A network of civil society organizations has filed petitions with the National Health Security Office (NHSO) and the Bhumjaithai Party over budget restrictions preventing people outside the Universal Health-Care Coverage scheme from accessing some healthcare services.

Representatives of civil society organizations gathering at Bhumjaithai Party headquarters (Photo by Workers' Union)

Just before the New Year, the NHSO announced its 2023 National Health Security Budget Plan. Due to questions raised by legal advisors for Public Health Minister Anutin Charnvirakul, the plan allows that only budget allocated to health promotion and disease prevention can be used to provide services for those covered by the Universal Health-Care Coverage, or “Gold Card.”.

On Thursday (9 March), representatives of civil society organizations submitted an open letter, signed by 130 organizations, to the NHSO and the Bhumjaithai Party, which is led by Anutin, calling for them to resolve the issue before parliament is dissolved or expires, and reimburse both public and private medical facilities for services they have been providing by covering the costs themselves.

The letter states that the budget restriction affects at least 20 million people across the country who will no longer be able to access health promotion and disease prevention services, including HIV testing and prevention, birth control, abortion, and pre-natal care. Long-term care funding will also be affected, as the NHSO will no longer be able to provide the 6000 baht per month they have been paying caregivers of bed-bound patients if the patient is not covered by the Universal Coverage scheme. The budget restriction will also cut funding to the Community Health Fund, which has been funding health promotion projects run by local governments.

Children whose parents are covered by government employee benefits will no longer be able to be vaccinated, while the reduced budget may mean that there is not enough vaccine for every child and public hospitals in remote areas may not be able to purchase their own vaccine as they may not be able to cover the cost.

Protest signs seen at the gathering at Bhumjaithai Party headquarters calling for the return of equal access to healthcare (Photo by Workers' Union)

The letter raises the concern that, if the Public Health Minister continues to refuse to approve budget to cover healthcare for those outside of the Universal Coverage scheme, a large group of people will be prevented from accessing the healthcare they are entitled to, and that if every Thai citizen is not able to access the same health promotion and disease prevention services equally, the country may face a healthcare crisis in the near future.

It also notes that although the National Health Commission has filed a request with the Cabinet for permission to fund healthcare services for everyone, Anutin has not brought the Commission’s proposal to the Cabinet throughout January and February 2023. The Ministry of Public Health has also not informed the NHSO of the result of its discussion with the Office of the Council of State on the legal aspects of the issue. Meanwhile, the NHSO has had discussions with the Comptroller General’s Department, the Department responsible for government employee benefits, and the Social Security Fund, to issue decrees allowing the NHSO to provide health promotion and prevention services to people covered by these healthcare schemes.

The network calls on the Ministry of Public Health, the NHSO, and other relevant agencies to quickly resolve the issue before parliament is dissolved, including by announcing decrees allowing the NHSO to provide health promotion and disease prevention services to people outside of the Universal Health-Care Coverage.

The Ministry of Public Health and the NHSO must also commit to reimbursing medical facilities for services they have already provided, which the network said now amounts to several million baht.

The network also calls for political parties to have a clear policy guaranteeing that every Thai citizen will have equal access to all healthcare services.

The letter said that in addition to medical treatment, health promotion and disease prevention is a health benefit funded by taxpayer’s money. It is therefore the government’s job to provide these services to everyone equally. It also said that the network will support MP candidates and political parties who care about people’s health and living conditions.

“Depriving the people of the right to health that they are already entitled to is unacceptable,” says the letter, “and will lead to the people using their fundamental right by not supporting anyone who disrespects the people to get the chance to enter parliament.”