1. Health care system
In Thailand

2. THailand Total 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 per capita (Intl $, 2006)
: 346
Total expenditure on health as % of GDP (2006)
: 3.5%

3. Thailand Health Financing

4. Health care finance and service provision of Thailand
after achieving UC in 2002

5. Total health expenditure of Thailand
Source: NHA Working Group 2009

6. Share of government and non-government health financing sources
Source: NHA Working Group 2009

7. Thailand Health Insurance
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.

8. Thailand Health Insurance
After achieving universal coverage in Thailand had been three major public insurance schemes and private voluntary insurance schemes.
The Civil Servant Medical Benefit Scheme (CSMBS) covers 5.2 million.
The Social Health Insurance (SHI) scheme 9.5 million employees
The Universal Coverage(UC) Scheme cover 47 millions of populations
(30 baths co-payment,now,ultil 2008 abolished this copayment)
The Voluntary private insurance Scheme

9. Thai Population coverage
Civil Servant Medical Benefit Schem (CSMBS)
Covers government employees plus dependants (parents, spouse and up to two children age <20)
Financing sources
general tax, noncontributory scheme
Access to services
Free choice of public providers, no registration required
Mode of provider payment.
Fee for service ,direct disbursement to mostly 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.
In 2007 the Scheme encouraged the beneficiaries to register with a preferred public hospital in order to receive outpatient services without paying upfront and reimburse later

10. Thai Population coverage
Social Health Insurance
Covers private sector employees,excluding dependants.
Financing sources
Tri-partite contribution,equally shared by employer, employee and the government. [ Ministry of Labour]
Access to services
Registered public and private competing contractors
Mode of provider payment.
Inclusive capitation for outpatient and inpatient 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

11. 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 district health system
Mode of provider payment.
Capitation for outpatients and global budget plus DRG for inpatients plus additional payments for accident and emergency and high 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
free of charge

12. Thailand having more than two millions irregular migrants
Migrant populations
Thailand having more than two millions irregular migrants
Health services for the registered migrants
A small fraction of total migrants were covered by their employers with full access to health service.
Employers pay some 2,000 Baht to cover one employee for a year,
The scheme is managed by the MOPH provincial health office.

13. Private Voluntary Health Insurance
Covers Additional health insurance scheme for those who can afford premiums (2.2%)
Financing sources
Health insurance premiums paid by individuals 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

14. Out of Pocket
When universal coverage was achieved and benefit packages were comprehensive, there was a rapid and significant reduction in the proportion of out-of-pocket payments
44.5% in 1994
19.2 in 2007

15. Compulsory sources of financing
General Government Health expenditure (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)

16. 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”

17. Civil Servant Medical Benefit 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.

18. Difference between the UC. scheme and SHI. scheme
Dental care benefit package
The UC scheme limits dental condition to be covered such as all basic such as extraction, filling, preventive treatment, scaling and acrylic partial and full dentures(5yrs/piece or pair).
SHI scheme limits the maximum reimbursement 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)

19. Reference
NHA Working Group. Report of Thailand National Health Accounts International Health Policy Program, Nonthaburi
Dental benefits. [cite 17 Oct 2010]. Available from :

20. Thank you
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