Voice of the People in the Thai National Health Security y (Insurance) System

Orajitt Bumrungskulswat Director, Bureau of Public & Private Participation, NHSO

1. People movements to sponsor the National  Health Security (Insurance) Bill lh i ( ) ill • In In 2001, 12 civil society organizations campaigned and  2001, 12 civil society organizations campaigned and succeeded in collecting 52,772 signatures of Thai  citizen to sponsor the National Health Security Bill to citizen to sponsor the National Health Security Bill to  the parliament. This is according to the 1997 People’s  constitution. It is the first Bill under this clause. constitution. It is the first Bill under this clause. • After the parliament considered and accept the Bill in  the first reading a Parliamentary Commission was set the first reading, a Parliamentary Commission was set  up with 5 representatives from the civil society to  consider and revise the Bill consider and revise the Bill. • 11 Nov.2002,  enactment of the National Health  S Security Act. it A t

2. Voice in the governing bodies  of the UHC •5 5 representatives each from NGOs t ti hf NGO and  d local govt. are members in the Governing Board and Quality Board and also members  g g in their subcommittees including Regional  and Provincial Sub Boards, as well as  community health development funds community health development funds. • Provincial Independent Complaint Centers  were established and operated by civil  y g society organization

People Participation Mechanisms in                National Health Insurance System National level

Regional level

Health Secur. Board Quality Qua ty Co Contr. t Board oa d

Sub Committee

Region. HS Subcomm. Provincial HS Subcomm.

Provincial level

Provinc. Q Qual. Contr. Subcomm.

Compensat. Subcomm. L Local l level l l

People HS Coordination and complaint Center

Comm. Health Fund Comm.

People (PP, Provider, Consumer, local autho.)

Voice of the People in NHSS through 1. General Opinions of Providers and Beneficiaries  p in Annual Meeting of the Board. (section 18(13) 2 Consumer Protection channel (call center 1330) 2. Consumer Protection channel (call center 1330) 3. Independent Complaint Center in accordance  with NHS Act Section 50(5) with NHS Act Section 50(5)  4. Preliminary Assistance for Patients and Service  P id (N F l C Providers (No Fault Compensation) (section 41) i )( i 41) 5. Friendship Support Center: Patient   Participation in the Healthcare System

1. The ‘1330’ call center Services Provided Complaints about quality of services 3,175 (0.56%)

569,164 complaints

Complaints about management in general 4 337 (0 4,337 (0.76%) 76%)

Inquiries 558 528 (98.13%) 558,528 (98 13%) Complaints about patient refer 3 124 (0.55%) 3,124 (0 55%)

As of June 2011

2 Independent Complaint Centers 2. • Section 50(5) stipulates that a complaint unit that is  S ti 50(5) ti l t th t l i t it th t i

independent from the accused be established as a center  to protect rights (now 42 centers) to protect rights. (now 42 centers)   • Have to disseminate information and knowledge  to  foster the people’ss understanding of their rights and the  foster the people understanding of their rights and the channels for accessing those rights independently.   • The Standard and Quality Control Board declared the  The Standard and Quality Control Board declared the criteria for registration of Independent Complaint Centers  on 19 February 2009 and develop training curricula to on 19 February 2009 and develop training curricula to  train the center’s staffs.

Implementation Progress p g 1. Explanation 1 Explanation, foster understanding: Section 57,59 82 cases (61%)

Total Complaints 135 cases (100%) 41 centers

2.Submit case to Consideration S b Sub-committee: itt S Section ti 41 12 cases (8.8%)

3. Submit case to Quality Control Sub-committee

7 cases ( 5.1%)

4.Provide other assistance 34 cases ( 25.1%)

As of June 2011

3. Preliminary Assistance for Customers and  Service Providers (No Fault Compensation) • Section 41 required that the NHS Committee earmark  no more than 1 percent of the fund for preliminary  monetary assistance to service recipients. t it t i i i t • This is manage as the No Fault  Compensation  fund.  Th The patient has only to prove that there have been  ti t h l t th t th h b negative implications from receiving health services.  There is no need to prove who is wrong There is no need to prove who is wrong. • The Standard and Quality Control Board will make the  final decision in providing the no fault compensation  final decision in providing the no fault compensation within the determined rate or refusing the appeal.

Implementation Progress ฿90,000,000.00 ฿80,000,000.00 ฿70,000,000.00 ฿60 000 000 00 ฿60,000,000.00 ฿50,000,000.00 ฿40,000,000.00 ฿30,000,000.00 ฿20,000,000.00 , , ฿10,000,000.00 ฿0.00 2004 2005 2006 2007 2008 2009 2010 2011 Customer Provider 800 700 600 no fault liability y in chapter41 p and provider protection 500 of National health security act 400 2002 300 200 100 0

Rate of no fault comp. - Death or permanent disability y no more than 200,000 baht or US$ 6,350 - Loss of organ or handicapped no more than 120 000 baht 120,000 b ht or US$ 3,810 3 810 - Injury or chronic illness no more than 50,000 baht or US$ 1,587 1 587

2004 2005 2006 2007 2008 2009 2010 2011 Customer

Provider 10

4. Friendship Support Center: Patient 

P ti i ti i th H lth Participation in the Healthcare System S t • NHSO has coordinated and supported the  creation of networks and volunteer  communities of patients who have received  high cost treatment since 2003 high cost treatment since 2003.  • Emphasis on enabling healthcare centers  providing care for chronic patients to provide  f h space and to establish and continuously  develop a system of active patient volunteers  and care providers. and care providers

High Cost Chronic Patient Network            in Health Security System in Health Security System   Heart Patient Network

Diabetic Patient Network

Cancer Patient Network

เครือข่ายผูป้ ่ วยโรคไต

Renal Patient Network เครือข่ายผูป้ ่ วยโรคไต ไ

Disability Network

AIDs Patient Network

เครอขายผู ครือข่ายผ้ป่ วยโรค วยโรคเอดส อดส์

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Implementation Progress  p g as

of September 2011

• 253 healthcare centers have participated in implementing  Friendship Support Center activities and provided Friendship Support Center activities and provided  opportunities for networks of patients / communities to  p participate.  p • Result to the development of the service system where  patients and service recipients participated in providing  humanized healthcare services leading to the tangible creation  and implementation of the “Friendship Support Center”. 

Satisfaction of UC People and Providers

f from 2003 2003-2009 2009

percent 100 90

83.0

83.4

82.3

84.0

83.1

88.3

89.3

80 70 60 50

45.6

40

47.7

56.5

50.9

60.3 50.7

39.3

30 20 10 0 ปี2003 2546

ปี2004 2547

ปี2005 2548

people

ปี2006 2549

ปี2007 2550

ปี2008 2551

provider

Souce: ABAC poll, Assumtion University

ปี2009 2552

Conclusion • The The Universal Coverage Healthcare System has  Universal Coverage Healthcare System has emphasized the importance of protecting the rights  to participation of the people healthcare recipients to participation of the people, healthcare recipients  and patients,  • To receiving no fault compensation and to provide  T i i f lt ti dt id humanized healthcare with the objective of  achieving a healthcare system that responds to the  hi i h lth t th t d t th needs of the people and patients • And to improve their quality of life both physically  and mentally.

Thank you for your attention

www.nhso.go.th

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