Judging from the way the policy is being promoted, it looks like the government is trying to mislead the public by refusing to acknowledge the serious effects that unfettered commercial exploitation would have on the healthcare industry as the public and private sector would be forced to compete for limited resources, particularly doctors.

In June 2004, the Cabinet approved a strategic plan proposed by the Public Health Ministry to encourage both the public and private sectors to develop their healthcare services to meet international standards. The aim was to persuade foreigners, particularly from wealthier countries, and their health insurers to take advantage of medical services in Thailand, which in most cases are at least 50 per cent cheaper when compared to the same services in their countries of origin. The long-term goal calls for the Kingdom to provide medical services to two million foreigners annually by the year 2008.

The government also paints the rosy picture that foreigners seeking medical services in Thailand will boost the revenues of the tourism industry and other related businesses. Medical tourists are now being referred to as a special category of visitors, which the government is targeting with a big-budget PR campaign. The government’s plan involves marketing and public relations, management and the development of health services and products.

All is very well and good, or so it seems. According to official statistics, the number of foreigners receiving medical treatment in Thailand has risen dramatically in the past several years, even before the government stepped in to help promote the medical-hub plan in a big way. The number stood at 630,000 in 2002 and rose to about 1.28 million last year, generating revenues of some Bt33 billion.

But a closer look at the statistics reveals that only a fraction of the oft-cited figures account for foreign patients who actually travel to Thailand with the express purpose of undergoing a medical procedure. The rest are either foreign tourists who happen to require medical attention while vacationing in the country, or foreign residents who live and work here.

That means the government and private hospitals, which are profiting from the promotion of the medical-hub policy, are misleading the public into believing that Thailand has an excess capacity that can be exploited without causing negative effects on the country’s public health system as a whole. That is the farthest thing from the truth.

Thailand’s public health system is modelled on a socialistic approach in which the government retains the power to intervene in the industry through regulation to increase equity of access to healthcare services. This model has served the country well as it has provided the vast majority of people with access to adequate medical services – people who would not be able to afford modern healthcare otherwise.

Even now, the country’s public health system is unable to meet its target of providing one doctor per 1,800 people in the population, a key indicator of the quality of healthcare services provided by the government. Simply put, our public health system still suffers from a shortage of doctors. Of the 31,039 physicians’ positions required in the public health system last year, only 25,815 were filled. Brain drain, in which state-employed doctors migrate to the more lucrative private sector, has been a problem for decades.

The idea of Thailand as medical hub to serve foreigners could make it a lot worse. The government, which under the Constitution has a duty to ensure equity of access to adequate healthcare services for all citizens, has no business spending general taxpayers’ money to promote the commercialisation of medical services by the private sector, which is fully capable of doing its own PR and marketing. The government’s priority must be to ensure quality healthcare for all citizens.