For the poorest in Thailand, it can take a very long wait to see a doctor
There are three ways to get health care in Thailand, Thai economist Ammar Siamwalla muses. You pay a lot of money. You use your connections. Or you spend a lot of time.
ASEAN’s second-largest economy has many health care options for the rich and influential but far slower lanes for those with a lot of time but little cash to spare. The last group is covered by the 14-year-old universal health care system, which provides medical treatment free or for 30 baht (90 U.S. cents) per visit, depending on the policy of each hospital.
Dubbed the “30-baht scheme,” it is closely associated with exiled former premier Thaksin Shinawatra, who was elected in 2001 on the strength of his appeal to the rural masses.
Today, the scheme covers some 47 million people in Thailand, with the government subsidizing each person an average of 2,895 baht per year.
The funding cap, coupled with expanding demand, has stretched the line so much that it is normal to wait two hours or more to see a doctor.
San Srikaysuk, a 58-year-old spectacle shop employee, is nodding off in a corner of a Bangkok hospi- tal waiting room when I approach him. He had arrived at 7 a.m. for an 8 a.m. appointment, only to be told his doctor would be available only in the afternoon.
“They said ‘afternoon,’ but I have no idea what time in the afternoon,” he mutters, pulling out from his back pocket a rolled-up M2F tabloid distributed free on the streets.
But he is used to waiting. He sees the doctor every three months to collect medicine for hypertension. All of that is free, but each outing lasts from 7 a.m. to 3 p.m., and requires him to take leave from work. “It’s not that long,” he insists. A few rows away, a woman snoozes with her palm on her cheek next to a teenager engrossed in his smartphone. The front row is filled by patients with their eyes glued to the local drama played out on a flatscreen television set. A boy leisurely chomps his way through a bag of meatballs dipped in chilli sauce.
No one seems even vaguely miffed at the long wait.
“Our system can prevent people from becoming bankrupt,” says Dr. Weerawat Phancrut, deputy secretary-general of the National Health Security Office (NHSO), which runs the scheme. “But for minor ailments, common ailments, we still have problems.”
The NHSO hopes to shorten lines by convincing more private hospi- tals to serve patients on the universal health care scheme. According to Dr. Weerawat, just about 50 of the roughly 500 private hospitals nationwide do so now.
In the meantime, it is thinking of introducing co-payment significantly higher than the nominal sum of 30 baht collected by some institutions now.
That is something San is open to, if it helps to shorten the wait.
“I don’t mind paying a few hundred baht,” he says. “But if they increase the price, they have to improve the service.
“They should have called me beforehand and told me the doctor was coming late.”
Visitors stroll in a garden covered with moss phlox in Tatebayashi, Gunma prefecture, about 80 kilometers north of Tokyo on Sunday, April 12. Blossoming moss phlox are expected to attract many visitors until the upcoming Japanese “Golden Week” holiday season in late April and early May.