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Health care system

In Thailand. Health care system. 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

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Health care system

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  1. In Thailand Health care system

  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 HealthFinancing

  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 2002 . Thailand had been threemajor 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 insuranceScheme

  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 • Accessto 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. • excludesa 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] • Accessto 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, • pharmacyand 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 ] • Accessto 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. 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 VoluntaryHealth Insurance • Covers Additional health insurance scheme for those who can afford premiums (2.2%) • Financing sources • Health insurance premiums paid by individuals or households • Accessto 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 beenCovered within threemajor public insurance schemes and private voluntary insurance schemes “But,the services benefitwere 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 in2009 to be covered acrylic partial denture (1-5 teeth reimburse 1,200bath and >5 teeth reimburse 1,400bath,5 years/piece)

  19. Reference • NHA Working Group. Report of Thailand National Health Accounts 2006-2007. International Health Policy Program, 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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