For the poor­est in Thai­land, it can take a very long wait to see a doc­tor

The China Post - - BUSINESS - BY TAN HUI YEE

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.

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