Interview: Gordon Cameron
In what ways can Thailand improve the health care financing structure to cope with rising expenditures and the demands of an ageing society?
GORDON CAMERON: The ageing population has increased demand for health care not only in Thailand, but in many other countries around the world, adding strain to the financing structure. According to the World Bank, the percentage of the Thai population over 65 years old has grown from 5% in 1995 to 11% in 2016, and is projected to reach more than 25% in 2040. This growing age category is driven by a move from high fertility and high infant mortality rates to low fertility and low infant mortality rates.
Reforms have been implemented since the 2000s to reduce the financial burden on the health care system; the sin tax-funded Thai Health Promotion Foundation is one recent example of efforts. We have also noticed a higher uptake of private insurance or co-pay to help balance the costs and reduce the burden on state funds. Improving preventative care and promoting healthy lifestyle practices such as exercise and a good diet is yet another method to hedge future costs.
Where does Thailand stand regionally in terms of medical research and development (R&D)?
CAMERON: The government is promoting the concept of a centre of excellence for clinical trials. The authorities, together with established organisations and research centres, support R&D growth in the pharmaceuticals industry by encouraging clinical studies in compliance with the International Conference on Harmonisation-Good Clinical Practice standards.
Thailand has strong health care infrastructure with over 1000 government and 400 private hospitals, and is considered a leader in medical tourism. Thailand was the first country in Asia to receive the prestigious Joint Commission International accreditation. Teaching hospitals, in particular – such as Sirirat Hospital of Mahidol University, Ramathibodi Hospital of Mahidol University, Srinakharinwirot University and Chiang Mai University – have been driving research collaboration.
Thailand has strong medical expertise, according to opinion leaders and experienced investigators of many regional advisory boards and publications. Conducting more clinical trials in Thailand will help boost the quality of medicine in the broader Asia-Pacific region.
How could the health care innovation ecosystem of companies, research institutes, state agencies and academia be improved?
CAMERON: The government has an ambitious 10-year plan running from 2016 through to 2025 to become Asia’s health care hub. This plan is driven by the digital system eHealth – a strategy in line with Thailand 4.0, an economic model to transform the country into an innovative and digital nation. The strategy includes reducing public health management costs through the efficient administration of care and seamless sharing of medical data. To fully embrace this shift, health care agencies and state regulators like the Food and Drug Administration will need to anticipate the coming technological changes and pass the laws necessary to protect sensitive patient data. In addition, medical professionals and other stakeholders will be required to continually educate themselves on matters such as combining digital literacy with heath care.
The government is already improving the regulatory environment for clinical trials. A good example was when the Thai Clinical Trials Registry joined the International Clinical Trials Registry Platform in August 2013, which has encouraged stronger operating standards and transparency procedures.
In regard to the private sector, we see an increasing number of health care start-ups creating solutions that increase efficiencies in patient management systems. Such innovation can encourage others to build on their success, and ultimately it is the Thai population that will benefit through a healthier and brighter future.
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