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Top Health official did not propose cost-sharing by patients

RESPONDING to criticism of a reported Health Ministry proposal submitted to the junta that patients should share treatment costs under a ministry reform to ease budgetary constraints, a senior health official yesterday took responsibility for having made the proposal.

He denied the idea had come from the permanent secretary, Dr Narong Sahametaphat, as widely speculated by ministry officials and beneficiaries who would have been affected.

Dr Thawatchai Kamoltham, director general of the Department for Development of Thai Traditional and Alternative Medicine, said he had floated the idea during a meeting on May 31 with NCPO officials, when they visited the ministry. He said he had not suggested any ratio, nor commented that 30-50 per cent of cost should be borne by the patients, as discussed widely in media or among beneficiaries who enjoy free or low-cost scheme under the National Health Security |Office (NHSO) or other packages, including people with Aids, or human immunodeficiency virus (HIV).

After the seizure of power by the military on May 22, several government agencies are attempting to launch reforms of their own, jumping on the NCPO's reform bandwagon. The issue at the Public Health Ministry stands out the most because of the complicated and controversial nature of costly government-supported healthcare and other relevant schemes, including social security package and a state health fund for government workers.

Dr Narong, at a ministry press conference yesterday, made public the meeting's minutes, and said only four issues were brought up with the NCPO: improvement of the ministry's medical public service; joint reconciliation efforts between the ministry and the provincial Internal Security Operations Command; morale of ministry officials, and a new ministry corruption-free framework based on good governance.

"The cost-sharing issue was brought up, and the meeting concluded that the ministry would look into it. If cost-sharing would have been officially on the agenda, it should have been me tabling it myself," he added.

At yesterday's meeting, some 200 members of the Public Health Community met and discussed an appropriate ratio , said Dr Prachumphon Booncharoen, the president of the Federation of General Hospitals, who jointly presided over the meeting.

She said members realised that it was necessary for people to share medical costs with the state if tambon hospitals and public community clinics, which were suffering budgetary constraints because of the universal healthcare scheme, were to survive. She said the rate would not be as high as 30 to 50 per cent of the medical bill as rumoured on the social network.

The doctor said the cost-sharing ratio might be Bt30 to Bt50 per visit, and those in need - the underprivileged and the elderly - would be granted exemption.

At a meeting on Monday, attended also by members of ThaiPlus - a charity for people with Aids or HIV - complaints were made about their free or low-cost prescription of Aids medicines. ThaiPlus chairman Apiwat Kwangkaew said the cost-sharing should be first tried with a state health fund for government workers, and if it worked it should then be applied with the NHSO scheme.








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