Patients suffering from kidney failure have expressed opposition to a plan to introduce a co-payment system for their treatment in an attempt to reduce the public health budget.

On 4 July 2017, representatives of the Kidney Failure Patients Association (KFPA), Healthy Forum, Thai NGO Coalition on AIDS, Thai Network of People Living with HIV/AIDS (TNPLH) and other organizations submitted a joint statement to Piyasakol Sakolsatayadorn, Minister for Public Health.

The group calls on the Ministry to reconsider a proposal by the Office of the Auditor General (OAG) to demand co-payment from patients with kidney failure for haemodialysis treatment. The OAG reasoned that according to the Bureau of the Budget in 2007, the high cost of haemodialysis resulted in an accumulated debt for the National Health Security Office (NHSO) of 2.3 billion baht.

According to the group, the government should allocate more budget for public health, arguing that under the current national healthcare plan the government could spend up to five per cent of national GDP and up to 20 per cent of the government budget on public healthcare. Currently, the government spends 4.2 per cent of GDP or 17 per cent of the budget on healthcare.

Pointing out the inequality in the public healthcare system, the group states that the average budget per person under the Universal Public Healthcare, the Gold Card scheme, is 3,100 baht per person, while health coverage for civil servants runs at 13,000 baht per head.

Aphiwat Kwangkaew, representative of TNPLH, said the co-payment proposal from the OAG goes against the principles of universal health care policy and human rights. He recommended that the agency should look into the inequalities of the country’s healthcare system instead.  

Somkuan Ketthong, Deputy Chair of the KFPA, said there are currently about 50,000 kidney patients using the Universal Public Healthcare and the co-payment proposal would directly affect them.

About three years after Gen Prayuth Chan-o-cha, the junta leader and Prime Minister, hinted of a plan to introduce co-payments into the national healthcare scheme, Public Health Minister Piyasakol Sakolsatayadorn set up a committee on 9 January 2017 to amend the National Health Security Act, which will directly affect the functions of the NHSO.

The committee was quickly formed after the junta-appointed National Legislative Assembly (NLA) proposed the amendment on the grounds that the changes will improve the efficiency and sustainability of the national healthcare system.

Many civil society organisations, however, have pointed out that the amendment will only put at risk the lives of the country’s most vulnerable people because of the lack of public participation in the amendment process.

Representatives of Kidney Failure Patients Association (KFPA) and other civil society organisations submit a joint statement to staff of the National Health Security Office (NHSO) on 4 July 2017