Medical bills give govt fever

       The Democrat-led coalition has taken a courageous step in pursuing long-delayed plans to overhaul the medical benefits scheme for civil servants. The decision will certainly prove unpopular. It most likely will be met with strong opposition frommembers of the government's workforce, whose resistance to the initiative derailed the project two years ago.
       The reason that has forced Deputy Prime Minister Korbsak Sabhasavu, who is in charge of national economic affairs, to pick up this potentially hot political potato for consideration again, is more than obvious.The government's financial health is in a precarious condition at present. The long-standing medical cost overrun has, therefore, again become a major and logical target for slashing, in the government's attempt to maintain the state's balance sheet. The past several governments have noted the alarming trend in the state's expenses with regard to the ballooning cost of civil servants' medical welfare. But none dared seriously tackle the problem out of fear that this would stir discontent among the 2.3-million-strong civil workforce - the main work horse which implements state policies.
       It was not until 2007, when the Surayud Chulanont government assumed office, that the problem was raised for serious consideration. This occurred after the 37-billion-baht budget earmarked for civil servants was quickly used up within the first nine months of that fiscal year, forcing the military-installed government to turn to the Treasury's reserves to cover the shortfall.The Comptroller General's Department was then instructed to study guidelines to curb medical expenses incurred by state employees. A ceiling on medical expenses for certain diseases and lists of essential and non-essential medicines were then drawn up, along with tighter control over the reimbursement process for medical expenses for civil servants nationwide.However, that effort to overhaul the welfare collapsed even before the new systemwas put in force the following year. This happened after the Council of State ruled in favour of civil servants' complaints that the Comptroller General had no power to control doctors' dispensing of expensive medicine under the medical welfare system.
       Deputy PM Korbsak has pointed out that uncontrolled expenses plus the unethical exploitation of the medical welfare scheme by some civil servants has caused the state's medical bills to jump from 30 billion baht to 80 billion baht in just four years. This almost equals the state's annual budget for the universal health scheme covering more than 40 million people nationwide.
       In comparison, it is understandable that civil servants earn substantially less than employees at the same job level in private firms. Many people found state employment attractive only because it offered job security and generous welfare which extended to their families.However, civil servants must realise that the government is in no position to carry on footing these astronomical medical bills. Without proper control, the expenditure on civil servants' medical bills could climb beyond 200 billion baht a year within the next decade. This is outrageous and unacceptable.
       Minister Korbsak has suggested that instead of relying on the national budget alone, civil servants should join the government in helping to contribute to a fund to cover their medical welfare. The idea is worth exploring if it will ease the state's financial burden. But first the government will need to get civil servants to accept that they must stop freeloading on the state budget for their medical expenses. Getting civil servants to acquiesce will be a difficult job indeed.