Yesterday one of our readers wrote (in relation to my appalling lack of intellectual rigor!):

The most objective and fact-based analysis of any of Mr. Thaksin’s programs that I’ve seen was a British Medical Journal report about the inevitable insolvency of the 30-B health care program – an outcome entirely predictable based on health financing trials in a wide variety of countries.

I have tracked down the article and provide it here for New Mandala readers:


The conclusion is interesting:

The Thai policy is a bold reform driven by top level political imperatives and incorporating many innovative features. However, the approach has carried with it many problematic side effects, including driving major reforms in healthcare delivery through changing financing mechanisms. A continued emphasis on monitoring, evaluation, and research will be vital in fine tuning the reforms. Major revisions may need to be considered if the policy is to survive. These include allowing greater patient choice, providing greater opportunity for private sector participation and competition in urban areas, strengthening further the rural district health system with adequate clinical staff, protecting key national functions such as teaching and research, and expanding the sources of finance beyond general taxation.