Welfare blues as scheme proves a slog

As the Social Security Office (SSO) is proposing a plan for salaried workers and their employers to pay more to its scheme by raising the contribution cap of 750 baht a month to 1,000 baht, I thought it was time for me to claim the benefits that I have rarely used.

A few days ago, I tried the service at a private hospital. I didn’t expect convenient, custom-made treatment. Nor did I expect to be treated as a third-class customer. Well, I got the latter reception. It made me feel like I was a destitute patient, or something close to that status.

I have contributed to the social security scheme for years but rarely bothered to use the service, thanks to a separate medical insurance package my employer provides.

Last week, I had to pay for my first rabies vaccination shot out of my own pocket at an “international” private hospital in Nonthaburi, where (I thought) I was also registered under the scheme.

After realising that the vaccinations are now covered by the scheme, I needed to make sure I wouldn’t have to pay for the follow-up shots so I called the hospital to make some inquiries.

But I was informed that those people who, like me, use the social security service can only seek treatment at a designated hospital. This has an almost identical name to the one I had visited — just drop the word “international” — and was just a few minutes’ drive away.

That baffled me at first, until I realised I had got the two mixed up when I selected this hospital several months earlier.

The front building of the one I had (erroneously) picked is considerably smaller than its “international” cousin but it looked decent enough inside with only a few patients waiting to be seen.

However, to my dismay, the receptionist informed me I had again arrived at the wrong place, as this was only for “paying” customers, and that I must proceed to the rear end of the building.

When I finally arrived at the right place it was like entering a different world: The reception room was cramped and it took about an hour simply to register as there were 40 people ahead of me.

I then spent another hour waiting to chat with a doctor for just two minutes or so. The whole experience left me tired, frustrated and more than a little peeved.

Obviously, the venue was badly understaffed. Nurses were running around frantically and I only spotted a few doctors. Other patients confirmed that they, too, had suffered unduly long waits just to pick up their medicine. One woman told me the social security service is always like that there. She said it sometimes requires a whole day of waiting just to see a doctor.

In contrast, it took just 15 minutes to administer that initial shot at the international hospital.

Numerous private hospitals participating in the scheme have introduced a similar system that separates those using the social security scheme from their regular services. Many people have complained online about the poor state of the service.

But the service doesn’t need to be this bad, especially if the participating private hospitals integrated it with their regular services. That would give all patients access to the same pools of doctors, nurses, receptionists and pharmacists. The process could be faster and everyone could have access to the same quality doctors and medicine.

In previous years, participating hospitals have cried foul over what they claimed were insufficient contributions from the SSO, despite the fact that a large share of those who are insured privately have never used the service. Their complaints prompted the SSO to increase its annual contribution for each hospital from 1,460 baht a head last year to 1,500 baht.

This spells good news for hospitals. For example, reports say 45% of the revenue at Ladprao General Hospital comes from social security service contributions from 160,000 people who registered there — the highest proportion among private hospitals.

Expecting an increase in the number of insured, the hospital said it has plans for further business investment to cater to that.

At other hospitals, revenue from the scheme is known to account for between 22-40%.

There is no good reason for these hospitals to introduce such a class-based system, especially when that scheme benefits them financially.

The social security scheme is a safety net for many low-income earners. They should not be treated as secondor third-class citizens, whatever the circumstances.