In our meeting with Dr. Suwat he taught us about Thailand’s health care system.
First he went over the structure of the system, specifically the four main levels of care. The bottom level is the primary health care level. At this level the government provides health to the local people through village hospitals. If a Thai person had a cold or a flu they would come here for basic treatment. The next level up is the primary level and here we find community health centers for a larger population size. If the situation is more serious, such as giving birth, the patient will come here. The second level is secondary care where we find the general hospitals. These are for the more serious injuries and accidents. Problems that cannot be treated at the primary level. Our top level is tertiary care which includes the regional/ university hospitals. These are the last resort for treatment including difficult surgeries and other serious medical tasks. By having this structure of health service systems it decreases the costs of health care. Patients who need to be seen for a mild problem, such as a cold can be treated locally instead of at the major hospitals with the well-trained doctors.
Dr. Suwat also discussed with us the current health care statistics:
- Since 2002, 80% of Thailand’s health care has been provided by the government.
- The other 10-20% is covered by private health care.
- Only 4% of Thailand’s GDP goes to health care unlike the United States who spends 16% of our GDP on health care.
- In order to receive health care Thai people must be registered. In the villages by the border there are 200,000 hill tribe people who are not able to receive health care because they are not registered citizens of Thailand.
Following this discussion on health care we were curious about the situation of doctors and we found out the following information:
Tuition for medical school is the same price as it is for other schools because the government helps cover the higher costs.
However, because the government helps cover the costs after medical students graduate they must work for the government for 3 years, usually in a rural setting. Salaries are the same as many other professors but they get packages to compensate which include benefits like free health insurance for the private practices, having their children’s education paid for, and so forth. To increase their salaries, many doctors open up a private practice at night. However, since this can only be effective in the cities and not the rural areas, making working in the city more desirable, the government offers higher salaries for doctors in rural areas. The typical age of retirement is 60 although professors work until they are 65. From 60+ doctors receive 70-80% of their last earned salary each month until they pass away.