The Thailand Consumer Council (TCC) has called on the Office of Insurance Commission (OIC) to reconsider the controversial co-payment health insurance rule, arguing it is unfair to consumers and fails to address the root of the problem.
The rule, which took effect last Thursday, sees policyholders pay up to 50% of medical expenses, unlike the all-inclusive plan it has replaced.
After the fallout from the Covid-19 pandemic, increasing healthcare costs and cases of policyholders making unreasonable claims for common illnesses led the insurance regulator and insurers to move to curb rising costs.
The co-payment will be triggered by specific conditions. If policyholders make three claims for common medical conditions such as a headache, influenza, diarrhoea, muscle inflammation, stomach acid or gastroesophageal reflux, amounting to 200% of the annual insurance premium, they become subject to co-payment the following year.
The TCC on Sunday decried the rule as failing to tackle the underlying issue of inflated medical prices and unfairly shifting the financial burden onto consumers, especially vulnerable groups such as the elderly.
TCC deputy head of policy and innovation, Monrudee Phoin, insisted the rule would not tackle excessive insurance claims. Instead, it would pile financial burden on consumers.
Although the rule is meant to curb unreasonable medical claims, forcing patients to share medical expenses at up to 50% might not be the right approach for insurers, she noted.
"Without a thorough review, it could have long-term consequences, especially on children and older people who need extra health protection," Ms Monrudee noted.
She said the TCC and the OIC met last Thursday to discuss the concern. The OIC acknowledges the limitations of the co-payment policy but argues it will curb unreasonable claims, which is says are the real problem.
As a result, the TCC is urging the OIC to reconsider the policy and delay its implementation until clear guidelines on keeping medical costs under control are established.
"Healthcare should not be treated as business figures but as a fundamental right for all," Ms Monrudee said.
