Health needs wealth

It is hard to tell whether the Jan 24 article “New law clamps down on hospitals” is accurate or whether it is a piece of “fake news” that got past the editors. If it is accurate, then it is quite alarming.

The article reports that, in the name of “standardising the quality of state and private hospitals for better patient care,” hospitals “must waive medical fees for patients who are admitted to the emergency unit”. That raises the question of who is going to pay for such care, if private hospitals cannot charge users. (State hospitals, of course, can rely on the state budget.)

If they cannot charge patients for emergency care, then one option is for private hospitals to spread the costs among other patients. However, emergency rooms are very expensive to operate, so private hospitals may choose instead to shut down their emergency rooms and send emergency patients to state hospitals. If that happens, then there will be less emergency care available.

Moreover, it is likely that the average standard of care in the country will get worse — not better — if one assumes that the standard of care at an average private hospital is higher than the care provided at an average state hospital. So “standardising” care could well mean lowering the quality of care throughout the kingdom, rather than raising it.

If the government thinks that the best way of “standardising care” is to bring the quality level down, then it could next tackle income inequality by imposing maximum salary levels in Thailand, perhaps at 20,000 or 25,000 baht per month in order to “standardise incomes”. GEORGE ROTHSCHILD