Ethics and the Drafting of the "National Health Insurance Bill"
SUKHIT PHAOSA VASDI, M.D.*, SURASAK TANEEPANICHSKUL, M.D.*, YUEN TANNIRANDORN, M.D.*, AURCHART KARNJANAPITAK, M.D.*, PINIT KULLAVANUAYA, M.D.**
Affiliation : * Member of Thai Medical Association ** President of The Royal College of Physicians of Thailand
Ethics and the drafting of the National Health Insurance Bill are related and have points to
ponder as follow.
In general Jaws are passed to solve problems and to cater for the need of society. There
fore before a law is passed it has to be drafted and to pass through the Lower House and Upper
House of parliament. Most laws come from policies of the government, for example, the ministry of
public health wants to improve the way to look after the health of the people so they draft a law,
in this case a law on National Health Insurance for the nation and ask one person or a group of peo
ple, or Committee to scrutinize it, and then submit it to the Office of the Council of State to look at
before passing it to the cabinet to approve before passing it to the parliament.
So it can be seen that in passing a law there are many steps or processes that the draft bill
must be closely looked at so that when passed, society will abide by this law strictly for the benefit
and peaceful existence of society.
But the drafting of the law on National Health Insurance of the nation which has passed the
third stage and is being examined by the Upper House at the moment, is being widely critizised daily
in all kind of media and from every angle. At the moment it looks as if, if passed, this law will cause
problems for society more than before because:
1) It is a law with good principle as it supports everyone to have efficient health insurance
according to standard and this raises everyone expectation.
2) It is a law concerning everyone as it involves their health. It involves the behaviors
of a person, group of people, institutions, and actions to reach standard of medical professions and
others directly. It has many details, is complex, and involves so many people who all have different
ideas.
3) Regarding the quality of standard in public health there are 3 points
3.1) To outline the quality according to standard.
3.2) To develop services in public health to reach the quality of standard that was set.
3.3) Auditing and punishment.
4) In principle it is agreed that the institutions giving services can be public or private but
the law is being drafted by the government so it is very clear that this lacks ethics in not being fair
to the private sector.
5) The Thai Medical Association, which has been in existence for longer than 80 years,
would like to say that the Association has been neglected, was not allowed or asked to express
ideas, thoughts, on the drafting of this important law at all eventhough we are NGO consisting of
doctors from the whole country.
So it can be seen that this problem has arisen from a little point in that those involved in
drafting the law has overlooked ethics, moral points, and were without conscience about fairness.
This might be a factor hindering a potential good law with much benefits to society in becoming a
law, and is thus a very great pity.
Keywords : Ethics, National Health Insurance Bill
