The first 10 years of the Universal Coverage Scheme in Thailand: review of its impact on health inequalities and lessons learnt for middle-income countries.

Abstract

AIMS: We aim to assess the impacts of Thailand Universal Coverage Scheme (UCS) of health insurance on health service use and healthcare finance in the past 10 years. METHODS: We review the impacts of the UCS on preventive and health promotion including dental care and reproductive health as well as on vulnerable population subgroups. RESULTS: Three decades after the implementation of low income health insurance in the 1970s, Thailand finally introduced a UCS in 2001. It has brought under its umbrella the uninsured 30% of the Thai population. Many empirical studies of illness expenditure confirm that the Thai UCS substantially reduced the financial burden of healthcare among the poor. The Thai UCS mechanism boosts use of primary healthcare facilities and has substantially reduced catastrophic medical payments and consequent impoverishment. CONCLUSIONS: The UCS relies on a solid primary healthcare foundation. Continued investment into primary healthcare resources will help to ensure sustainable development of the UCS and reduced health inequity. The UCS development in Thailand can provide some valuable lessons for middle income countries pursuing the goal of equity in health and healthcare.