Health bill to sail through despite strong opposition

national June 19, 2017 01:00

By Chularat Saengpassa
The Nation

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Fourth public hearing in Bangkok hit by protesters amid claims that people had been excluded from the amendment process; possible copayments dominate criticism of plan



THE National Health Security Bill is set to sail ahead despite its four public hearings utterly failing to appease opponents.

The People’s Health Systems Movement (PHSM) demanded yesterday that the whole drafting process begin anew to include participation from all sides. 

But it was clear their demand would not be met by authorities promoting the plan.

“The public hearings have already concluded. Officials will forward the views aired at the forums and various other channels to the next step,” Public Health Ministry inspector-general Dr Marut Jirasrattasiri said in his capacity as spokesman of the committee drafting the bill. 

He said the draft law would proceed, along with opinions gathered from various channels including the public hearings, to his committee, and then to the public health minister, the Cabinet and the National Legislative Assembly (NLA).

Marut said major concerns from opponents surrounded copayments and the proposed higher representation of medical service providers in the National Health Security Commission (NHSC) that oversees the universal healthcare scheme. 

“The content of the bill can still be adjusted during further reviews by my committee or the NLA,” he said. 

Marut said copayments had existed in the law that governed the universal healthcare scheme since its introduction 15 years ago. 

He said the number of people’s representatives in the NHSC could be increased, but they should be labour or local leaders – not from non-government organisations (NGOs) with close links to powerful figures in the NHSC.

Healthcare ‘mission’ 

Several NGOs have joined the People’s Health Systems Movement (PHSM) recently in its so-called mission to protect the universal health scheme. Initially known as the Bt30-per-medical-visit project, it offers most types of medical service to citizens for free with about 48 million people covered by the scheme.

Opponents to the bill are concerned that the proposed amendment did not remove copayments from the National Health Security Act, which initially required patients to pay just Bt30 per medical visit. They suspected that the powers-that-be would try to force people to partly pay for medical services, adding that the state should provide healthcare services to its citizens.

The PHSM suggested that the government should be able to fund the scheme via a tax on capital gains or other means. 

The current bill also failed to authorise the National Health Security Office to procure expensive medicines – a task that the office did competently for over a decade, the PHSM stated. 

“Public hearings do not provide any assurance that the current draft law will be improved,” the PHSM said in its statement. 

All four public hearings on the bill saw dissatisfaction expressed by people who opposed the changes. The first two in the South and North saw walkouts, while the third one in Khon Kaen collapsed abruptly on Saturday because opponents took over the stage. 

The fourth and the last took place in Bangkok yesterday. But participants were outnumbered by opponents who lay down in front of the door leading to the venue. 

“It’s a symbolic gesture to make clear that those who have backed the bill have stepped over people,” PHSM member Apiwat Kwangkeaw said.

PHSM members have said they did not join the hearing because they did not want to be part of a process to rubber-stamp the law.

Although the bill has drawn criticism, it is not without supporters. Several doctors and health experts believe some adjustments must be made to the universal healthcare scheme or Thailand will be negatively affected by the scheme’s massive costs.