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There will be the link to the article https://www.latimes.com/business/story/2019-09-23/overseas-healthcare-costs
Please read and discuss.(10 marks)———————–Due Date 24 Feb 2020 ———————-
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The universal health coverage program is a good project that creates equity for people in the country to access and received fundamental health care services. Under UHC we left no one behind, unlike the health care system in some countries that people have to pay on their own or by their insurance company.
Thailand is one of the country that runs the universal health coverage for a long time and I think now we are ranking in the best 20 health care system in the world. Under the UHC, more people can access to medical treatment more people have better health literacy in disease prevention when compare to the previous system.
Unlike in the US, the health care service is paid by the patient or their insurance company. And most of health care services run as a private business, the business has to create their profit. It is not surprising to me that the cost of medical treatment in the USA is very expensive.
On the other hand, in the country with UHC, such as in Thailand, the cost of health care services is cheaper than in the US but met the same US standard. One of the reasons is the medication cost is cheaper because we can negotiate the drug prices by volume of purchase and we can use the drug at the lower prices by in-country made generic drug that more than 10 folds cheaper than original drugs. Another factor is, treatment cost in Thailand does not reflect the real cost because doctor’s and nursing charges in public organization is paid by a government that lower than the cost in private organization.
I agree that treatment in the US is better than in other countries. But, I don’t think that the US health care system is the best. The health care system in the US is paid by patients themselves and the cost of treatment is not an affordable price for most people. Even they have insurance coverage, they might need to pay as a co-payment. As we live longer, someday, a bigger proportion of US residence may don’t want to go to seek medical treatment because they don’t have enough money to pay for it.
In comparing the cost of health care services between countries, I don’t think that we can directly compare the cost only by how much we paid, we should also think of the difference in cost of living index too. -
I agree with K.TULLAYA, Cost of living index in the US is higher than another country. Health insurance for American citizens pay any costs for the elderly and the disabled. The government has a health insurance program that covers medical cost and medicines for up to 80%.There is also a health insurance program for the poor population, including health insurance programs for children with low-income families, but many American citizens cannot the health insurance and pay all health insurance costs by yourself. Example of Workplace health insurance only covers the same treatment cost and medication cost that worker to pay most of the pay it that impacted for the group of unemployment about is losing access to Health Insurance. I think, Health Insurance is necessary in the US because Healthcare is very high cost because of high costing that the Resulting in more expensive Health Insurance too.
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In the insurance industry, we have so much pain for medical expense in the US. Most travel insurance plan worldwide, coverage in the USA are excluded unless paying more insurance premium. I have experienced some cases in the US, where I think horrible. An example of a hemorrhagic stroke in California cost 400,000 USD which our company could pay the only ¼ of the cost, left the rest for the patient, compared to a case in the UK with the same condition and treatment, cost only 9,000 USD. The case in the UK, the patient, even was prescribed a one-week stay for an occupational therapy course which already charged in the packages while in the US did not. Recently we have a case of a car accident on a highway in San Francisco, our customer who was in the accident was repatriated with an air ambulance following by a ground ambulance to a hospital a less than 10 miles away. Only the air ambulance cost 55,000 USD. Even only with mild external injuries, the total expense cost almost 20,000 USD. Unlike the US, New Zealand has a no-fault scheme which the government covers all car accident regardless of coverage from private insurance.
In the US, due to the unreasonable cost and complex billing, we hire a cost containment company to negotiate with hospitals and its provider. The company could make the billing amount dropped to 90%. In many cases, out-of-pocket payment upon counter can give patient up to 50% discount too. The US, compared to other OECD countries, has the highest healthcare spending and more than a half are from the private sector while the rest mostly less than 10%. I think, apart from financial risk management hospital has to do as a result of the previous unpaid bill which often made the patient a bankruptcy, there has much to do with medical malpractice lawsuit in the states. At the emergency department, guidelines and protocols require numbers of lab test, imaging procedure and specialist; even the condition is just a common, to make sure “thoroughly checked” of any abnormal. Another case from our customer, for example, was a 6,000 USD for a common cold at the emergency department in New York. For me, besides implementing the affordable, what the US has to do to reduce the spending is lowering of administrative cost which made up to around 30% of the expenditure.
I think what made the US’s system unique and expensive, while the overall outcome is not going with the spending is the politico-economic system of the nations, the free market. There is no cost control mechanism for the healthcare industry the same as other. The patient can’t check and compare the cost of an elective procedure. The price will be told only when the treatment is done and are already liable to pay. Pharmaceutical and medical technology company can sell drugs and medical equipment with any price they want. Badly enough, competing of prices seemed does not work due to increasing of merging and acquisition of hospitals network, the pharmaceutical company, medical equipment and supplies and health insurance. For sure, physician fee in the states is high, and often numbers of specialist assigned for ED and admission. The higher physician fee and salary are relatively due to medical education cost in the states. The education loan is another trouble and cause of healthcare spending. Like Khun Tullaya said above, the most expensive system does not mean best-improved health outcome and system. There are so many factors involved.
For me, there are options of systems worldwide; concepts of UHC is not only a public-funded single-payer like the UK. It can be a private payer like in the Netherlands where citizens are mandated to buy private insurance at a low price, regulated by the government. In Thailand, lucky enough that UHC has been implemented. I, myself as a worker in private sector can have peace of mind that if I got a condition what my employer’s private insurance does not cover, I could seek coverage from my social security scheme which is a system of the UHC. The most concerns for me is, besides financing of the system especially UCS, shortages of healthcare worker are a big issue. The government should do more work to produce more healthcare professions especially general practitioner and nurse. Comparing to our region, physician per patient is still in critical with only less than 1/1,000. Most importantly, private’s hospital attracting of the healthcare worker. The government should think more about inequality and disparity in healthcare in our country. An example is in Canada, where healthcare is not allowed by law to be a product of luxury and privileges. Almost of general practices in the country are regulated to work for public hospitals. For Thailand, the workload in the network hospital is another factor that makes well-trained healthcare worker leaves the system or even leaves the healthcare sector, and country while importing of healthcare workers is not a good option.
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Universal Health Coverage (UHC) is medical insurance supported by Thailand’s state welfare. UHC does not only lessen the out-of-pocket expenditure but also improve preventive health care. However, this welfare burden the health care workers from the outrageous visits.
UHC profit the country reducing the medical expense because of several reasons. Firstly, the government can regulate the pharmaceutical provider having the essential medicine at a reasonable price. Secondly, hospitals funded by the government claim the insurance in the standard price thus the doctors would investigate only in need, not throughout the body. Thirdly, Hospital accreditation mandates the hospital to give a standard service to all patients. The citizen could trust the public hospitals and do not worry about their service charge, hence they will access to health care earlier when they face the abnormal symptoms. Health care providers then could restore the patients in time and regularly.
On the other hand, UHC is also a two-edged sword. Charge-free service persuades the patients with self-limited illness to the hospital unlimitedly. This situation burdens the health care providers and reduces treatment resources for serious illness patients. Modest capital gain in this UHC country could not attract the researchers to innovate the novel medicine or instrument like in the United States. Hence we could rarely see the new innovation for health care in Thailand.
To conclude, State medical welfare is beneficial for their citizen throughout the country, yet the number of patients with self-limited illness ought to be reduced. Also, the government should raise the incentive for innovation development. -
The UHC in discrete countries is different due to many factors including social, political and economics.
In Thailand, UHC covering more than 99% of the population is regulated by public organizations. Before UHC implementation, people seldom receive the treatment in the public hospital according to high health expenses. Therefore, health in the general population did not meet the world standard. After implementation, people can easily receive healthcare services from public hospitals without additional spending. They only pay for taxes or social security to afford these services. The three organizations (CSMBS, SSS, UCS) will directly allocate financial support to hospitals. Lowering health expenses and improving health in Thailand’s population are the major benefits of UHC. In contrast, it increases healthcare providers and hospital financial burdens. To solve these problems, the government should increase the healthcare workforce and its incentives, appropriately allocate financial support and improving health prevention more than health treatment.
In other countries such as the US, health insurance providers are the main health coverage system. Due to the high cost of medical insurances, low-income people cannot afford it and maybe bankrupt. Only high-income people can afford these treatments. Equity in healthcare services is the main issue to discuss in the US healthcare system. The US government cannot regulate medical pricing due to its capitalism. In addition, increasing healthcare prosecution from malpractice make HCP to do the best practice in healthcare for preventing these problems, resulting in the most expensive medical care countries. So, there are different problems of UHC in different settings to suitably resolve according to their social and economic environment.
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The article is about US health care system and compares to other countries’ health care system.
A 2014 study by the private American foundation The Commonwealth Fund found that although the U.S. health care system is the most expensive in the world, it ranks last on most dimensions of performance when compared with Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. The study found that the United States failed to achieve better outcomes than other countries and is last or near last in terms of access, efficiency and equity.
In our country, UHC become hot topic recently and MOH creating strategic plan to get UHC but sill long way to go. Former government announced that every citizen should get free medical services without proper planning and provided free health care to all citizen in public hospitals with no planning, rules and regulation. And current government is trying to fix it because it will crack down the system unless fix timely. There are still few insurance providers public or private. We are still using our own money for our health although some companies provide reimbursement for health care to certain amount.
When it come to health care, all our intention is to get proper medical treatment to everyone regardless patient’s condition. Equal services to entire population. Depending on the political, economical and law, health care can be affordable or expensive. As mentioned via Chanapong
there are different problems of UHC in different settings to suitably resolve according to their social and economic environment. -
Universal Health Coverage (UHC) is medical insurance supported by Thailand government.
More people can access to health care and have better health treatment in disease prevention with a standard health service. In rural area people have opportunity to care and treatment without a lot of money. But on the other side, No charge service for patient make huge workload for health care providers and reduces quality treatment. And people are not interested in maintaining their health.
Universal Health Coverage is beneficial for thai people in thailand, all thai people equal access to care in hospital or health care center. Patients have to get to know how to take care of yourself more than goto hospital with UHC. Unlike in the American. Health insurance for American citizens pay more costs for treatment to care. Health care system service in American country is business and very expensive. -
If we compare healthcare prices between the US and Thailand, it can be said that they are completely different.
The United States is mostly capitalistic that is an economic system based on private ownership. Medical price regulation mostly also depends on private sectors. Therefore some people may think better health services reflect how much they able to pay. whoever cannot afford it, they do not deserve it. It is a fact in a capitalist society. In Thailand, because of different settings, most Thai people can’t afford to pay for healthcare prices. The government can set the price and develop policy allows people to have more chances to receive healthcare services. Thailand UHC covers around 99% of the whole population, and for the rest, the government always try finds the way to help them. As a consequence of this, we cannot determine which country has the best healthcare system (price/service) because I believe that each country has its proper system fit to their social, political and economics. -
In my opinion, the Universal Health Coverage of Thailand and the health care system in the USA are different but it makes sense.
For US citizens, they have to pay for the healthcare service as much as they can afford it, which means the quality of health service will depend on how much they pay for.
But for Thai citizens with UHC programs which the government announced which services are included in the program and which services are not included. For the quality of the medical services, I heard some of the services or some of the medicines cannot use in this program while other programs like Social Security Scheme or Government Or State Enterprise Officer are covered more. But it makes sense because UHC has to cover all of the Thai citizens and a lot of money has to spend per year. -
WHO defines that Universal health coverage (UHC) is a vision of all people obtaining quality health services without suffering financial hardship. UHC means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
Only 58 countries (30.41%) have achieved UHC which involves three coverage dimensions – health services, finance, and population. It is defined as the legislation that provides for universal health insurance and > 90% coverage for skill birth attendance and prepayment health insurance that assures the service coverage with legal guarantees.
From the article “If you want to save money on healthcare, get sick in some other country “. The implementation of UHC in different settings. Many countries, however, remain challenged by financial constraints, increasing citizen demands, political obstacles, the surge in non-communicable diseases on top of the unfinished agenda of infectious, maternal, and child deaths, and by the complexity of moving towards UHC. Like US and South Korea. WHO has identified that poor government stewardship, governance and health delivery system are the main challenges in developing countries. Then Thailand and South Korea are in this scope. In USA, the cost of living index and healthcare in the US is higher than another country. I agree with Khun Chanapong that there are different problems of UHC in different settings to suitably resolve according to their social and economic environment.
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UHC is a too-good-to-be-true project, that may be challenging to implement in some countries. I think I relies on socialism, rather than capitalism; so it depends on how socialistic the government is.
Hard to say about the state of US government, but it does depend on state’s infrastructure.
Although the success also depends on lack of corruption, somehow Thailand made it through.
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