We Need Our Doctors More Than Ever
A recent research shows that over half of the babies born in advanced countries today will live to be 100 years old. Healthy behavior and improvements in diagnosis and treatment of illnesses are the main factors contributing to increased longevity. This is a continuation of past trends, resulting in a higher proportion of senior citizens in the general population, not only in advanced countries but also in middle-income countries such as Thailand. While more Thai children will have opportunities to know their great- grandparents, having relatively more and more senior citizens will significantly impact resource allocations as health care will demand an ever-increasing share.
Health-care issues are highly complex and finding satisfactory solutions is exceedingly difficult as the ongoing debate on the US health-care reform clearly shows. Thailand will face even more serious problems due not only to having much less resources but also to other issues. Recent campaigns by populist politicians have engendered a strong belief among Thais that everyone has a moral right to needed care and the government will pay for it if they do not wish to. Such belief has induced a behavioral change: Thais no longer hesitate to visit state hospitals when they feel minor aches and pains as such visits are free. As a result, state hospitals are overcrowded and health personnel overworked. We need our doctors to tell the politicians that populist policies have adversely impacted their ability to deliver quality care to those who really need it.
With general conditions in state hospitals becoming more intolerable, those who can afford it choose expensive private hospitals. As a result, the health-care system has made differences between the rich and the poor ever more glaring and thus unintentionally contributes to social tensions. Instead of jumping at the first opportunity to work in private hospitals where they can earn perhaps ten times as much, our doctors need to resist that temptation and to tell the politicians that the current system will reinforce factors that are pushing our country towards a social breakdown.
Demands for advanced diagnosis and treatment increase as new machines become available. Such machines are expensive and need to be imported. They are also costly to use. In stead of just being delighted to have opportunities to use those machines, our doctors need to tell the general public that we as a society cannot afford to pay for the costs of treating every sick person that uses those machines. Even in the much richer US, affordability is the leading constraint and not everyone has access to the most advanced treatment. Data also indicate that a substantial portion of health-care expenditures occurs during the patient’s last year when heroic efforts for a cure are the most costly but often compound the suffering. For these reasons, we need our doctors to openly discuss with the patients and their families while they are still in the position to do so the most proper procedures to end treatment when cure is no longer possible.
Recent reports indicate that while our needs keep increasing, our limited resources are made unnecessarily more constraining by corrupt politicians who continue to siphon off state funds allocated for the health sector. It is, therefore, heartening to see that the association of rural doctors is trying to expose those who are attempting to personally benefit from recent purchases of equipment and construction of health facilities. We know that our doctors are capable of delivering not only good health care but also corrupt politicians to jail as one former health minister is still serving time for corruption. We need our doctors to do more of that.
Our doctors already have a lot to do. However, I still believe more of them can do more along the lines I have suggested. After all, they come from the most intelligent and most educated segment of our society.
Sawai Boonma
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