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Health care system

In Thailand

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THailandTotal population: 63,444,000

Gross national income per capita (PPP international $)

: 7,440

Life expectancy at birth m/f (years)

: 69/75

Total expenditure on health p er capita (Intl $, 2 0 0 6 )

: 346

Total expenditure on health a s % of GDP(2 0 0 6 )

: 3.5%

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Thailand Health

Financing

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Heal thcare fi nance andservi ce provi si on of Thai l and

afterachievingUCin2 0 0 2

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Total health expenditure of Thailand

Source: NHA Working Group 2009

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-Share of government and non government health financing sources

Source: NHA Working Group 2009

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Thailand H ealth I nsurance

Before 2002 Thailand’s health care system had 5 major health insurance schemes.

• Civil Servants’ Medical Benefits Scheme (SCMBS)

• Social Security Scheme (SSS)

• Voluntary Health Card Scheme (VCS)

• Low-income Card Scheme (LICS)

• Private Indemnity Insurance.

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Thailand H ealth Insurance

2002After achieving universal coverage in . Thailand had bbbb bbbbb bbbbb bbbbbb bbbbbbbbb

schemes and private voluntary insurance bbbbmes.

bbbbbbb bbbbbb bbb bbbbbbbb ()5.2. 95The Social Health Insurance (SHI) scheme . mil

lion employees bbb bniversal Coverage(UC) b cheme cover 47

millions of populations

(30 baths co-payment,now,ultil 2008

abolished this copayment) The Voluntary private insurance b cheme

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Thai Population coverage

Civil Servant Medical Benefit Sch em (CSMBS)

Covers g overnment employees plus dependa nts (parents, spouse and up to two children a

ge <20)Financing sources

g eneraltax,noncontri butory schemeAccess to services

Freechoi ce of publ i c provi ders,no regi strati onrequi red

Mode of provider payment. Fee for service , direct disbursement to mos

tly public providers and DRG for inpatient care

Services Benefit - out patient services and hospitalization,

medical and surgical services, dental services emergency services, operation,

expensive health services and medicines. excludes a cosmetic surgery and

preventive services , except -for annual health check up.

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Thai Population coverage

• Social Health Insurance Covers p rivate sector employees,excluding depe

ndants. Financing sources

- Tri partite contribution,equally shared by emp loyer, employee and the government.

[ Ministry of Labour] Access to services

Regi steredpubl i c andpri vate competi ng contractors

Mode of provider payment. Inclusive capitation for outpatient and inpatie

nt services plus additional adjusted payments for accident and emergency and high cost care.

Services Benefit diagnostic and medical treatments,

hospitalization including room ,nutrition and other treatments,pharmacy and medical

excluded - self inflicted illness or injuries

Fee-for-services

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Thai Population coverage

• Universal coverage Scheme

Covers the rest of the population not covered by SHI and CSMBS.

Financing sources General tax [national health security office ]

Access to services Registered contractor provider,notably dist

rict health system Mode of provider payment.

Capitation for outpatients and global budg et plus DRG for inpatients plus additional p

ayments for accident and emergency and h igh cost care

Services Benefit ambulatory care, hospitalization,

laboratory investigation, dental care, disease prevention, health promotion,

-radiotherapy and chemotherapy for cancer treatments,surgical operations

and healthcare for accidents and emergency illnesses.

Prescription drugs are also f ree of charge

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Migrant populations

•Thailand having more than two million s irregular migrants

• Health services for the registered migrants A small fraction of total migrants were cov

ered by their employers with full access to health service .

• Employers pay some 2,000 Baht to cove r one employee for a year,

•T he scheme is managed by the MOPH p rovincial health office.

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Private Voluntary H ealth Insurance Covers Additional health

insurance scheme for those who can afford premiums (2.2%)

Financing sources Health insurance premiums paid by i

ndividuals or households Access to services

Free choice of health care providers, either public or private providers

Mode of provider payment. Retrospective reimbursement

Services Benefit ambulatory care, hospitalization,

laboratory investigation, dental care, disease prevention, health promotion,

-radiotherapy and chemotherapy for cancer treatments,surgical operations

and healthcare for accidents and emergency illnesses.

Fees- for- services

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Out of Pocket

• When universal coverage was achi eved and benefit packages were c

omprehensive, there was a rapid a nd significant reduction in the pro

- - portion of out of pocket payments

44.5% in 1994

19.2 in 2007

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Compulsory sources of financing

• General Government Health expe nditure (GGHE)

Taxation Direct tax ( personal income and corporate tax)

Indirect tax ( consumption tax, excise tax and import and export duties respectively)

• - Compulsory pay roll tax Social Health Insurance (SHI) Workmen’s Compensation Fund (WCF)

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Financing in Oral Health

•Financing in Oral heath cares in Thailand had been Covered within three major public insurance schemes and private voluntary insurance schemes“But,the services benefit were difference”

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Civil Servant Medical Be nefit Schem (CSMBS)

•Dental care benefit package All Basic service - Filling,extraction,tooth

surgery,miscellaneous oro-facial surgery,periodontal treatment,root canal treatment, fluoride FM, splinting,

In 2008 , can be reimbursed the crown restoration fee (10 yrs/piece), acrylic and full denture (5 yrs/piece or pair)

Not cover ortrodontic , vital tooth bleaching and sealant (except the children under 15 yrs,sealant without paying)

Following sevices rate not exceed more at the Comptroller General's Department , Ministry of Finance noted.

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Difference between the UC. sc heme and SHI. scheme

• Dental care benefit package

The UC scheme limits dental condition to be covered such as all basic such as extr

action, filling, preventive treatment, scali ng and acrylic partial and full

dentures(5yrs/piece or pair ). SHI scheme limits the maximum reimbu

rsement level per annum. (not more than 2 visited/annum, 250 bath per visit) and in 2009 to be covered acrylic partial denture (1-5 teeth reimburse 1,200 bath and >5 teeth reimburse 1,400 bath,5 years/piece)

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Reference

• - NHAWorkingGroup.ReportofThailandNationalHealthAccounts20062007.InternationalHealthPolicyProgram,Nonthaburi.2009.

•Dental benefits. [cite 17 Oct 2010]. Available from : http://www.dentalcouncil.or.th/content/

people/detail.php?type=6&id=158.

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