Professor Dr. Kriengsak Chareonwongsak Egalitarianism,

Egalitarianism, however, places a heavier emphasis on enforced and measured equity for every person in every thing. Paramount in this ideology is impartiality on every front: equal opportunity, access, public welfare, prices and services for all. This philosophy often partially rejects the idea of market mechanisms because of market failure as the market is regarded as a possibly faulty apparatus for disbursing public benefit. Proponents of egalitarianism view a free marketplace as biased because it allows some players to gain a greater share of power or profit-generating information than others.
Which of these two ideals should Thailand pursue as it seeks to bring greater equity into its health care system? Is the 30 baht per visit scheme the best way to assure equity in our health care system?
In fact, equity should be created by mixing the two appropriately in the Thai context. One example of a libertarianism model may be found in the strongly market-oriented health care system in Singapore. In that country, individuals make their own choices of health care based on the many available services throughout the country, in both the private and public sectors, motivated in part by financial constraints as well. However, provision of subsidised health care is made for the financially poor but, such health care is confined to certain wards in government hospitals and outpatient clinics.

 Professor Dr. Kriengsak Chareonwongsak

Executive Director, Institute of Future Studies for Development

kriengsak@kriengsak.com, http://www.ifd.or.th

Kriengsak Chareonwongsak Self-reliance is a healthy thing

Professor Dr Kriengsak Chareonwongsak
Executive Director, Institute of Future Studies for Development (IFD)
kriengsak@kriengsak.com, http://www.ifd.or.th

This article was first published in the Bangkok Post on March 4, 2001 After the Thai Rak Thai Party had formed a coalition government and had announced the 30- baht per visit health care policy, actual implementation of the program has always encountered problems. These problems have included, the medical services provided do not cover all diseases, the level of service and medicine given to patients is unsatisfactory, and inadequate budgets are given to hospitals that take part in the program. In addition, there is the further problem incurred when  transferring patients from small hospitals to larger hospitals.  

Philosophies of social equity are usually into two streams: libertarianism and egalitarianism. Libertarians see no need to guarantee individual equity for everyone. Instead, they seek to establish minimum standards and then give individuals the freedom to make their own decisions for standards above the minimum. The libertarian view on the other hand, often places a heavier focus on freedom of choice rather than on ensuring equality in exact numerical proportions. In such a system, efficient market mechanisms are held to be necessary for the establishment of equity.