MAIDS, Faculty of Political Science of Chulalongkorn University
The global pandemic of COVID-19 started around December 2019, and this major public health crisis has a huge negative impact on countries’ economies and societies around the world. For example, public health threats, economic depression, rising poverty, and social instability have exacerbated new social conflicts and de-globalization. Although the pandemic situation in the Southeast Asian region has been gradually under control by launching some measures such as border closure or travel ban, it is also important to rethink the role of the public healthcare system to manage major public health crises after the COVID-19 pandemic.
Based on the concept of the Washington consensus, the state encouraged the privatization and liberalized market economy, which may contribute to the prosperity of the national economy and promote innovation. Adams Smith also described the market as the “invisible hand” in his book “Wealth of Nations”. Some ASEAN countries’ authorities have promoted the privatization and marketization of national healthcare sectors, which has improved mechanisms for increased efficiency and quality of health services, and meet the diverse needs of patients. On the other hand, countries have also realized the limitations of healthcare industry privatization in solving the public health crisis faced with the COVID-19 pandemic, especially the medical and health industry is facing the problem of market failure (Ghosh, 2008). Privatized healthcare systems may improve efficiency or growth in the short-run, but reduce countries’ long-term preparedness for dealing with pandemics (Jacob & Cecilia, 2020).
In the case of Thailand, Thailand’s healthcare ranked sixth-best in the world (Bangkok Post, 2019). Almost 1,400 hospitals and medical facilities in Thailand, 378 are private hospitals, and more than 60 are accredited by the Joint Commission International (Bangkok Post, 2020). Through privatization and marketization to improve the quality level of medical services, and increase medical practice revenue. However, although private hospitals provide first-class medical facilities and services, the medical cost is also high for the local citizens. After the spread of the COVID-19 virus in Thailand, the local public health departments mainly send confirmed patients to public hospitals for treatment at low cost or free. At the same time, compared with the cost of virus testing, the average cost of public hospitals is also lower than private hospitals (Thaienquirer, 2020). The World Health Organization (WHO) and the Ministry of Public Health of Thailand highlight some of the factors that have allowed Thailand to successfully control COVID-19, including strong leadership that responds to the best scientific evidence, and a strong underlying public health system. For example, Thailand’s Universal Healthcare Coverage (UHC) is one of the low-cost healthcare systems which are mainly implemented in public hospitals. Universal Healthcare Coverage (UHC) does not only protect people from expensive health expenditure, and also enables Thailand to mobilize health finance in response to health crises, and provide essential health services and interventions to control COVID-19 effectively (NHSO, n.d.).
Generally, public hospitals are responsible for providing public healthcare services and public medical welfare. In the face of large-scale infectious diseases, the local public departments can integrate medical resources through macro-control, coordination, and intervention to better control the virus. It is important to encourage the public healthcare sector to continue and increase its efforts to safeguard the welfare of underprivileged and low-income beneficiary populations while pursuing a privatization policy (Russo, 1994). Although private hospitals take an important role in promoting the development of the national healthcare industry and medical tourism economy. It is undeniable that public hospitals are playing an irreplaceable role in coping with the public health crisis, and provide the basic needs of healthcare services to the general public. Meanwhile, the public healthcare system is also a guarantee to ensure most citizens can enjoy the equal “Right to Health”. For local authorities, it is also necessary to rethink how to balance the relationship between public and private health systems, to achieve long-term strategic and inclusive development for the future.
Bangkok Post. (2019). Thailand’s healthcare ranked sixth best in the world. Available at: https://www.bangkokpost.com/thailand/general/1746289/thailands-healthcare-ranked-sixth-best-in-the-world#:~:text=Bangkok%20Post%20photo
Bangkok Post. (2020). Thailand Races Ahead as Global Healthcare Hub. Available at: https://www.bangkokpost.com/business/1882145/thailand-races-ahead-as-global-healthcare-hub
Ghosh, B. N. (2008). “Rich doctors and poor patients: Market failure and health care systems in developing countries”. Journal of Contemporary Asia. https://doi.org/10.1080/00472330701546525
Jacob Assa & Cecilia Calderon. (2020). “Privatization and Pandemic: A Cross-Country Analysis of COVID-19 Rates and Health-Care Financing Structures”. New School for Social Research, Department of Economics. http://dx.doi.org/10.13140/RG.2.2.19140.65929
National Health Security Office (NHSO). (n.d.). Secretary-General of Thailand’s National Health Security Office (NHSO). Available at: http://eng.nhso.go.th/view/1/Secretary-General/EN-US
Russo, G. (1994). The Role of the Private Sector in Health Services: Lessons for ASEAN. ASEAN Economic Bulletin, 11(2), 190-211. Retrieved December 15, 2020, from http://www.jstor.org/stable/25770540
Thaienquirer. (2020). Thailand’s private hospitals are charging a fortune to test for Covid; no it’s not profiteering, it’s much worse. Available at: https://www.thaienquirer.com/9572/thailands-private-hospitals-are-charging-a-fortune-to-test-for-covid-no-its-not-profiteering-its-much-worse/
World Health Organization (WHO). (2020). The Ministry of Public Health and the World Health Organization Review Thailand’s COVID-19 Response. Available at: https://www.who.int/thailand/news/detail/14-10-2020-Thailand-IAR-COVID19