Junta to get rid of Thaksin initiated universal healthcare

The junta is attempting to abandon the universal healthcare scheme, one of the most acclaimed policies of former Prime Minister Thaksin Shinawatra, and replace it with a co-payment system. Analysts say under the draft constitution, healthcare will be no longer a state obligation, but state assistance to the poor.

Amid news that the junta plans to reduce the budget for the universal healthcare scheme, formerly known as 30-baht policy, and ultimately abolish it, the equal right to healthcare has been removed from the draft constitution. This is despite the fact that the junta’s head proudly presented the current scheme as a prototype for healthcare in other ASEAN nations in his speech at a UN conference last year.

Thaksin Shinawatra introduced the universal health coverage scheme in 2001. The scheme was called the ‘30 baht policy’ where people receive a ‘Gold Card’, allowing them to access medical treatment in their registered district with a co-payment cost of 30 baht per illness. Then in 2008, PM Abhisit Vejjajiva changed it to a free healthcare service but most people still called it the ‘30 baht policy’.

Minister of Public Health Piyasakol Sakolsatayadorn recently proposed a co-payment model to replace the current one where patients do not have to pay a single baht. For the new scheme, patients will pay part of the medical costs. The junta has not yet announced the proportion of co-payment. The state however will fully sponsor medical costs for the poor (see ‘Thai health care scheme may be weakened after reform by the junta’ for further details)

Sureerat Treemanka, an activist from the People’s Health Systems Movement, told Prachatai that the junta’s co-payment model will make poor people hesitate to go to hospital and receive treatment since it requires people to pay immediately when they want to receive treatment.

Sureerat added that the junta does not understand that healthcare is a universal right, not state assistance to the poor. She foresees that the budget for healthcare will either be cut or remain the same, but definitely not increase.

Article 47 of the draft charter strongly supports Sureerat’s words. The draft has cut the word ‘equal’ from the rights of all Thai citizens to access healthcare services and makes it a priority for the poor.

The draft’s Article 47 in the Chapter on the Rights and Freedoms of Thai Citizens states: ‘A person shall have the right to receive health services of the state. The indigent shall have the right to receive health services of the state without payment in accordance with the law.’

The corresponding Chapter of the 2007 Constitution states (Article 51): ‘A person shall enjoy an equal right to receive proper and standard public health service and the indigent shall have the right to receive free medical treatment from public health centres of the State. A person shall have the right to receive thorough and effective public health services from the State’ and Article 80 adds that the state shall encourage participation by the community and private sector.

However, the provision that the healthcare services of the state must be thorough and effective has been moved to the Chapter on the Responsibilities of the State of the draft charter.

Article 55 ‘The State must operate so that the people shall receive thorough and effective health services, promote the people to have a basic knowledge of health promotion and preventive medicine, and promote and support the development of traditional Thai medical wisdom for maximum benefit.’

The Gold Card (source: Organization of Songkla Consumer)

News