Attempt to rein in out-of-control
medical expenses
of civil servants in Thailand
By Jon Fernquest 
Taking
back what has already
been given
is always more difficult than not
giving it in the first place. For example, when squatters occupy the land next to railway lines, it will be next to impossible for the railway to relocate them when it comes time to expand the tracks (Read article about Cambodia's problem)
In recent years the medical expenses of civil servants and their families have skyrocketed.
Now the government is trying to cut back on these expenses.
In the private sector medical expenses are paid largely by medical insurance with regular payments by employer and employee and a limited set of medical expenses covered.
In contrast, for civil servants medical expenses are taken directly out of the government budget every year and apparently there is no reasonable limit to the medical expenses that civil servants can claim.
Entitlement programmes and balancing the budget
Governments around the world have spent large sums recently in fiscal stimulus to jump start the world economy and pull it out of a global economic slump.Large budget deficits have been common.
During a recession tax receipts are down and government spending is up.
This means that the government runs a budget deficit and must borrow funds to cover it.
Both the increased government spending and budget deficit can only be a temporary measure to get the economy back on its feet again.
Eventually the government must reduce spending and the most logical place to do this is future spending in entitlement programmes such as Social Security and medical insurance. With greying populations around the world this is where the savings are to be found (Read article by IMF Chief Economist Olivier Blanchard and watch Economist video interview).
Today's article follows the vocabulary:
rein in - reduce
and control
out-of-control - cannot control (cannot make it do what you want it to do)
civil servants - government workers
skyrocketed - increased suddenly by large amount
not giving in the first place - not giving in the past (should not have given)
squatters - people who live on land they do not own without permission
will be next to impossible - will be almost impossible to do (very difficult)
relocate - move to another location (to live)
when it comes time to Y - when it is the right time to do project or task Y
cut back on expenses - reduce expenses
apparently Y - it appears to be Y
no reasonable limit -
claim expenses - ask to be paid back for money that you paid (for medical treatment)
a budget deficit, run a budget deficit - when receipts are less than spending
cover a budget deficit - borrow to pay for the amount that spending is greater than receipts
a temporary measure - something as a temporary solution to a problem
get the economy back on its feet again - (like helping someone stand up after they have fallen)
entitlement programmes - government system that provides help to a group of people (for example, paying a retirement pension or medical expenses)
Social Security - money that the government pays regularly to people who are poor, sick, disabled, or unemployed
out-of-control - cannot control (cannot make it do what you want it to do)
civil servants - government workers
skyrocketed - increased suddenly by large amount
not giving in the first place - not giving in the past (should not have given)
squatters - people who live on land they do not own without permission
will be next to impossible - will be almost impossible to do (very difficult)
relocate - move to another location (to live)
when it comes time to Y - when it is the right time to do project or task Y
cut back on expenses - reduce expenses
apparently Y - it appears to be Y
no reasonable limit -
claim expenses - ask to be paid back for money that you paid (for medical treatment)
a budget deficit, run a budget deficit - when receipts are less than spending
cover a budget deficit - borrow to pay for the amount that spending is greater than receipts
a temporary measure - something as a temporary solution to a problem
get the economy back on its feet again - (like helping someone stand up after they have fallen)
entitlement programmes - government system that provides help to a group of people (for example, paying a retirement pension or medical expenses)
Social Security - money that the government pays regularly to people who are poor, sick, disabled, or unemployed
Opinion
EDITORIAL
Government gets a fever
28/08/2009The Democrat-led coalition has taken a courageous step in pursuing long-delayed plans to overhaul the medical benefits scheme for civil servants. The decision will certainly prove unpopular. It most likely will be met with strong opposition from members of the government's workforce, whose resistance to the initiative derailed the project two years ago.
a coalition
- when two groups join together
courageous - brave
overhaul - repair completely and rebuild
medical benefits (for employees) - the medical treatment that employees receive as part of their pay
medical benefits scheme for civil servants - the medical treatment that government employees receive as part of their pay
X's workforce - the workers for a company X or whole economy X
government's workforce - government workers
derail Y - cause Y to fail
resistance to the initiative derailed the project -
courageous - brave
overhaul - repair completely and rebuild
medical benefits (for employees) - the medical treatment that employees receive as part of their pay
medical benefits scheme for civil servants - the medical treatment that government employees receive as part of their pay
X's workforce - the workers for a company X or whole economy X
government's workforce - government workers
derail Y - cause Y to fail
resistance to the initiative derailed the project -
The reason that has forced Deputy Prime Minister Korbsak Sabhasavu, who is in charge of national economic affairs, to pick up this potentially hot political potato for consideration again, is more than obvious. The government's financial health is in a precarious condition at present. The long-standing medical cost overrun has, therefore, again become a major and logical target for slashing, in the government's attempt to maintain the state's balance sheet. The past several governments have noted the alarming trend in the state's expenses with regard to the ballooning cost of civil servants' medical welfare. But none dared seriously tackle the problem out of fear that this would stir discontent among the 2.3-million-strong civil workforce - the main work horse which implements state policies.
a deputy - second
most important person in an organisation
Deputy Prime Minister - person assisting Prime Minister (delegated tasks and serving in his place when not present)
delegate tasks - when a manager gives tasks to staff to do (instead of doing it himself)
in charge of Y - managing project Y and making sure that goals are acheived
a hot potato - an issue that is difficult to handle (a sensitive issue that many disagree about)
potentially hot political potato - could be a difficult issue to deal with and solve
precarious - not in control, may fail anytime, unstable and uncertain
in a precarious condition - in a situation where things are out of control
cost overrun - when more is spent than was budgeted
slash costs - reduce costs
logical target for slashing - a good area of the budget to cut expenses in
balance sheet - an accounting report that shows a company's financial state at a point in time (assets, liabilities, owner's equity)
a state's balance sheet - the balance sheet of a whole government
an alarming trend - a trend that makes you worry
ballooning cost - a cost that is increasing by large amounts suddenly (like blowing air in a balloon)
civil servants - permanent government workers
tackle the problem - try to solve the problem
discontent - a feeling of not being satisfied with your situation or condition
stir discontent - create feelings of disatisfaction
a work horse - does a lot of the work to get the job done
implements state policies - carry out or do state policies
Deputy Prime Minister - person assisting Prime Minister (delegated tasks and serving in his place when not present)
delegate tasks - when a manager gives tasks to staff to do (instead of doing it himself)
in charge of Y - managing project Y and making sure that goals are acheived
a hot potato - an issue that is difficult to handle (a sensitive issue that many disagree about)
potentially hot political potato - could be a difficult issue to deal with and solve
precarious - not in control, may fail anytime, unstable and uncertain
in a precarious condition - in a situation where things are out of control
cost overrun - when more is spent than was budgeted
slash costs - reduce costs
logical target for slashing - a good area of the budget to cut expenses in
balance sheet - an accounting report that shows a company's financial state at a point in time (assets, liabilities, owner's equity)
a state's balance sheet - the balance sheet of a whole government
an alarming trend - a trend that makes you worry
ballooning cost - a cost that is increasing by large amounts suddenly (like blowing air in a balloon)
civil servants - permanent government workers
tackle the problem - try to solve the problem
discontent - a feeling of not being satisfied with your situation or condition
stir discontent - create feelings of disatisfaction
a work horse - does a lot of the work to get the job done
implements state policies - carry out or do state policies
It was not until 2007, when the Surayud Chulanont government assumed office, that the problem was raised for serious consideration. This occurred after the 37-billion-baht budget earmarked for civil servants was quickly used up within the first nine months of that fiscal year, forcing the military-installed government to turn to the Treasury's reserves to cover the shortfall. The Comptroller General's Department was then instructed to study guidelines to curb medical expenses incurred by state employees. A ceiling on medical expenses for certain diseases and lists of essential and non-essential medicines were then drawn up, along with tighter control over the reimbursement process for medical expenses for civil servants nationwide. However, that effort to overhaul the welfare collapsed even before the new system was put in force the following year. This happened after the Council of State ruled in favour of civil servants' complaints that the Comptroller General had no power to control doctors' dispensing of expensive medicine under the medical welfare system.
problem raised for serious
consideration - finally start to discuss how to solve a
problem (with goal of actually solving it, not just talking about it)
budget earmarked for civil servants was quickly used up within the first nine months of that fiscal year, forcing the military-installed government - a government that the military appoints or puts in place after a coup
a shortfall - having less than you need
cover the shortfall - find money when you don't have enough
reserves - money kept for a special purpose
turn to the Treasury's reserves to cover the shortfall -
comptroller - the person in charge of the finances of an organisation or department
Comptroller General - the head of finances for the whole government
curb Y - stop or reduce Y
incur an expense Y - have to pay amount of money Y
curb medical expenses incurred by state employees -
a ceiling - the greatest or maximum amount possible
ceiling on medical expenses - the greatest amount that can be spent on medical treatment
essential - important and needed
drawn up - put a document in writing
reimbursement - paying someone back for something they already paid for (expenses)
Council of State - a group of legal experts that tells the cabinet about whether laws being considered would be legal
X ruled in favour of Y - when court X decides a legal case that benefits Y
dispensing medicine - when staff at a pharmacy give people medicine
budget earmarked for civil servants was quickly used up within the first nine months of that fiscal year, forcing the military-installed government - a government that the military appoints or puts in place after a coup
a shortfall - having less than you need
cover the shortfall - find money when you don't have enough
reserves - money kept for a special purpose
turn to the Treasury's reserves to cover the shortfall -
comptroller - the person in charge of the finances of an organisation or department
Comptroller General - the head of finances for the whole government
curb Y - stop or reduce Y
incur an expense Y - have to pay amount of money Y
curb medical expenses incurred by state employees -
a ceiling - the greatest or maximum amount possible
ceiling on medical expenses - the greatest amount that can be spent on medical treatment
essential - important and needed
drawn up - put a document in writing
reimbursement - paying someone back for something they already paid for (expenses)
Council of State - a group of legal experts that tells the cabinet about whether laws being considered would be legal
X ruled in favour of Y - when court X decides a legal case that benefits Y
dispensing medicine - when staff at a pharmacy give people medicine
Deputy PM Korbsak has pointed out that uncontrolled expenses plus the unethical exploitation of the medical welfare scheme by some civil servants has caused the state's medical bills to jump from 30 billion baht to 80 billion baht in just four years. This almost equals the state's annual budget for the universal health scheme covering more than 40 million people nationwide.
In comparison, it is understandable that civil servants earn substantially less than employees at the same job level in private firms. Many people found state employment attractive only because it offered job security and generous welfare which extended to their families. However, civil servants must realise that the government is in no position to carry on footing these astronomical medical bills. Without proper control, the expenditure on civil servants' medical bills could climb beyond 200 billion baht a year within the next decade. This is outrageous and unacceptable.
job security - how
safe you are from losing your job
in no position to Y - not able to do Y
footing a bill - paying a bill
astronomical - very large
footing these astronomical medical bills - pay these very large medical bills
outrageous - shocking and unacceptable
in no position to Y - not able to do Y
footing a bill - paying a bill
astronomical - very large
footing these astronomical medical bills - pay these very large medical bills
outrageous - shocking and unacceptable
Minister Korbsak has suggested that instead of relying on the national budget alone, civil servants should join the government in helping to contribute to a fund to cover their medical welfare. The idea is worth exploring if it will ease the state's financial burden. But first the government will need to get civil servants to accept that they must stop freeloading on the state budget for their medical expenses. Getting civil servants to acquiesce will be a difficult job indeed.
freeloading - take
something without giving anything in return
acquiesce - agree to accept what someone else wants (after initial resistance)
acquiesce - agree to accept what someone else wants (after initial resistance)
(Source: Bangkok Post, EDITORIAL: Government gets a fever, 28/08/2009, link)
