Lessons From The Healthcare System in Thailand for the US
While as Americans we pride ourselves in the remarkable rights our people enjoy compared to populations in other parts of the world, when it comes to healthcare we seem to be struggling just a bit. The Affordable Care Act, or the ACA for short, seemed to be a step in the right direction, offering coverage to a greater number of people. However, even that seems to have taken a hit considering recent change in policies of the new administration.
December 12th saw the world celebrating what has come to be known as the Universal Coverage Day, a day which commemorates the passage of the resolution in the UNGA which supported universal health coverage for all member states.
Of course, the resolution itself was non-binding, so member states cannot be forced to adopt universal healthcare. However, the resolution is still praised as it has definitively set a standard which member states should aspire towards in order to ensure provision of healthcare to all citizens of the land.
Interestingly, the resolution has also brought to light another remarkable fact: countries much poorer than the United States, such as Thailand or even Ghana, have been able to offer a wider healthcare net to their citizens.
This, obviously, makes it very clear that we are approaching the whole healthcare scenario rather incorrectly, and possibly there are lessons which we can learn from countries like Thailand to improve our own healthcare system to ensure coverage for all Americans.
The Case in Thailand
Before extensive reforms were introduced within the country’s healthcare system, Thailand was able to provide coverage to around 70% of its population through four distinct insurance schemes. Then, in 2002, two of the four insurance schemes were combined into one and coverage to a greater number of people was provided as the larger insurance fund had a greater capacity for better planning.
Such reforms have obviously brought improvement in the overall health of the general population, and according to statistical reports, the life expectancy has increased, mortality in children has decreased, and the disparity which used to exist between the healthcare of the rich and the poor of the country in the past seems to have narrowed.
The people, especially the poor, who found it especially difficult to service their medical expenditure considering their limited income have received great relief through the universal healthcare coverage policy of the country.
To ensure that its healthcare programs remain sustainable, the country has introduced certain controls in the system. For example, patients, if they want to utilize their insurance, must visit the hospital that is nearest to their residence.
The country also provides the physicians who work at the facilities a fixed sum as compensation for their OPD services on an annual basis. These measures ensure that the costs do not escalate, as has been a problem in the United States (although the impact has slowed down in recent times).
An Example for the US
One might argue that both the countries have very different systems and processes, hence a comparison shouldn’t be made. However, considering that Thailand only spends around 4% of its GDP on health compared to the US spending around 20% of its GDP, and yet is able to provide better coverage to its people, speaks volumes about the efficiencies in its health system, some of which the US will definitely benefit adopting.
However, the US is not far behind. The ACA was devised along the same lines and aimed to promote accessibility of healthcare to a greater number of people. Unfortunately, it has been marred by policy changes and political discourse which has limited a lot of its powers.
Perhaps the creation of a public insurer in addition to Medicare, which would effectively compete with private insurances and hence keep costs much lower, is the way to go. Of course, and it goes without saying, the costs being charged by hospitals and pharmaceutical companies also need to come down in order to make healthcare more affordable.
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