Thailand’s Universal Coverage System
400 million people in the world are without access to basic healthcare. ‘11 million people a year fall into poverty’ (Edmond 2019) in Africa as a result of healthcare costs. South East Asian country Thailand has successfully introduced an affordable healthcare system, which has globally been labelled a success. The effective model proves that accessibility to healthcare and medicine is not dependent on the wealth of a country, but rather on the supportive structure. It provides hope and guidance that through appropriate planning and implementation, healthcare doesn’t just have to be a goal for countries currently lacking a scheme.
The United States, one of the most industralised countries in the world, has a fractured healthcare system and no universal coverage. The incredibly high costs of accessing healthcare cause many to be unable to receive treatments and medication required for living. Insurance premiums are constantly rising, whilst the quality of service falls. Despite progress with the Affordable Care Act of 2010 introduced by Barack Obama, serious problems remain. When we compare the healthcare systems of a country like Thailand, compared to the lack thereof in the United States, we realise that there is truly a lot to be learnt.
Before the UCS, one quarter of people did not have insurance (Jongudomsuk et al. 2015, p. 19). As a result, in 2000 many families fell into poverty due to healthcare costs and thousands died ‘from easily preventable infectious diseases’ (George 2016). In 2001, the introduction of the Universal Coverage Scheme (UCS) began, and was fully implemented by January 2002 in Thailand. Prior to the reform, four different health insurance schemes covered 70% of the population. The reform strengthened two of the programs. As a result, there has been a decrease in child mortality rates, the amount of people unable to go to work due to illness and also in out of pocket payments (Edmond 2019). Quality of life standards and life expectancy have increased (Edmond 2019).
Since 2000, treatments such as antiretroviral therapies and renal replacement therapy have become widely accessible. 98% of the population in 2011 had access to healthcare (Edmond 2019), and the health scheme since this time only costs $80 per person annually (George 2016). The UCS has ensured extensive collaboration with rural health centers and providers in community hospitals to ensure quality care (Harris 2018). Fixed annual payments are also provided to physicians ‘to cover outpatient care’ (Harris 2018). The scheme also allows the government to have control over medicinal purchases and costs.
Thailand’s scheme is being praised as a global model for emerging markets. Political investment to the health of the country began decades ago. In 1992, the Health Systems Research Institute was established. This institute joined together academic and research agencies to ‘generate knowledge supporting policy formulation’ (Jongudomsuk et al. 2015, p. 1). Financially, ‘healthcare is funded through taxation’ (Edmond 2019). The burden is placed on those who are able to afford it, simultaneously benefiting those receiving the lowest bracket income. Public participation is also an essential element of the UCS. There are representatives on the ‘National Health Security Committee and Regional Health Security Committee’ from civil society groups (Jongudomsuk et al. 2015, p. 49). The direct contact between the community and government has allowed to community needs to be met.
The early progress Thailand made shouldn’t discourage other countries lacking a healthcare scheme from beginning now. With the right reformative measures in place, results can arise.
Edmond, C 2019, ‘Thailand gave healthcare to its entire population and the results were dramatic’, World Economic Forum, 15 April, viewed 27 June 2019, https://www.weforum.org
George, S 2016, ‘What Thailand can teach the world about universal healthcare’, The Guardian, 24 March, viewed 27 June 2019, https://www.theguardian.com/au
Harris, J 2018, ‘What the US could learn from Thailand about health care coverage’, The Conversation, 14 December, viewed 27 June 2019, https://theconversation.com/au
Jongudomsuk, P, Srithamrongsawat, S, Patcharanarumol, W, Limwattananon, S, Pannarunothai, S, Vapatanavong , P, Sawaengdee, K, Fahamnuaypol , P 2015, ‘The Kingdom of Thailand Health System Review’, Health Systems in Transition, vol. 5, no. 5, pp. 1-265