New well being advantages, transplants on the best way

The National Health Security Office (NHSO) is set to approve payment for 11 selected health promotion, prevention and rehabilitation services.

This will be on top of the regular percapita universal healthcare budget paid.

The NHSO’s subcommittee overseeing the on-top healthcare budget allocation just finished shortlisting 11 out of 88 healthcare services, Phithakphon Bunyamalik, assistant permanent secretary for public health minister said Sunday.

However, the NHSO needed to conduct economic feasibility studies of the selected services. The studies are expected to be complete this year.

Of the 11 services, three are services in the category of health promotion and prevention and the other eight services in the category of health rehabilitation, said Dr Phithakphon, who also a member of the subcommittee. The 11 services shortlisted are: Liver transplant for patients with laterand end-stage of liver scarring (cirrhosis); laparoscopy — an operation performed in the abdomen or pelvis through small incisions with the aid of a camera for obese patients with diabetes; replacement of the aortic heart valve with a mechanical heart valve for the elderly; renal replacement therapies; and cochlear implants costing no more than 850,000 baht.

Others are plasmapheresis (the removal, treatment, and return or exchange of blood plasma or components thereof ); laboratory tests using a molecular assay technique to screen for drug-resistant tuberculosis; treatment of obstructive sleep apnea using a continuous positive airway pressure (CPAP) machine; HIV Pre-exposure prophylaxis (PrEP) — a way for people who do not have HIV but who are at substantial risk of getting it to prevent infection by taking a pill every day; physical skill training and rehabilitation for disabled people; and liver fluke screening.

The NHSO has allocated on-top budgets to hospitals under the healthcare scheme since October. Among treatments receiving a windfall under such payments are treatments for colon cancer, the third deadliest illness in Thailand. The on-top payment policy is based on the benefit gain. Colon cancer is treatable and affects a lot of patients, so it is cost-effective to spend tax money for on-top payments.

Colon cancer is commonly found to affect people aged between 50 and 70, he said, adding the NHSO finds it worth investing in funding the screening test of people with risk factors including a family history of this type of cancer. He said if the disease is detected in its early stages, chances of survival after proper treatment are high. The NHSO has been responsible for determining types and scope of the health care benefits under the universal health coverage scheme. Initiated by Thaksin Shinawatra’s government around 15 years ago, the project has been lauded by international communities as a model for healthcare service.

The NHSO hopes on-top payments will improve public access to necessary health care services. However, some of the on-top payments also draw criticism, mostly for economic viability reasons. A case at point is the budget given to patients with final stage kidney disease who wish to do their own kidney dialysis at home through socalled continuous ambulatory peritoneal dialysis (CAPD).

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