NHSO backs plan to ditch Bt30 fee
Mongkol to put proposal to Cabinet today despite Budget Bureau objections
The National Health Security Office decided yesterday to stop collecting the Bt30 fee for hospital visits charged under the universal healthcare scheme, despite strong objections from the Budget Bureau.
Official cancellation of the "unfair" fee will be put for Cabinet approval today, along with a new budget of Bt2,089 per capita that should cover income lost from collecting the Bt30 fee, said Public Health Minister Mongkol na Songkhla.
To enable the scheme to survive a financial crisis in the future, the National Health Security Office (NHSO) agreed to set up a panel to search for other sources of funds to guarantee its stability, Mongkol said after chairing an NHSO board meeting yesterday.
One potential source of funding support is a proposed co-payment system, and the new panel is expected to come up with details within the tenure of the interim government, he said. While reasoning that it is unfair to collect Bt30 for each hospital visit from certain patients and not from the rest, Mongkol said Article 5 of the Act that established the health scheme clearly allowed co-payment to be imposed, presumably based on people's capacity to partly pay for their healthcare service.
Mongkol made headlines shortly after taking office when he vowed to stop collecting the Bt30 fee and to rename the scheme. He called the "Bt30 Healthcare" title a gimmick of the Thai Rak Thai Party.
Collection of the Bt30 fee has been waived for about 25 million people out of 47.5 million registered under the Bt30 scheme, including poor people who used to receive free treatment before the scheme was implemented six years ago.
But the Budget Bureau's adviser to the NHSO and a member of its board, Orawan Chayangkul, said cancelling collection of the Bt30 fee would significantly hit the scheme's financial status.
NHSO figures show that total income from collecting the Bt30 fee is about Bt1.07 billion, accounting for about 2 per cent of the total budget allocation for the scheme.
"Even one or two million baht, in terms of budget management, does matter," Orawan told yesterday's meeting. Doing without such income would greatly affect hospitals already in the red.
Still, she said, as there was no convincing evidence to back the approval of the Bt1,089 per-capita budget, the NHSO would have to keep its fingers crossed and hope the proposal is approved.
Ever since the Bt30 scheme was first introduced, Cabinet has never approved the requested budget. Last year, the NHSO requested a budget of Bt1,901 per capita, but only Bt1,659 per capita was approved.
Mongkol said the universal health scheme could no longer be left the way it was in terms of budgetary and financial management.
"They [hospitals under the scheme] have survived because of their out-of-pocket money and their pockets will be empty sooner or later," he said, adding that the total deficit facing about 200 state hospitals under the scheme is more than Bt1 billion.
Mongkol was confident Cabinet would approve the proposed budget of Bt2,089 per capita today and said he would not reconsider cancellation of the Bt30 fee.