Is free healthcare for everyone possible?
After 10 years of universal healthcare hospitals are turning away patients, cutting hospital beds & seeking ways to avoid the massive losses they face.
After 10 years of universal healthcare hospitals are turning away patients, cutting hospital beds & seeking ways to avoid the massive losses they face.
Photo above of patient in Intensive Care Unit (ICU) for patients facing life-threatening medical emergencies, one of the more expensive places to receive medical treatment in a hospital (Source: Wikipedia & Wikimedia Commons)
Click button to listen to Universal Healthcare Burden to download
Health
Hospitals 'are choosing costs over patients'
Gold card scheme a huge drag, says expert
22/03/2012
Onnucha Hutasingh
Some hospitals avoid treating people who might not be able to pay the bills and reduce the number of beds to cut losses incurred by the state "gold card" universal healthcare scheme.
Dr Sutham Pincharoen, a representative of the University Hospital Network, also said staff at gold card hospitals endure a heavier workload with the same pay.
"Many hospitals have now decided to avoid the risk," he said.
Hospitals are given a fixed budget each year by the state to take gold card patients. But in some cases, there are more patients seeking medical attention than there is money to pay the bills.
In other cases, the patients require lengthy and expensive treatments which also overstretch the budget, resulting in losses for the hospital.
As a result, some hospitals ease the losses by turning away non-gold card holders seeking treatment whom they think might not be able to pay.
"The hospitals avoid admitting patients needing expensive treatments from whom they might not be able to collect money. They also reduce the number of beds for ordinary patients," Dr Sutham said.
This is what is happening in some hospitals. It's called risk avoidance.
This is partly the reason the hotline of the National Health Security Office, which oversees the gold card scheme, has been flooded with complaints over a shortage of hospital beds, Dr Sutham said.
State-owned hospitals affiliated to the gold card scheme are also forced to increase revenue by opening clinics within their premises outside office hours. This way they can charge patients more, Dr Sutham said.
Also, some privately-run hospitals apply for listing on the stock market so they can receive capital.
However, once they become public companies, it is feared their operations become money-oriented, as there are financial goals to meet in order to please shareholders.
Dr Sutham added that loss-making hospitals could also lose their ability to train medical students.
"They have had to rely on the old way of training medical students. The medicine and the equipment were outdated," he said.
"What will the country's medical personnel be like 10 years from now?" he said.
Dr Sutham was voicing his concerns at a seminar held yesterday to mark the 10th anniversary of the gold card scheme.
Dr Somchai Nitphanit, deputy public health permanent secretary, said each year the losses from treating gold card patients amount to 40% of the operating costs of many hospitals.
But Aphiwat Kwangkaeo, a representative of patients with chronic diseases, wanted the government to continue the gold card scheme and even expand it to cover ethnic minority groups.
The universal healthcare scheme was launched in 2001. The state gives a yearly subsidy of 2,755 baht per patient to participating hospitals, which accounts for 1.1 billion baht of the fiscal 2012 budget.
The government insists it will continue and further develop the gold card scheme because Thailand is viewed as a model for the universal healthcare scheme by many countries.
Public Minister Witthaya Buranasiri, who presided over the seminar yesterday, admitted the scheme will commit the government to a long-term financial burden.
However, the government will work harder to encourage people to protect themselves against diseases, which will help the government save on the cost of treating them, he said.
(Source: Bangkok Post, Health, Hospitals 'are choosing costs over patients', Gold card scheme a huge drag, says expert, 22/03/2012, Onnucha Hutasingh, link)
Universal Healthcare Scheme Vocabulary
universal healthcare - national health care systems built around the principle of universal coverage for all members of society (See Wikipedia)
universal healthcare scheme - the government system that attempts to provide free healthcare to everyone
healthcare - the treatment and prevention of diseases and other medical problems
universal - involving everyone ทั่วไป
scheme - a plan that is developed by a government or large organisation in order to provide a particular service for people แผนการ โครงการ
state - government รัฐ
gold card scheme - Same as "universal healthcare scheme"
the state "gold card" universal healthcare scheme
drag - to pull something or someone along with difficulty; slowing something down ลาก (here: a drag on the healthcare system, making it go slower and work less efficiently)
Gold card scheme a huge drag, says expert
Intensive Care Unit (ICU) - the part of a hospital with special equipment for the "diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring" (See Wikipedia)
emergency - an unexpected situation involving danger that requires action right now, immediate action ภาวะฉุกเฉิน
medical emergency
threaten - being dangerous, being a possible cause of harm or damage ขู่, แสดงอาการโดยการพูดหรือการกระทำให้ผู้อื่นเกรงกลัว
life-threatening - possibly causing the death of people
life-threatening medical emergencies
medical treatment - the process of providing medical care การรักษา
bills - money owed to others that must be paid quickly
pay the bills
treating people who might not be able to pay the bills
incur losses - when an organization loses money
cut losses incurred - reduce the amount of money being lost
Some hospitals avoid treating people who might not be able to pay the bills and reduce the number of beds to cut losses incurred by the state "gold card" universal healthcare scheme.
representative - typical of people or things in a group
staff - workers, employees พนักงาน
endure - to suffer something difficult or unpleasant in a patient way over a long period of time อดทน อดทนเพื่อให้ผ่านเวลาหรือเหตุการณ์ที่เลวร้าย
workload - the amount of work that a worker must do each day ปริมาณงานที่คนหรือเครื่องจักรทำได้ระยะเวลาหนึ่ง
endure a heavier workload with the same pay
Dr Sutham Pincharoen, a representative of the University Hospital Network, also said staff at gold card hospitals endure a heavier workload with the same pay.
risk - danger, how likely or possible it is for a bad event that causes harm and damage ความเสี่ยง
avoid the risk
risk avoidance
budget - the amounts of money that an organisation has available to spend on different things during a period งบประมาณ (See Wikipedia)
fixed budget - one budget that doesn't change (can't be increased)
patients seeking medical attention - sick people going to the doctor for medical treatment
overstretch the budget - use up all the money in the budget (perhaps even more than the budget)
"Many hospitals have now decided to avoid the risk," he said. Hospitals are given a fixed budget each year by the state to take gold card patients. But in some cases, there are more patients seeking medical attention than there is money to pay the bills. In other cases, the patients require lengthy and expensive treatments which also overstretch the budget, resulting in losses for the hospital.
ease - to make or become less severe, difficult, unpleasant, painful, etc ทำให้ง่าย บรรเทา
ease the losses - reduce losses, make the losses less
turning away - not accepting people for medical treatment
As a result, some hospitals ease the losses by turning away non-gold card holders seeking treatment whom they think might not be able to pay. "The hospitals avoid admitting patients needing expensive treatments from whom they might not be able to collect money. They also reduce the number of beds for ordinary patients," Dr Sutham said. This is what is happening in some hospitals. It's called risk avoidance.
reason - an explanation of an event, why an event happened เหตุ ; เหตุผล ; สาเหตุ
this is partly the reason
hotline - a telephone number that people can call for information โทรศัพท์สายตรงที่จัดไว้สำหรับเหตุเร่งด่วนหรือเฉพาะเรื่อง
complaints - when people say there is something wrong and they want it changed
flooded with complaints
shortage - when there is not enough of something การขาดแคลน
shortage of hospital beds
This is partly the reason the hotline of the National Health Security Office, which oversees the gold card scheme, has been flooded with complaints over a shortage of hospital beds, Dr Sutham said.
affiliated - are members of, are associated with เป็นสมาชิกของ Some gangs even have members who are former officers of the CSD. The Neng Lop Buri gang was involved in
revenue - income from taxes or business activities รายได้
clinics - places where people go to receive medical treatment
premises - the buildings and land that a business or organisation uses ที่ดินและสิ่งปลูกสร้าง ในที่นี้หมายถึงในรั้ว ในบริเวณทำเนียบรัฐบาล
State-owned hospitals affiliated to the gold card scheme are also forced to increase revenue by opening clinics within their premises outside office hours. This way they can charge patients more, Dr Sutham said.
apply - to make use of something นำมาใช้
listing - (of a company) the process of becoming a member of a the stock market and having shares sold to the public
capital - money invested in a business (See glossary)
oriented - many concerned with or directed towards
money-oriented - people whose life and activities are directed only towards making money
shareholders - people who own the stock shares of a company (and who are therefore part owners of the company)
Also, some privately-run hospitals apply for listing on the stock market so they can receive capital. However, once they become public companies, it is feared their operations become money-oriented, as there are financial goals to meet in order to please shareholders. Dr Sutham added that loss-making hospitals could also lose their ability to train medical students.
training - to teach people how to do an activity or job การฝึกฝน
training medical students
outdated - old and no longer suitable or useful, old-fashioned
outdated equipment - old equipment
personnel - people who work for a company or organisation
medical personnel - people who work in the field of medicine (doctors, nurses, physical therapists, pharmacists, etc)
"They have had to rely on the old way of training medical students. The medicine and the equipment were outdated," he said. "What will the country's medical personnel be like 10 years from now?" he said.
concerns - worries ความกังวล
voicing his concerns - telling people about his worries
mark - to celebrate something ฉลอง to show respect for or commemorate; record สถิติ
anniversary - a date when you celebrate something that happened in a previous year that is important to you วันครบรอบ
mark the 10th anniversary
Dr Sutham was voicing his concerns at a seminar held yesterday to mark the 10th anniversary of the gold card scheme.
deputy - a person who is given the power to do something instead of another person, or the person whose rank is immediately below that of the leader of an organisation รอง, ตัวแทน,ผู้รักษาการแทน
permanent - happening or existing for a long time or for all time in the future ถาวร
deputy public health permanent secretary
Dr Somchai Nitphanit, deputy public health permanent secretary, said each year the losses from treating gold card patients amount to 40% of the operating costs of many hospitals.
chronic - (of a disease or pain) serious and lasting for a long time เป็นประจำ
chronic diseases
expand - to become larger ขายตัวออกไป
cover - include, provide for this group also
minority - a small percentage, less than 50% จำนวนน้อย
ethnic minority - of a part of a population that is different in race, religion or culture form most of the population ชนกลุ่มน้อย
expand to cover ethnic minorities
But Aphiwat Kwangkaeo, a representative of patients with chronic diseases, wanted the government to continue the gold card scheme and even expand it to cover ethnic minority groups.
launched - began เริ่ม started เริ่มต้นดำเนินการ
subsidy - helping to pay the costs of something เงินชดเชยที่รัฐเป็นผู้จ่ายให้ เงินสนับสนุน
patient - someone who is receiving medical treatment คนป่วย, คนไข้
fiscal - related to government spending; connected with the government budget, i.e., public money เกี่ยวกับงบประมาณ
fiscal 2012 budget
insists - say that something is surely so (will not change thinking on this)
The universal healthcare scheme was launched in 2001. The state gives a yearly subsidy of 2,755 baht per patient to participating hospitals, which accounts for 1.1 billion baht of the fiscal 2012 budget. The government insists it will continue and further develop the gold card scheme because Thailand is viewed as a model for the universal healthcare scheme by many countries.
presided - to be in charge of a formal meeting or ceremony เป็นประธาน
presided over
commit - to promise to do something ให้คำมั่นสัญญา
burden - a responsibility, a difficult thing that must be done, a heavy load to carry ภาระ (See glossary)
financial burden - something that is difficult to pay for
commit the government to a long-term financial burden - promise that the government will pay for (over a long period of time) something that is difficult to pay for
encourage - to make someone more likely to do something, or to make something more likely to happen ปลุกใจ cause someone to gain enthusiasm, motivation, and energy in what they are doing
Public Minister Witthaya Buranasiri, who presided over the seminar yesterday, admitted the scheme will commit the government to a long-term financial burden. However, the government will work harder to encourage people to protect themselves against diseases, which will help the government save on the cost of treating them, he said.
