News Forum - 30-baht scheme in hot water: is Thailand’s gold card running out of cash?

[Thaiger]

Thailand’s universal healthcare policy, known as the 30-baht gold card scheme, faces scrutiny over its financial sustainability and adequacy in providing security to all citizens. Health experts call for a reform to ensure the scheme’s long-term viability. This populist policy, launched by the Pheu Thai Party more than two decades ago, strives to offer equitable … …

The story 30-baht scheme in hot water: is Thailand’s gold card running out of cash? as seen on Thaiger News.

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[AussieBob]

IMO the health system in Thailand needs to be changed. Obviously not an issue for me, but it is clear that Hospitals are being swamped with less than serious medial issues, because it costs the person SFA. If they go to a medical clinic they are charged far too much, so they go to the public Hospitals.  Tough issue because if they subsidise the clinics for 'poor' Thais - it will be scammed and ripped off.  Perhaps they need to open public 'clinics' inside Hospitals that can be the first point of call for those who have minor non-ER issues?   

[Khunmark]

1 hour ago, AussieBob said:

IMO the health system in Thailand needs to be changed. Obviously not an issue for me, but it is clear that Hospitals are being swamped with less than serious medial issues, because it costs the person SFA. If they go to a medical clinic they are charged far too much, so they go to the public Hospitals.  Tough issue because if they subsidise the clinics for 'poor' Thais - it will be scammed and ripped off.  Perhaps they need to open public 'clinics' inside Hospitals that can be the first point of call for those who have minor non-ER issues?   

This was one of the arguments in Australia for dismantling the bulk billing scheme. The public system in Thailand is collapsing because a significant proportion of the people using it, are booked as overnight stays unnecessarily. Taking valuable beds from those whom really need it. And that is a cultural issue dating back decades which needs to be addressed.
 

 

The second issue relates to professionalism. Devolving some of the less critical cases away from doctors and towards competent nurses and pharmacists would also alleviate the strain on the system. This has been a successful reform initiative employed in the Australian public health system.

[ChrisS]

Can't have free at point of service healthcare unless it is properly funded. A lot of countries including Britains NHS are under the cosh due to ageing population and under investment.

[AussieBob]

On 8/19/2024 at 11:19 PM, ChrisS said:

Can't have free at point of service healthcare unless it is properly funded. A lot of countries including Britains NHS are under the cosh due to ageing population and under investment.

The NHS is under threat because of too much Immigration over the last 3-4 decades.  Same for cost of housing, and many other things too - which is all driven by increasing demand. That demand is because of the ever increasing number of people - Govts love an increase in population to justify their wasted spending and for new programs/changes they want to implement.

[Pinetree]

12 minutes ago, AussieBob said:

The NHS is under threat because of too much Immigration over the last 3-4 decades.  Same for cost of housing, and many other things too - which is all driven by increasing demand. That demand is because of the ever increasing number of people - Govts love an increase in population to justify their wasted spending and for new programs/changes they want to implement.

The UK NHS is ridden with inefficiency and is a bottomless pit for money. Blaming its issues on immigration is to ignore the real issue, it is no longer fit for purpose and is un-fundable. Let's face it, immigration of doctors and nurses from outside of the UK  stops it collapsing altogether.  It was a great idea in 1948 when the majority were poor and in desperate need of government assistance.  With the rapid rise of a wealthier middle class in the last 40 years  It now needs massive reform and restructure and no single government has the courage to tackle it. 

[AussieBob]

33 minutes ago, Pinetree said:

The UK NHS is ridden with inefficiency and is a bottomless pit for money. Blaming its issues on immigration is to ignore the real issue, it is no longer fit for purpose and is un-fundable. Let's face it, immigration of doctors and nurses from outside of the UK  stops it collapsing altogether.  It was a great idea in 1948 when the majority were poor and in desperate need of government assistance.  With the rapid rise of a wealthier middle class in the last 40 years  It now needs massive reform and restructure and no single government has the courage to tackle it. 

I am not ignoring the underlying incompetence and inefficiency of a public hospital system (and the public service overall), but the cause of the problems is not that alone.  The cause is an increase in population and thereby the number of people using the system. The same thing has happened in Australia where increased population has led to an ever increasing burden on the public health system - especially on hospitals. 

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Yes it needs massive reform and restructure, but with politics being what it is, as soon as one side says reform (inevitably conservatives), the other side says fascist nazis.  IMO the easiest and quickest way to reform them both, and the same for the schools system, is to privatise the lot of them in one single stroke. And then ignore all the protestor's claims and arrest those causing public disturbances and any media inflaming the problems. The problem is to keep it quiet before getting elected and then to impose it immediately in power - it will take 2-3 years for it to settle down and work out.

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Only when they are private can the underlying reasons of why they are inefficient and incompetent be fixed. Just like Musk found out at Twitter, when the loony left take over, there is massive wastage - he sacked 70-80% of the staff, and the business and systems did not collapse.  If you sack most of the public service and hospital administrators (not doctors and nurses) and thereby remove all the red tape BS, then the NHS can spend more money on meeting the needs of the public.  Right now all public systems in the west (including hospital systems) are wasting a lot of money on administrators, social workers, gender experts, DEI initiatives, etc etc etc. 

[NonThaiKiwi]

NZ govt are trying to do that right now.  Massive amount of public service workers are being laid off. 

The vast majority are pen pushers. Admin staff and the like.  There are a lot of pissed off people but there was too much fat in the public sector. 

I remember years ago when the govt sold NZ Rail.  Suddenly under private ownership it started to run at a profit. 

Public health is suffering in NZ too.  Not enough doctors and nurses,  they are tired from over work and many are leaving for overseas. Better pay and life balance. Can't say I blame them. 

[Khunmark]

49 minutes ago, AussieBob said:

Only when they are private can the underlying reasons of why they are inefficient and incompetent be fixed.

You obviously weren’t in Australia when the debacle that was the Covid outbreak in private aged care facilities occurred, prompting a royal commission into the industry. Or the scandal of the privatisation of the TAFE sector in education that also triggered an inquiry into the rampant corruption that involved store front classrooms claiming student contact hours from the public purse. Or the private banking industry and their litany of underhanded behaviours to fleece customers out of there hard earned, through dodgy insurance services. Or the private utilities companies that were jacking up usage prices, far and beyond the CPI. And the list goes on and on. Give me the perceived inefficiencies of the public sector over the greed and corruption of the private sector anytime. 
 

The only benefit the private sector has delivered, is to the auditors and lawyers who have increased their presence by adding layer upon layer of compliance to an already bureaucratic system. And this is to the detriment of all stakeholders. As something as important as health, privatisation would be the last thing I’d be hitching my wagon to.

[Pinetree]

3 hours ago, AussieBob said:

The cause is an increase in population and thereby the number of people using the system.

In any business, if demand increases, you expand your business to accommodate it and invest accordingly. But, and its a big but, you also expect a corresponding increase in efficacy and profitability to fund the increase in demand. And this is where the whole idea of a universal health care service, free to everyone , at the point of delivery,  is an unaffordable luxury for any society, more than that, it's a economic nonsense. People should , as a minimum, and as in Ireland,  be paying for GP appointments and food and lodging while in hospital. All medication should be at least partly funded by the patient.  Anyone on benefits gets it all free, others should pay.  Companies and individuals  should be incentivized, through the tax system,  to take out private health cover and leave the NHS to those who really need it.  Stop all IVF, elective plastic surgery and gender surgery on the NHS. Cap the budget at todays figure for 5 years, then inflation minus 1 percent thereafter. All this would be a good start.

Oh one more thing, no free NHS treatment for illegal immigrants,   

[AussieBob]

21 hours ago, Khunmark said:

You obviously weren’t in Australia when the debacle that was the Covid outbreak in private aged care facilities occurred, prompting a royal commission into the industry. Or the scandal of the privatisation of the TAFE sector in education that also triggered an inquiry into the rampant corruption that involved store front classrooms claiming student contact hours from the public purse. Or the private banking industry and their litany of underhanded behaviours to fleece customers out of there hard earned, through dodgy insurance services. Or the private utilities companies that were jacking up usage prices, far and beyond the CPI. And the list goes on and on. Give me the perceived inefficiencies of the public sector over the greed and corruption of the private sector anytime. 
 

The only benefit the private sector has delivered, is to the auditors and lawyers who have increased their presence by adding layer upon layer of compliance to an already bureaucratic system. And this is to the detriment of all stakeholders. As something as important as health, privatisation would be the last thing I’d be hitching my wagon to.

I see I touched that socialist nerve of yours - sorry about that comrade.

All those government enquiries and the outcomes and the great changes made were what?

Lets agree to disagree - I am extremely well versed in Government wastage and inefficiency that leaves the private sector behind by miles. The private sector errors and greed are always media highlighted, but the government wastage and ongoing idiocy runs rampant and is never ending.  

[AussieBob]

19 hours ago, Pinetree said:

In any business, if demand increases, you expand your business to accommodate it and invest accordingly. But, and its a big but, you also expect a corresponding increase in efficacy and profitability to fund the increase in demand. And this is where the whole idea of a universal health care service, free to everyone , at the point of delivery,  is an unaffordable luxury for any society, more than that, it's a economic nonsense. People should , as a minimum, and as in Ireland,  be paying for GP appointments and food and lodging while in hospital. All medication should be at least partly funded by the patient.  Anyone on benefits gets it all free, others should pay.  Companies and individuals  should be incentivized, through the tax system,  to take out private health cover and leave the NHS to those who really need it.  Stop all IVF, elective plastic surgery and gender surgery on the NHS. Cap the budget at todays figure for 5 years, then inflation minus 1 percent thereafter. All this would be a good start.

Oh one more thing, no free NHS treatment for illegal immigrants,   

Could not agree any more - and that is the difference with the public service - they expand and expand and expand - but they are never held accountable. Try to sack a public servant - good luck with that, unless they committed a crime and even then you will have lots of appeals and complaints you did not follow due process. It is no coincidence that 70+% of public servants are women - they love the lack of accountability.  

[Khunmark]

2 hours ago, AussieBob said:

I see I touched that socialist nerve of yours - sorry about that comrade.

Something, something leftist agenda……something, something communist plot. Obsessed much.

2 hours ago, AussieBob said:

All those government enquiries and the outcomes and the great changes made were what?

I’ll give you a clue. It’s in the second paragraph.

 

2 hours ago, AussieBob said:

Let’s agree to disagree - I am extremely well versed in Government wastage and inefficiency that leaves the private sector behind by miles. The private sector errors and greed are always media highlighted, but the government wastage and ongoing idiocy runs rampant and is never ending

Errors now? No mate, flat out fraud. There is no way to spin it. Anyway, keep drinking the Murdoch cool-ade.

The Billionaires club will be satisfied to know that the plebs are buying their narrative.

 

[NonThaiKiwi]

Ouch.. 

[AussieBob]

4 hours ago, Khunmark said:

Something, something leftist agenda……something, something communist plot. Obsessed much.

I’ll give you a clue. It’s in the second paragraph.

Errors now? No mate, flat out fraud. There is no way to spin it. Anyway, keep drinking the Murdoch cool-ade.

The Billionaires club will be satisfied to know that the plebs are buying their narrative.

ROFLOL - unbelievable - did you write that all by yourself?  You need to get far better analysis and thought about the issue of private versus public wastage and corruption - they are light years apart.  Besides all the khrapp in the west - have you seen what is going on here in Thailand?  Do you ever leave that room besides for a bar/girl? Hey - they is AOK by me - but if you want to know what is really going on you need to get out there a lot more, and use better sources for your information. 

Murdoch absolutely su......... ............. - besides being an Aussie he and I have nothing in common.  He absolutely hates Trump with a passion - not my king of guy - he is much more like you in fact. 

[Khunmark]

1 hour ago, AussieBob said:

You need to get far better analysis and thought about the issue of private versus public wastage and corruption

No mate, you need to provide some evidence to support your original assertion;

On 8/21/2024 at 1:07 PM, Khunmark said:

Only when they are private can the underlying reasons of why they are inefficient and incompetent be fixed.

I’ve given plenty of examples where private enterprises has failed to deliver to the public on its mandate. As yet you have provided nothing. So remind me once again why services placed in the hands of private enterprise outperform services provided by the government? But this time provide something of substance, beyond your political ideology.

[AussieBob]

On 8/22/2024 at 7:30 PM, Khunmark said:

No mate, you need to provide some evidence to support your original assertion;

I’ve given plenty of examples where private enterprises has failed to deliver to the public on its mandate. As yet you have provided nothing. So remind me once again why services placed in the hands of private enterprise outperform services provided by the government? But this time provide something of substance, beyond your political ideology.

Yep - right - the Thai public service (like all of them) is a bastion of productivity and efficiency, and it totally not corrupted and full of nepotism and waste.  ROFLOL. 

Do you want legal proof that your sheite smells - or do you know that from experience. Well I call you out and demand you prove that your sheite does not smell absolutely terrible. LOL.  Get real mate. 

[Grumpish]

Margaret Thatcher said about socialism that "eventually it runs out of other peoples' money to spend" - and the same is true of any universal health care system that is allowed to become a bottomless pit. The problem with universal health care systems is that people come to think that it should be for everything, they will turn up at A&E for trivial things like a splinter in their finger, or think that they "have a right" to things that are not a medical threat or very expensive treatments that offer only marginal benefits.

[Khunmark]

7 hours ago, Grumpish said:

Margaret Thatcher said about socialism that "eventually it runs out of other peoples' money to spend" - and the same is true of any universal health care system that is allowed to become a bottomless pit. The problem with universal health care systems is that people come to think that it should be for everything, they will turn up at A&E for trivial things like a splinter in their finger, or think that they "have a right" to things that are not a medical threat or very expensive treatments that offer only marginal benefits.

All true Grumpish, however the private sector is not the panacea that others would have you believe. When given the choice of providing a public good or maximising a share price they will also opt for the latter.

And where health is concerned they are only interested in the profitable components of health where they can skim the cream. The less profitable areas such as complicated surgeries are still the domain of public health.

On 8/24/2024 at 10:31 AM, AussieBob said:

Yep - right - the Thai public service (like all of them) is a bastion of productivity and efficiency, and it totally not corrupted and full of nepotism and waste.  ROFLOL. 

Do you want legal proof that your sheite smells - or do you know that from experience. Well I call you out and demand you prove that your sheite does not smell absolutely terrible. LOL.  Get real mate. 

So, platitudes again I see. A hunch that has no basis in reality. 
 

 

On 8/22/2024 at 7:30 PM, Khunmark said:

Only when they are private can the underlying reasons of why they are inefficient and incompetent be fixed

Once again, like to back up this claim? Facts this time, not vibes.

[AussieBob]

2 hours ago, Khunmark said:

All true Grumpish, however the private sector is not the panacea that others would have you believe. When given the choice of providing a public good or maximising a share price they will also opt for the latter.

And where health is concerned they are only interested in the profitable components of health where they can skim the cream. The less profitable areas such as complicated surgeries are still the domain of public health.

So, platitudes again I see. A hunch that has no basis in reality. 
 

Once again, like to back up this claim? Facts this time, not vibes.

Waste of time talking to someone that demands you provide absolute proof of what you are saying, but never even provides an answer to specific questions, let alone any 'proof'.

Reminds me of a GenZ person. Believes anything that some idiot academic gets published, but refuses to accept common sense as 'proof' of anything. 

[AussieBob]

10 hours ago, Grumpish said:

Margaret Thatcher said about socialism that "eventually it runs out of other peoples' money to spend" - and the same is true of any universal health care system that is allowed to become a bottomless pit. The problem with universal health care systems is that people come to think that it should be for everything, they will turn up at A&E for trivial things like a splinter in their finger, or think that they "have a right" to things that are not a medical threat or very expensive treatments that offer only marginal benefits.

I think it is wrong that everyone has to pay for the future medical expenses of smokers and fat people that eat pizzas and chips and coke all day.  IMO they should be left to die if they dont have the money to pay for all their medical treatments in 20+ years.  As far as I am concerned you should reap what you sow.  Universal (communist) health takes away the advantage of being a healthy person, and actually gives more to those that live an unhealthy life. 

[Guest1]

10 hours ago, AussieBob said:

I think it is wrong that everyone has to pay for the future medical expenses of smokers and fat people that eat pizzas and chips and coke all day.  IMO they should be left to die if they dont have the money to pay for all their medical treatments in 20+ years.  As far as I am concerned you should reap what you sow.  Universal (communist) health takes away the advantage of being a healthy person, and actually gives more to those that live an unhealthy life. 

Dont forget the people riding  motos, bikes, are skating, footballer, boxer, doing P4P without condoms, alcoholics,  ..., ......, ..... ;-)

[NonThaiKiwi]

6 hours ago, Guest1 said:

Dont forget the people riding  motos, bikes, are skating, footballer, boxer, doing P4P without condoms, alcoholics,  ..., ......, ..... ;-)

In fact let's add anyone above ground and still breathing... 

But, I do hear what AB is saying... and in some ways agree.  Too many bludgers living in a welfare state (NZ) come to mind.  Expecting everything to be given to them on a plate. And kick up merry hell if they perceive that they've been hard done by. 

Most have never held down a full time job for long, and live off fast food and obese too hell. 

They have no drive to get a long term job cause welfare will look after them.  It's caused a generational problem and continues to this day. 

I'm a firm believer in user pays unless it's a true accident, unforseen etc. 

Edited August 26 by NonThaiKiwi

[Khunmark]

20 hours ago, AussieBob said:

Waste of time talking to someone that demands you provide absolute proof of what you are saying, but never even provides an answer to specific questions, let alone any 'proof'.

Reminds me of a GenZ person. Believes anything that some idiot academic gets published, but refuses to accept common sense as 'proof' of anything. 

Some light reading for you. And some of these events I have been subjected to;

https://en.wikipedia.org/wiki/Royal_Commission_into_Misconduct_in_the_Banking,_Superannuation_and_Financial_Services_Industry

https://en.wikipedia.org/wiki/2000–2001_California_electricity_crisis

https://www.theguardian.com/australia-news/2023/aug/26/fraudulent-course-providers-face-closure-in-labors-international-education-crackdown

https://reneweconomy.com.au/two-more-retailers-collapse-under-the-weight-of-inflated-coal-and-gas-prices/

https://theconversation.com/for-profit-nursing-homes-are-cutting-corners-on-safety-and-draining-resources-with-financial-shenanigans-especially-at-midsize-chains-that-dodge-public-scrutiny-225045

https://www.catalystproject.net/blogus/the-corruption-within-private-prisons

In summary, the privatisation of public service has seen a spike in malfeasance. Also to note, the less regulatory oversight, the more rapacious their behaviour becomes. And, there is no conclusive evidence to suggest that the usurpation of public institutions by private concerns delivers any economic benefit. The caveat being, if you are a lawyer. But then what do you expect when the sole motive for your existence is share price.

And you prostrate yourself at the altar of these guys.

[Khunmark]

19 hours ago, AussieBob said:

I think it is wrong that everyone has to pay for the future medical expenses of smokers and fat people that eat pizzas and chips and coke all day.  IMO they should be left to die if they dont have the money to pay for all their medical treatments in 20+ years.  As far as I am concerned you should reap what you sow.  Universal (communist) health takes away the advantage of being a healthy person, and actually gives more to those that live an unhealthy life.