March 10, 2014 00:00 By Thanapat Kitjakosol
According to Sanisa Yakham, an official at the Tambon Suthep administrative organisation in Chiang Mai, the organisation's healthcare scheme has turned her family's lives around, financially.
Its direct reimbursement means they must no longer reserve up to Bt5,250 a week for her 43-year-old husband Somkid’s hemodialysis sessions.
The scheme, run by the National Health Security Office (NHSO) since last October, operates through direct reimbursement, covering 200,000 local administrative organisation officials and employees – or 690,000 people, if family members are included.
In the past four months, officials and employees, as well as family members, have used the scheme’s services 364,154 times – representing a total of Bt742 million in reimbursements.
Sanisa, 43, said her family had to spend up to Bt50,000 a month to cover Somkid’s kidney-disease treatment expenses. Although the family was entitled to the healthcare coverage, they still had to use their own money in advance payments for the hospital’s treatments, including three hemodialysis sessions a week, which cost Bt5,250, she explained.
After the scheme implemented the direct reimbursement to hospitals, Somkid said he consulted with his doctor for a kidney transplant, in which Sanisa would be the matched kidney donor. The transplant operation was performed on October 28, 2013 and the family didn’t have to find Bt300,000 to pay in advance for the surgery.“We say ‘thank you’ to the scheme’s direct reimbursement for giving our family a new life,” he added.
Urging people stay clear from kidney disease, Somkid said despite the new kidney, he had to take immune-suppressants for the rest of his life, which would cost Bt10,000 a month. “If my wife hadn’t worked for the local administrative body, our family would have suffered hardship,” he added.
Muang district’s Tambon Suthep Mayor Thanyasak Saengsrichan said the new policy made it convenient for local bodies’ employees to get medical treatment, while his municipality now only had to contribute Bt300,000 per year to the scheme fund.
NHSO chief Dr Winai Sawasdivorn said medical treatments for local bodies’ employees were separate and supervised by each local body. The officials or employees had to make advance payments for medical bills and then be reimbursed later. This led to many having to borrow money to cover the advance payments, and it became a key obstacle for their access to medical treatment, he explained.
As a result, the healthcare fund for local bodies’ officials and employees was established and the direct reimbursement method was implemented last October, he added. Under this method, the local bodies’ officials and employees no longer had to make advance payments and only had to register for the direct reimbursement system once, according to Winai.
The Bt7 billion scheme still has 70,140 medical treatment receipts, worth Bt138 million totally, that were pending reimbursements through the old method.The NHSO has approved the payments for Bt55.1 million.