On the other hand, the full welfare state, as found in many European countries whose social nets are based on the principles of egalitarianism, has caused exceedingly high tax rates, which consequently weaken the overall economic efficiency of these countries. Heavy taxes on capital gains in these states tends to undermine the efforts of entrepreneurs and others who work hard. At the same time, the unemployed are indolent about finding new jobs as their needs are generously supplied by the state. In the same way, full libertarianism can lead to the neglect of some groups such as the disabled, the disadvantaged or the destitute, who cannot easily access the health care system.
Consequently, a blend of these two approaches is considered the best approach even though choosing the correct blend of the various characteristics of each ideology is an art requiring careful consideration and skilled application.
It is argued here that across-the-board 30-baht-per-visit type of equality will result in long-term fiscal burdens and even greater inequity in Thailand’s health care system. It will only exacerbate the differences between social classes and between those with differing degrees of illness.
It is necessary to take a closer look at how this new health care system would work in terms of affecting taxes and enhancing equity. This is divided into two segments: firstly, a consideration of who should pay their own medical costs, and secondly, a consideration of who should be partially responsible for medical fees.
For the purposes of this article a distinction is made between the terms ‘poverty line’ (the income level that is just enough to avoid inadequate subsistence living) and, ‘survival line’ (the income level which is the poverty line plus the average annual per capita medical fees, with adjustments for inflation).
Consequently, a blend of these two approaches is considered the best approach even though choosing the correct blend of the various characteristics of each ideology is an art requiring careful consideration and skilled application.
It is argued here that across-the-board 30-baht-per-visit type of equality will result in long-term fiscal burdens and even greater inequity in Thailand’s health care system. It will only exacerbate the differences between social classes and between those with differing degrees of illness.
It is necessary to take a closer look at how this new health care system would work in terms of affecting taxes and enhancing equity. This is divided into two segments: firstly, a consideration of who should pay their own medical costs, and secondly, a consideration of who should be partially responsible for medical fees.
For the purposes of this article a distinction is made between the terms ‘poverty line’ (the income level that is just enough to avoid inadequate subsistence living) and, ‘survival line’ (the income level which is the poverty line plus the average annual per capita medical fees, with adjustments for inflation).
Professor Dr Kriengsak Chareonwongsak
Executive Director, Institute of Future Studies for Development (IFD)
kriengsak@kriengsak.com, http://www.ifd.or.th
Executive Director, Institute of Future Studies for Development (IFD)
kriengsak@kriengsak.com, http://www.ifd.or.th
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