Ensure access of all residents to essential health care services Assessment National Dialogue No2 Bangkok, 30 Nov 2011

From the National Dialogue #1

Can we assume that we have the floor for healthcare?... … i.e. that residents have access to a nationally defined set of affordable essential health care services, although implementation issues remain. Key question: how to ensure financial and institutional sustainability of the system in place? Expressed need to review the basic package and the institutional organization of the existing schemes to reduce fragmentation.

Scenarios to ensure income security for the elderly Assessment National Dialogue No2 Bangkok, 30 Nov 2011

4. “All residents in old age and with disabilities have income security at least at the level of the nationally defined poverty line through pensions for old age and disability or transfers in kind”

Target: The elderly Deserving group of the population Growing number (ageing society) Providing income support to the elderly is providing income support to the whole household (especially grand children)

500 baths pension scheme for + 60 Informal economyPoor & vulnerableCivil servPrivate sector Coverage for government officials, state owned ent. Workers and private teachers 78% 7% The “official” income support for the elderly Formal workers working in establishments of more than 1 employee covered through contributory pension 15% Means tested transfer of 2000 baths National Savings Fund Coverage under Art 40 + Ministry of Finance Tax exemption What is already in place

500 baths pension scheme for + 60 = 1/3 of Poverty line Informal economyPoor & vulnerableCivil servPrivate sector Coverage for government officials, state owned ent. Workers and private teachers: no portability 78% 7% The real income support for the elderly Formal workers working in establishments of more than 1 employee covered through contributory pension 15% Means tested transfer of 3000 baths National Savings Fund Coverage under Art 40 lump sum + Ministry of Finance Fragmented!!!

Recommendations from the workshop “Costable and “non- costable” recommendations On the Floor and at higher levels On supply and demand About the need of harmonization of the overall pension system  For today with the RAP: costable. on the demand side guaranteeing the floor

Scenarios costed Translation of the recommendations two and three (E2. And E3.) into the following scenarios: - Status quo – 500 Bahts scheme for Scenario 1- Implementation of the new policy Increment from a flat rate of THB500/month to eligible older person who are 60 years and above to progressive rate according the ages i.e. 60 years and above = from THB500/month to THB600/month; 70 years and above =THB700/month; 80 years and above = THB800/month; and 90 years and above =THB1,000/month. The new rates will become effective as of 1 Oct Scenario 2 – Scenario 1 + indexation+ universal coverage - Scenario 3 – Status quo + indexation + increase of the benefit at poverty line level

First results TOTAL (benefit amount + costs) Status quo In % of GDP0.36%0.39%0.38%0.37%0.36%0.35%0.33% 0.32%0.31%0.30% In % of GGO (SQ) Expenditure TOTAL (benefit amount + costs) Scenario In % of GDP0.53%0.52%0.50%0.48%0.47%0.45% 0.43%0.41%0.40% In % of GGO (SQ) Expenditure TOTAL (benefit amount + costs) Scenario In % of GDP0.55% 0.57% 0.56%0.57% In % of GGO (SQ) Expenditure

Key questions to discuss Which level of benefit? Which indexation on CPI or 25% of weekly male earning? How to substract gvt officials with new policy? Any other scenario?