Thailand launches $1 health scheme

Long-term illnesses like Aids are expensive to treat

By BBC Bangkok correspondent Simon Ingram

Hospitals across Thailand are expecting a busy day as a scheme offering cheap universal health care begins operation.

The scheme fulfils one of the campaign pledges made by the Prime Minister, Thaksin Shinawatra, who was elected to office in January.

Trial period has revealed problems with the scheme

The project - aimed at the poor, and those not receiving private health care - entitles patients to visit a doctor for less than $1 per visit.

But many doubts remain about what services the scheme can provide, and whether the country is able to afford it.

Cut-price, universal health care was one of the key electoral promises that helped Mr Shinawatra to a landslide victory at the polls last January.

Millions of low-income people - especially in the rural provinces - were wooed by the idea that a visit to the doctor would, in future, cost no more than 30 Thai Baht - the equivalent of about $0.67.

Teething problems

The scheme has already been on trial in various parts of the country and ministers have declared their satisfaction.

Cut-price health-care promise helped PM to landslide election victory

But the trial period has revealed numerous teething problems, not to mention the deeper financial frailties of an idea that owed much to political expediency.

In order to qualify, prospective beneficiaries have to obtain a special gold card from their local medical authority - a process which can prove laborious.

But the real complaints have occurred at the hospitals chosen to provide the service. While many mundane ailments have no doubt been satisfactorily dealt with, critics say patients with more severe health conditions tend to find that 30 Baht doesn't go very far.

Full costs

Newspapers report people with tumours being told they must pay the full cost of treatment.

People suffering from long-term illnesses like HIV-Aids say they receive poor service, or are excluded from the scheme altogether.

The basic flaw seems to be that not enough government money has been allocated to make the scheme truly universal. And with the Thai economy in the doldrums, there is little prospect of extra funding being found in the foreseeable future.