Filling in the Gaps in Thailand’s Universal Healthcare Coverage

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Under Thailand’s Universal Coverage Scheme, Thai citizens at every stage of life are entitled to essential health services and 99% of its population are currently covered. This year, not resting on its laurels, the NHSO’s priorities are the introduction of expanded benefits and subsidies and identifying those who still remain without healthcare coverage. 

 

Our main objective is to improve accessibility and prevent health catastrophes. To do this, we have to invest more. The challenge for the future will be to have appropriate costs and an acceptable quality of medicine and technology in a good system.

Jadej Thammatacharee, NHSO

Thailand’s Universal Coverage Scheme (UCS) was launched in 2002 as an attempt to merge a patchwork of four different healthcare schemes that had previously been allowing a substantial number of Thai citizens to fall through the cracks. The tax-funded coverage scheme, despite being introduced in the aftermath of the 1997 Asian financial crisis, has proven highly successful, providing coverage to approximately 48 million people and accounting for 17 percent of the country’s healthcare expenditure. The biggest beneficiaries of the scheme have been those with the lowest income, while the wealthiest bear the highest cost burden. In the decade after the scheme was initiated (2001–2011) life expectancy at birth rose from 71.8 to 74.2 years compared with an increase of only 70.3 to 71.8 years during the decade before (1991–2001) according to the World Health Organization.

 

Jadej Thammatacharee, deputy secretary general of the Thai National Health Security Office (NHSO), recently told PharmaBoardroom that “One of the main objectives of the NHSO is to improve the Thai population’s access to high-quality healthcare. We believe that every Thai should feel secure, irrespective of whether they are sick or not. Another objective is prevention and how to prevent people from spending inordinate amounts on their healthcare.” 

 

With the aim of improving healthcare quality, the NHSO has recently announced that starting in October 2019, benefits provided under the universal healthcare scheme will be further expanded. Some of the highlighted benefits will be free Donezepil for Alzheimer’s patients, free faecal immunochemical tests for colon cancer screening, and free Rotavirus vaccines. The Thai Cabinet has earmarked BT 190 billion (USD 6.1 billion) for the coverage scheme in the 2020 fiscal year. A large percentage of the budget, BT 180 billion (USD 5.8 billion), will be allocated to state-owned hospitals that provide services on a flat per-head subsidy, increasing the amount of subsidy per patient. 

 

The NHSO continues to seek improvement, not only expanding benefits but ensuring coverage for the entire Thai population. Thammatacharee states that currently, a major priority is locating the marginalized groups that are still without health coverage, such as the elderly, prisoners, and monks, and making sure these groups have access under the coverage scheme. He believes that “our main objective is to improve accessibility and prevent health catastrophes. To do this, we have to invest more. The challenge for the future will be to have appropriate costs and an acceptable quality of medicine and technology in a good system.”

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