Medicare for less than a dollar




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Medicare for less than a dollar

By Tom Mintier, CNN.com news
November 5, 2003

It is a program most insurance companies would either love or hate: medical care for less than the cost of a cup of coffee.

As part the system, doctors and nurses make home visits. In Thailand the cost is 30 baht, or less than a dollar, not per month or visit, but a one-time payment.

Television ads tout the program for those who normally cannot afford a visit to the doctor, let alone a hospital.

A Bangkok taxi driver, for instance, tells TV viewers he suffered a hernia and without the program could not afford to be treated.

"Don't quit the program," he says, "it is helping the poor."

There are currently nearly 46 million people signed up for the program, more than two thirds of the Thai population, each with varying abilities to pay for healthcare.

Malee Dokteoy, 41, has heart disease. She is a farm worker who makes less than $4 a day and has no health insurance.

"This is good for the poor. Without it I could not get treatment," she told CNN.

The waiting room at Ban Phaew Hospital is filled each day with the poor seeking treatment. The Thai government currently funds more than 1,000 hospitals at a cost of $1.5 billion a year.

The administrator of the hospital, Dr. Witit Artavatkoon, told CNN despite charging patients less than a dollar the hospital is not losing money.

"Yes, it is enough right now."

Thailand 's Prime Minister Thaksin Shinawatra has said he is proud of the program because poor people can now afford heart surgery where they could not afford it before the plan.

"You can help 18 million people who can have access to their healthcare," Thaksin said.

The 18 million figure represents people with no health insurance or access to medical services in a country where care is already subsidized by the government.

People who work on farms or sell noodles on the street fit into that category.

The 30-baht health plan even includes house calls for medical treatment. In other words, doctors and nurses even visit a patient at home.

Take, for instance, a 41-year-old woman who has been bedridden for more than a year and suffers severe brain damage.

The Ban Phaew Hospital donated the bed and equipment and so far the family has made one payment -- less than a dollar.

Her case is not unusual.

Another patient had a stroke more than a year ago and was hospitalized for more than a month and then sent for home healthcare where a doctor visited everyday. Now the visits are twice a week -- all for 30 baht.

"I think this is risk sharing," Artavatkoon said. "In our community some people have serious illness, so it costs a lot, but some people are healthy."

In Thailand children under 12 and those over 60 receive free medical care. The 30-baht program is for those in between, and for those without the ability to pay.