Minister Witthaya: Good morning. Interviewer: Could you explain the prime minister’s policies regarding these three funds? Minister Witthaya: The core issue is that the prime minister wants to equalize coverage from these three funds. The Ministry of Public Health, which takes care of coverage for normal citizens, has coordinated with the Ministry of Labor, which takes care of the social security fund, and the Ministry of Finance, which deals with coverage for government officials. Now, people with life-threatening emergencies can go to the closest hospital and receive treatment by simply showing their ID card; they do not have to fill out a form to see what fund they belong to. The prime minister thought that was not enough, and extended coverage when it came to major illnesses that affected a large number of citizens, such as AIDS and kidney diseases. So for these major illnesses, the coverage between all three funds has been equalized. Interviewer: So does that mean for these three funds, people suffering from AIDS and kidney diseases will receive the exact same treatment? Minister Witthaya: They receive the same standard of treatment, yes. Interviewer: Since the inception of the same standard for life-threatening illnesses on April 1, what is the progress on information exchange between the three funds? It’s my understanding that there has to be some sort of information exchange. Minister Witthaya: As I said before, people with life-threatening injuries or illnesses can now go to any hospital and receive treatment. This has already been implemented. The next step is more tricky; after the treatment, where do we refer their case? What we’ve talked about is to identify which fund they belong to and then refer them to hospitals that deal with patients from that fund. We’re working on streamlining this system. For example, some hospitals may require payment before the treatment, but under this new system, people under coverage from the three funds are able to receive treatment, then pay afterwards. If it’s within thirty days, the clearinghouse has no problem with it. Another issue we’re looking at is expediting claims so patients can receive full and comprehensive health care. Interviewer: How about AIDS patients? As far as I know, there are 148,357 AIDS patients covered under the fund for every day citizens. How do you manage the system so that one of the funds is not weighed down by such a big share of patients? Minister Witthaya: Well the first thing you should know is that AIDS medication is now very effective. Secondly, it’s important that people who have just been diagnosed be treated very comprehensively. Thirdly, measures preventing people from contracting AIDS in the first place are very important; as such, the prime minister has charged an agency with working to distribute information about the disease. I will be the liaison between the agency and the Ministry of Public Health. Interviewer: So I see you’ve been taking a two-pronged approach: treating those already affected and also trying to prevent people from contracting the disease in the first place. Minister Witthaya: Exactly. The prime minister has said that we should treat people under these three funds equally, so they can receive quality medication and extend their lives. And as important or even more important are the preventive measures; the prime minister has placed much importance on making sure these measures are as effective as possible. Interviewer: When you say that these three funds receive equal treatment, do you mean that they have the same guidelines, approaches, or what? Minister Witthaya: The establishment of the same rules. The meetings of our meetings with the prime minister is to approach this in the right way and to find the most efficient way to care for Thai citizens, no matter what coverage you are under. That is the prime minister’s hope. Interviewer: So the purpose is for people to not feel that just because they’re not government officials, they don’t receive lesser care, correct? Because beforehand, people thought that coverage under the government officials fund was the best, followed by social security, then followed by the fund for everyday people. But the truth is that the standards have been equalized. Minister Witthaya: A few seconds before, we talked about HIV/AIDS. Now let’s talk about kidney diseases. There has been an increase in patients suffering from kidney diseases, because of diabetes, blood pressure, etc. Treatments from kidney filtration to medication take a lot of time and a lot of money; we are committed to providing the best health care for our citizens but the problem right now is that we cannot pay the entire cost of treatment. The patient will have to pitch in. Interviewer: Another is continuous care. Let’s pretend I’m an office worker with social security, but then I get laid off for some reason. And what if I have an illness, such as a kidney disease. What happens to my continuous care? Minister Witthaya: You are going to have to switch coverage correct? Our responsibility is to make sure that the transition is as smooth as possible. Interviewer: So there has to be information exchange between the funds, correct? But I’m not just talking about kidney disease. How about other diseases that need regular medication? If I have to switch coverage, will my medication stay the same or will I have to switch medications? Minister Witthaya: Okay, about medication. I’m the president of the Committee of Medicine, and we don’t only deal with the quality of medicine. We also deal with the price of medicine and negotiations regarding the purchase of medicine; if the medicine is expensive, all three funds will buy it (as to lower the cost). The point is this: if you are on one set of medication and need to switch coverage, you will be able to still stay on that medication. HIV, for example; we can create a standard where you get the same medication under all three funds. This will save a lot of money too. This means that hospitals won’t have to stock up on as much medicine as they once had to; the medicine agency can take care of it. In the future, the medicine agency will be the producer of medicine, determine the type of medicine or negotiate the price. They will have the ability to compare the quality and price of different medicines since they are a government agency. This is a better alternative to the government having to subsidize the medicine bought by the hospitals at a very expensive cost. Interviewer: And the quality of medicine won’t decrease at all? If I’m covered under the government officials plan, will this switch decrease the quality of my medicine? Minister Witthaya: No, not at all. The prime minister has told us to make sure the quality of medicine stays the same, since this is one of people’s biggest concerns. The committee will make sure that the quality of the medicine does not suffer as a consequence of this transition. Interviewer: How about shopping for medicine? Minister Witthaya: There’s no more shopping for medicine; if they receive regular care, we have a database that will take care of all of this. So there will be no problem of “shopping” for medicine. There will also no longer be a problem with citizens taking low-quality medicine or medicine that is not appropriate for them. There’s actually an exchange program in place where citizens can exchange old medicine that they don’t use anymore for newer medicine that is better suited to their illnesses. This decreases cost for the citizen and for the government. Interviewer: I see. So citizens can bring the medicine that they don’t use, or medicine that’s left over, and bring it to the hospital to exchange. A lot of people are concerned that the reason the government is equalizing coverage under all three funds is because you want to decrease the budget spent on health policy. Minister Witthaya: Yes, the cost decreases. But I can tell you that the quality of care has not lessened. Interviewer: So you’re decreasing the costs that can be decreased, but the quality does not suffer. Minister Witthaya: Correct. You have to realize that the government spends 370 billion baht annually on medicine. Of course, health care is of utmost quality, but why would we spend more than we need to? There is some over-priced medicine, and we can decrease our cost simply by using medicine that’s less expensive but just as effective. We can use the money we save by spending it on other treatments or better appliances or better-trained doctors. That is a better way to manage our money. It’s smarter. Interviewer: Will the “30 Baht” program come back? Minister Witthaya: The committee has agreed on the program, but we need to make it clearer to the Thai people what the program means. The program is set up so that if you just want to consult the doctor, you can do so for free. Interviewer: If I just want to get checked up, maybe I feel like I have a cold but I’m unsure, can I use the program? Minister Witthaya: If you walk in and just get checked up, you won’t have to pay. If you need medicine, however, you’re going to have to take on the 30 baht cost. We’re also expanding coverage geographically; for example, if you’re a worker who moved from Khon Kaen to Bangkok, you’ll be able to enroll in the program in Bangkok too. This wasn’t previously the case. Interviewer: How about cancer? Minister Witthaya: We’re currently in talks about it with the three funds. This will be a long-term issue. Interviewer: Other than HIV/AIDS and kidney diseases, are you going to cover any other illnesses? Minister Witthaya: Regarding this issue, we’re going to have to focus on ensuring quality. To make sure that people receive the same quality of treatments in every hospital. Interviewer: What’s the public response to the improved emergency care? Minister Witthaya: The reception has been good; they feel that the government understands the need for better emergency care. We have installed systems such as Telemedicine, used to deliver online medical advice. We’re using it in over a thousand places now. In this future, this system will become more prevalent; your house will be able to serve as a hospital room with a camera system and online connection. Interviewer: So you’re using technology in order to make health care more accessible. Minister Witthaya: In the present, we’ve used this system for diseases such as high blood pressure and diabetes. Doctors can consult patients who are thirty or forty kilometers away through Skype. Interviewer: What are the reviews of this new technology? Minister Witthaya: For people with mild problems with high blood pressure and diabetes, I think this is ideal. It’s more convenient for them for the doctor to be able to consult with them long-distance. Interviewer: But actual check-ups need to happen face to face. Minister Witthaya: Correct. But we’ve discovered that forty out of a hundred patients have high blood pressure or diabetes. These diseases aren’t life-threatening in the short-term and require regular consultation, and the technology is ideal in these situations. If the illnesses develop into more life-threatening ones, that’s when the face-to-face checkups need to happen. Interviewer: So, to summarize: the government is committed to looking after the health of its Thai citizens, no matter what health plan you fall under. I would like to thank the Minister for his time. Minister Witthaya: You’re welcome; thank you for having me. Interviewer: Ladies and gentlemen, no matter what health plan you fall under, the government’s policy is to equalize your treatments. From patients suffering from HIV to those with kidney diseases, you will be able to receive high-quality, standardized treatment. The prime minister is also committed to bettering preventive care. We’re going to take a short break, and we’ll be right back. |