October 12, 2010

THAILAND: Funds transfer seen as threat to elderly

BANGKOK, Thailand / The Bangkok Post / Health / Healthcare / October 12/ 2010
Revamping the social security fund to include members' families by using money from the universal healthcare scheme is being handled wrongly by the government, a senior official says.

Deducting the entire family allocation under the universal scheme and giving it to the fund would have a severe impact on major areas of the scheme, especially care for the elderly, National Health Security Office secretary-general Winai Sawasdiworn said yesterday.

Dr Winai said only a portion of the whole family allocation under the universal scheme should be transferred to the fund.

The NHSO expects to present its views next month to the government on its plan to expand health care under the social security fund to include members' families.

The fund covers 9.2 million employees of private companies, but not their families, who come under the universal scheme.

"We feel it would be unfair to the majority of the population listed under the universal healthcare scheme if the budget per head is diverted to the Social Security Office (SSO) without a proper calculation," Dr Winai said.

If the government goes ahead with its plan, 5 million family allocations would be moved over to the social security fund. That would take 12.73 billion baht from the universal health scheme's budget.

The Council of State is amending the social security law to extend healthcare benefits to the family members of private employees.

Dr Winai said the universal scheme had an allocation of 2,546.30 baht a head for 46 million people. This was calculated on the average treatment cost for all members including children and the elderly.

However the actual budget per head for a spouse and child members of a private employee under the fund would be about 700 baht.

"The budget planned under the government's policy should be based on this actual cost, not the entire budget per head. If it isn't, then the universal healthcare scheme will be severely affected when those funds are deducted," he said.

"This will exacerbate the burden of high-cost treatment among the elderly."

The social security scheme requires employers and employees to contribute 1.5% of their income to the fund, which is worth over 400 billion baht and makes 20 billion baht in annual profits.

Dr Winai questioned the practicality of extending the social security fund's coverage as most company workers live in big cities while their family members live upcountry. The government's policy could also cause some disruption to the whole medical system.

A patient's right to compensation from medical malpractice could also become an issue. Unlike those covered by the social security scheme, patients under the universal scheme are entitled by law to compensation in the event of medical malpractice, he said.

Public Health Minister Jurin Laksanavisit has asked the NHSO to evaluate the policy but insisted it was impossible to put it on hold.

Panus Thailuan, chairman of the National Congress of Thai Labour, also disagreed with the move. He said a study on how many family members would be affected had not been finalised. Without careful study, both schemes could face financial problems over the long term.

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