All veterans should get free health care

Reform need under Thailand's crown

A huge step forward. Because before the reform, a quarter of the Thai population had no health insurance. For the poor, the elderly, day laborers, farmers, the disabled, veterans, priests and monks, illness or an accident often meant financial ruin.

A reference person for every household.

Suwit Wibulpolprasert, who was Minister of Health when general health insurance was introduced at the time, is proud of what has been achieved. Thailand has shown that you don't have to be a rich country to achieve universal health care for everyone, says the doctor. But the late sixties also sees the weaknesses in the system: "Because of the aging population and the rapid increase in chronic diseases, we are facing enormous challenges." However, he does not believe that medical technology is the answer. Wibulpolprasert: “We have to take social and community measures.” This is why his team has advised the current government to strengthen primary care. “Every household needs a caregiver. It doesn't necessarily have to be a doctor, it can also be a medically trained social worker or nurse, ”says the ex-politician.

Researchers sound the alarm.

It is not clear who should pay for all of this. "The system is facing a spending collapse," says Nuttanan Wichitaksorn, researcher at the prestigious Thailand Development Research Institute (TDRI) in Bangkok. At the moment about 13 percent of the state budget is earmarked for health expenditure. According to calculations by Wichitaksorn's research group, state health expenditure could reach the equivalent of 39.5 billion euros in 2032 - that's almost half of the current state budget. “With our aging population, precaution would be the order of the day,” complains Wichitaksorn. “But hardly anything happens in this area. There is no concept of how to approach this problem. "

Civilization diseases are increasing.

Chronic, noncommunicable diseases such as cancer, diabetes and cardiovascular diseases are typical of developed countries. In Thailand, too, 70 percent of all people now die from it. Wichitaksorn criticizes the lack of good prevention and precautionary programs. “Hospitals are allocated money, but organize dance lessons in the evening.” He is convinced: “We have to change our lifestyle, for example we have to exercise more because many people now have office jobs.” Because eating habits are also changing, we are in Thailand almost 24 percent of the population are now overweight or obese. Wichitaksorn also complains that there are no mandatory health checks or preventive measures such as flu vaccinations, the costs of which are borne by the system.