SSO earmarks Bt4.4 bn for complicated cases

With this fund, SSO beneficiaries will no longer have to pay in advance for treatment that exceeds the normal rate, Labour Minister Phadermchai Sasomsap said, adding the budget could be increased in the future if it proves to not be enough.

Hospitals under the SSO contract do not normally transfer complicated cases to specialist hospitals because they do not want to shoulder the costs exceeding the per-head subsidy they are provided with. Hence, many cases end up in needless fatalities or complications due to delays or insufficient treatment.

Under the new scheme, the SSO now also provides coverage for kidney complications and various types of cancer. The new fund, which will in effect be ready for use from January 1, will allow the initial hospital and the specialist institution to directly seek reimbursements from the SSO.

Until next year, the SSO was providing a Bt2,050 per-head subsidy to hospitals under contract. Next year, the subsidy will be paid on a type-of-disease basis and will drop to Bt1,955, which can be broken down to Bt1,446 in general treatment, Bt77 in hospital credential index and Bt432 in risk burden for complications, permanent secretary Somkiat Chayasriwong said.

Under the disease-type criteria, diseases will be classified into 40 scales, or put under three levels entitled to treatment worth Bt15,000 to Bt600,000. The types and names of diseases will soon be made public on www.sso.go.th.

Though Dr Phongsathorn Phork-phermdee, an academic on public health economy, praised the new policy, he questioned whether the new scheme would only benefit contract hospitals rather than beneficiaries, whose contributions were partly used to make up the fund. "The fund mainly benefits the hospitals but not the beneficiaries," he added.

The SSO has done virtually nothing to serve its beneficiaries - the only people who contribute to social security - while those under the gold-card scheme or government officials enjoy better services for nothing, he said.