Panel backs health co-payments

A committee amending the national health insurance law said it will submit its recommendations to Public Health Minister Piyasakol Sakolsatayadorn next week after endorsing a controversial copayment provision despite opposition from health activists.

All Thais are entitled to free treatment at state hospitals but the co-payment scheme would give patients the option of making a financial contribution in exchange for better service.

The committee decided yesterday to keep this in the bill to encourage more affluent patients to use and support state hospitals, said Dr Narongsak Angkasuwapla, a member of the drafting committee.

“We will not make it mandatory for patients to pay for their medical treatment,” he said.

Pirom Kamolratanakul, a former president of Chulalongkorn University, is heading a working group to study the details of the co-payment scheme and the sustainability of health insurance funding before more details are announced, Dr Narongsak said.

The meeting focused on issues relating to the Universal Coverage (UC) healthcare scheme that have met with fierce opposition.

These include an increase in the number of National Health Security Board members, a change in the way National Health Security Office (NHSO) salaries are managed, and the legitimacy of the NHSO being responsible for medical procurement at all state hospitals

The NHSO oversees an annual budget of 170 billion baht for state-run hospitals.

Dr Narongsak said the current law fails to clarify whether the NHSO is entitled to buy medical equipment and medicine for public hospitals. The Office of the Auditor-General said earlier that is outside the NHSO’s jurisdiction.

“We do not want to transfer the power to buy medicine and equipment away from the NHSO. Rather, we want to enable it to work closely with the Public Health Ministry on procurement,” he said.

The committee also agreed to add another two members to the NHSO board for more balanced management.

Nimit Thien-Udom, director of the Aids Access Foundation, agreed with having extra seats on the board but not the copayment scheme, allowing the NHSO to procure medicine for all state hospitals, or separating NHSO salaries from the rest of the budget.