30 baht anybody???

[Flashermac]

THE NATION

25 March 2006

 

 

BT30 SCHEME: Debt woes piling up for Siriraj

 

Hospital blames under-funded plan

 

 

Siriraj Hospital, the country's oldest medical school, is struggling with the spiralling number of high-cost patients who are entitled to treatment under the government's healthcare plan and are blamed for the hospital's Bt500 million debts.

 

"The situation in other university hospitals is no different," said Prof Piyasakol Sakolsataya-dorn, dean of the faculty of medicine.

 

"At every monthly meeting the financial impact [of the Bt30 scheme] is the main topic."

 

Over the past few years the number of patients referred to Siriraj under the Bt30 scheme has risen from less than 30 per cent to more than half this year, said the dean.

 

He said the hospital is being paid far below the cost of treatment due to the "impractical" regulations of payment imposed by the scheme.

 

Caesarean sections, carried out to the hospital's standards, require a team of gynaecologists, nurses and an anaesthetist, however, Piyasakol said Siriraj was paid at the same rate as a community hospital that did not even have a gynaecologist.

 

Siriraj's debts have risen from about Bt300 million three years ago to Bt500 million, in correlation with the rise in Bt30 patients, he said.

 

"We all know the scheme has insufficient investment," said Piyasakol. "And the government and the National Health Security Office need to face the reality."

 

University hospitals have to find extra income to fill the hole caused by the healthcare scheme and Siriraj relies largely on donations and payments for superior treatment by wealthier patients.

 

Piyasakol said the government's payment to the hospital was about 20 per cent of overall expenditure.

 

Due to its limited beds, Ramathibodi Hospital, in collaboration with Phyathai, a nearby private hospital, offers well-heeled patients beds at Phyathai while receiving care from Ramathibodi's medics.

 

"What can we do? We cannot reject patients. The patients sent to us all have serious and complicated conditions and are expensive to treat," said Piyasakol.

 

Despite saying the universities can still handle the situation, he conceded he did not know how long these hospitals could stay afloat.

 

University hospitals were geese that lay golden eggs, he said and were expected to produce the finest medical results, but this was being thrown into peril.

 

Last month, Thammasat University medical school said it would leave the Bt30 scheme and only receive cases referred from other hospitals. The hospital was running a deficit of about Bt105 million accumulated through providing treatment to patients under the Bt30 scheme.