Thailand urged to review new co-payment health insurance rule
The Thailand Consumer Council (TCC) urged the Office of Insurance Commission (OIC) to reevaluate the new co-payment health insurance rule, calling it unjust for consumers and ineffective in addressing fundamental issues.
Implemented on March 20, the rule requires policyholders to cover up to 50% of medical expenses, replacing the previous comprehensive coverage plan.
Post-Covid-19 pandemic, rising healthcare costs and an increase in unreasonable claims for common ailments have prompted the insurance regulator and companies to take action to control costs.
The co-payment is activated under certain circumstances. If policyholders file three claims for common conditions such as headaches, influenza, diarrhoea, muscle inflammation, stomach acid, or gastroesophageal reflux totalling 200% of the annual insurance premium, they will face co-payment in the following year.
Yesterday, March 23, the TCC criticised the policy for not addressing the root cause of inflated medical costs and shifting the financial burden unfairly onto consumers, particularly affecting vulnerable groups like the elderly.
Monrudee Phoin, the TCC’s Deputy Head of Policy and Innovation, argued the rule would not reduce excessive insurance claims but would instead impose additional financial burdens on consumers.
She highlighted that while the rule aims to discourage unreasonable medical claims, requiring patients to bear up to 50% of medical costs might not be the optimal solution for insurers.
“Without a thorough review, it could have long-term consequences, especially on children and older people who need extra health protection.”
Monrudee mentioned that the TCC and OIC had a meeting on March 20 to discuss these concerns. Although the OIC acknowledges the co-payment policy’s limitations, it maintains that it will control unreasonable claims, which are seen as the core issue, reported Bangkok Post.
Consequently, the TCC is appealing to the OIC to revisit the policy and postpone its enforcement until clear strategies for managing medical costs are in place.
“Healthcare should not be treated as business figures but as a fundamental right for all.”
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