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NHSO’s 19th anniversaries: Answer people’s healthcare needs
November 19 marks the 19th year anniversaries of the National Health Security Office (NHSO), the governmental agency operating the Universal Coverage Scheme (UCS).
As the NHSO's long-term staff, I recalled the early days when our organization was newly born with few people but with a lot of hope in changing the face of the Thai health system.
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Today the NHSO is an established organization covering healthcare for over 49 million Thais. We have initiated many health programs, including free high-cost treatment for kidney disease and cancer, that save lives and improve the livelihood of patients and their families.
Our organization has grown with increasing staff and implemented programs over the past decade. But one thing that has never changed is our principle to assure healthcare access and prevent household catastrophic health expenditure for all Thais.
This will still be our principle in the next coming decades. However, past achievements do not guarantee future performance. We have many challenges lying ahead, and gaps need to be filled for the sustainability of UCS.
Health Intervention and Technology Assessment Program (HITAP), our long-term partner, comes up with many factors that are and will be the NHSO's challenges.
These include the rising cost of health staff and medicines, aging population, digital health disruption, quality of primary care, emerging diseases, and climate change. These factors will add more complexity to the health system and require us to initiate new benefits packages and health interventions.
In addition, some health services are moving into virtual space due to digital acceleration during the COVID-19 pandemic.
Though this is considered positive progress, there will be a challenge for service providers and the NHSO to maintain strong relationships with patients or beneficiaries for successful treatment, behavioral changes, and health intervention programs.
To succeed in the following decades, we can't navigate the organization in the same old way in the winds of change.
In the past, and still today, many health organizations were run based on a health perspective alone, focusing on hospital-based health intervention.
It does not work the same way nowadays when the general public's and patients' needs are more complex. We must integrate multi-disciplinary approaches, especially behavioral science, that allow us to understand their needs and respond to them fast.
For example, while running UCS, we found that many beneficiaries need a fast track to health services to save their time. Meanwhile, they also have a goodwill for society and demand healthcare for all. The Thai government has responded by funding healthcare schemes for every Thai that end up with hospital crowding and increasing waiting time.
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NHSO has learned this particular need and introduced new programs such as medicine home delivery, one-day surgery service, and home chemotherapy which would be impossible in the past because patients and doctors preferred hospital-based services.
People also adopt technology fast and do not always prefer expensive choices. We learned this while running a home isolation program for COVID-19 patients who prefer isolation at home than hotels.
Initially, we assumed they would prefer hotel isolation because it seems to be a more comfortable place (with food and medicine available at the facilities) despite costing six times of home isolation. Instead, patients feel more comfortable at home.
This finding led us to plan to introduce home therapy programs in the future. Home-based healthcare will help reduce hospital crowding in return.
These are just a few examples that convince us to change the way we work and be a proactive and adaptive organization that invents health programs to answer people's needs.
Looking forward, the NHSO aims to achieve 100% coverage of the targeted population. Currently, we cover healthcare for 99% of Thai people uncovered by the other two government's healthcare schemes, namely Social Security Scheme and Civil Servant Medical Benefits Scheme.
Even 1% we count as it aligns with our principle. Regarding health service coverage, we aim to expand the coverage to high-cost services such as rare diseases and genetic disorders, and effective low-cost interventions such as homecare and community-based primary care.
The selection of coverage area comes from our beneficiaries and partners, whose voices are heard through the series of public hearing, participatory meetings and focus group discussions.
Their ideas help us understand their behaviors and update us on their needs. We will always engage all stakeholders in UCS, and push ourselves beyond our limit to develop more innovative solutions for the scheme's beneficiaries.
The 19th year anniversaries of NHSO are the beginning of another new chapter, full of fresh idea and endless thought on bettering people's health and well-being.
As the NHSO's long-term staff, I recalled the early days when our organization was newly born with few people but with a lot of hope in changing the face of the Thai health system.
Today the NHSO is an established organization covering healthcare for over 49 million Thais. We have initiated many health programs, including free high-cost treatment for kidney disease and cancer, that save lives and improve the livelihood of patients and their families.
Our organization has grown with increasing staff and implemented programs over the past decade. But one thing that has never changed is our principle to assure healthcare access and prevent household catastrophic health expenditure for all Thais.
This will still be our principle in the next coming decades. However, past achievements do not guarantee future performance. We have many challenges lying ahead, and gaps need to be filled for the sustainability of UCS.
Health Intervention and Technology Assessment Program (HITAP), our long-term partner, comes up with many factors that are and will be the NHSO's challenges.
These include the rising cost of health staff and medicines, aging population, digital health disruption, quality of primary care, emerging diseases, and climate change. These factors will add more complexity to the health system and require us to initiate new benefits packages and health interventions.
In addition, some health services are moving into virtual space due to digital acceleration during the COVID-19 pandemic.
Though this is considered positive progress, there will be a challenge for service providers and the NHSO to maintain strong relationships with patients or beneficiaries for successful treatment, behavioral changes, and health intervention programs.
To succeed in the following decades, we can't navigate the organization in the same old way in the winds of change.
In the past, and still today, many health organizations were run based on a health perspective alone, focusing on hospital-based health intervention.
It does not work the same way nowadays when the general public's and patients' needs are more complex. We must integrate multi-disciplinary approaches, especially behavioral science, that allow us to understand their needs and respond to them fast.
For example, while running UCS, we found that many beneficiaries need a fast track to health services to save their time. Meanwhile, they also have a goodwill for society and demand healthcare for all. The Thai government has responded by funding healthcare schemes for every Thai that end up with hospital crowding and increasing waiting time.
NHSO has learned this particular need and introduced new programs such as medicine home delivery, one-day surgery service, and home chemotherapy which would be impossible in the past because patients and doctors preferred hospital-based services.
People also adopt technology fast and do not always prefer expensive choices. We learned this while running a home isolation program for COVID-19 patients who prefer isolation at home than hotels.
Initially, we assumed they would prefer hotel isolation because it seems to be a more comfortable place (with food and medicine available at the facilities) despite costing six times of home isolation. Instead, patients feel more comfortable at home.
This finding led us to plan to introduce home therapy programs in the future. Home-based healthcare will help reduce hospital crowding in return.
These are just a few examples that convince us to change the way we work and be a proactive and adaptive organization that invents health programs to answer people's needs.
Looking forward, the NHSO aims to achieve 100% coverage of the targeted population. Currently, we cover healthcare for 99% of Thai people uncovered by the other two government's healthcare schemes, namely Social Security Scheme and Civil Servant Medical Benefits Scheme.
Even 1% we count as it aligns with our principle. Regarding health service coverage, we aim to expand the coverage to high-cost services such as rare diseases and genetic disorders, and effective low-cost interventions such as homecare and community-based primary care.
The selection of coverage area comes from our beneficiaries and partners, whose voices are heard through the series of public hearing, participatory meetings and focus group discussions.
Their ideas help us understand their behaviors and update us on their needs. We will always engage all stakeholders in UCS, and push ourselves beyond our limit to develop more innovative solutions for the scheme's beneficiaries.
The 19th year anniversaries of NHSO are the beginning of another new chapter, full of fresh idea and endless thought on bettering people's health and well-being.
