It is easy to say that government officials are earning far less than those in private companies with comparable skills and qualifications, however one matter that is always overlooked in this regard is the generous welfare benefits they receive, particularly the Civil Servant Medical Benefit Scheme (CSMBS).

The CSMBS, which provides free medical services to all 1.2 million government officials and their parents, spouses and children under 20 years of age, is the most generous when compared to the country's other major healthcare schemes, including the Social Security Office's (SSO) health insurance and the universal healthcare scheme.

While the SSO health scheme and universal healthcare have effectively capped their spending at a per capita payment of slightly over Bt2,000 per year, the CSMBS is shelling out well over Bt4,000 per patient per year and the cost is escalating out of control. The CSMBS stubbornly adheres to a pay-for-service reimbursement system, which means that the government pays whatever amount is charged by hospitals providing medical services to persons under the scheme.

According to the latest available statistics, the CSMBS spent Bt37 billion to provide medical services to 1.2 million government officials and their dependants in 2006, a 26-per cent increase over the previous year, or a more than 10-fold increase when compared to the Bt3.1 billion spent in 1988. These soaring medical bills were attributed mostly to the use of expensive, imported medicines, as well as a high rate of admission and the use of costly diagnostic procedures, which continues to be much higher than under other healthcare schemes.

That raises suspicions of an unnecessary or wasteful use of healthcare resources. Yet we have not heard taxpayers complain about all this. Perhaps that's why government officials continue to take it for granted that taxpayers will remain docile and continue footing the bills without question.

The Public Health Ministry has long tried to persuade successive governments, including the interim Surayud administration, to rationalise the use of drugs by the country's three healthcare systems, as part of an effort to rein in escalating costs and ensure social justice. Under this proposal, the universal healthcare scheme, SSO health insurance and CSMBS would be forced to use the national list of essential drugs as a reference when providing their medical services.

The Public Ministry argues very sensibly that the standardisation of prescriptions based on a list of essential drugs would not only reduce healthcare costs and ensure fairness to those receiving the different healthcare service, but would also improve the performance of health service providers, and therefore benefit society as a whole.

The national list of essential drugs, based on guidelines from the World Health Organisation, serves as a model for the selection of drugs on the basis of comparative efficacy and safety, quality and cost consideration. According to the WHO, essential drugs are those that satisfy the healthcare needs of the majority of the population.

But the Public Health Ministry's recommendation continues to fall on deaf ears. This is mainly because government officials - arguably the most powerful interest group in the country - have been vigorously opposing any such move to make the CSMBS conform to the standards that are applied to SSO health insurance and the universal healthcare scheme.

The public should not tolerate this outrage. Further salary increases should cease until civil servants accept the same standard that applies to other healthcare schemes for taxpayers and everybody else in this country.