Piyasakol Sakolsatayadorn told Thai media on Thursday.

"However, its budget is getting out of hand, increasing steadily to 4.6% of gross domestic product. Some countries with similar systems can survive because there are some forms of contributions.

"It's high time Thailand reconsidered whether we would allow it to continue like this," he said.

Next year, the "People's State", needs to rethink the model as apparently it is not sustainable, he said.

"The government can't keep footing the bills and there must be some form of contributions," he said, citing a recommendation by a committee chaired by Suwit Viboonpolprasert and Ammar Siamwalla, a distinguished scholar at the Thailand Development Research Institute.

Mr Piyasakol said the committee would meet with the ministry and civic groups are welcomed to join the meeting on Dec 29.

Asked to comment on criticism that the government has spent more on the healthcare benefits for government officials than it has on the 30-baht programme, Dr Piyasakol said government officials' salaries are lower than in the private sector so the welfare is appropriate or the government will have to raise their salaries.

Thailand has three healthcare programmes for different groups of people. Apart from the 30-baht programme, there are a healthcare scheme for government officials and their families, also fully subsidised by the central budget, and the Social Security Fund for private-sector employees where the government contributed 2.5% and employees and employers 5% each.

A 2011 study found the government paid 14,000 baht per person to cover medical bills for some 5 million government officials and their families, or 62 billion baht a year in total.

The 30-baht programme for 48 million people costs 2,700 baht per person, or 101 billion baht in all.

The government contributed to the SSF 2,500 baht for each of its 9.9 million members, or 24.48 billion baht in all.

The 30-baht universal healthcare programme was implemented in 2002 by the Thaksin Shinawatra government. It was proposed by Dr Sa-nguan Nittayarampong, a rural doctor.

It has caused resistance among medical professional from the start because most of the public healthcare budget was shifted to the National Health Security Office, which acts as the "buyer" of the services on behalf of the people, instead of the Public Health Ministry and state hospitals.


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