Security and Sustainability of Universal Health Coverage Scheme: the Equitable Health Care Financing for Thai On Saturday 9th August 2014 at TK Palace hotel, Bangkok, Thailand, the “we love Universal Coverage Scheme” group hosted the seminar on
“Security and Sustainability of Universal Health Coverage Scheme: the Equitable Health Care Financing for Thai”. This event served as a platform for economists, health financing specialists, and civil society members to share their view on Thailand’s Universal Coverage Scheme (UCS).
Dr. Ammar Siamwalla, Distinguished Scholar of the Thailand Development Research Institute (TDRI), pointed out that at the time of establishment, the UCS was believed to be only benefit for the poor and use a large portion of the national budget, when in fact the Thai health expenditure consumed just four percent of the Gross Domestic Product (GDP). He added that providing health services must be the Government’s commitment by supplying an adequate health budget. For the past couple years, however, the UCS budget has been halted and has not advanced along with inflation or increased health professionals’ salary. Dr.Ammar recommended the Government reduce the budget for ineffective, high cost projects and shift those fund to proven effective activities. He stated, “UCS is the most cost-effective health insurance system.”
Dr.Viroj Tangcharoensathien, Secretary General of IHPP Foundation, cited that Thai UCS is well accepted by international development agencies, namely the United Nations, the World Bank, and the World Health Organization. Over the past thirteen years UCS has contributed to better health for Thais, but key challenges for UCS remain including: annual budget allocation that is dependent on political decisions, the health transition from infectious to non-communicable diseases (NCDs), the demographic transition to an ageing society, and providing health protection to non-Thai citizens. Dr.Viroj suggested maintaining the strengths of UCS, e.g., the benefits package, purchasing mechanism and budget source, while increasing fiscal space through tax reform, both for general purposes and specifically for health, and focusing on primary and secondary prevention for NCDs. New sources of tax should be introduced when political windows of opportunity open such as Tobin tax, or the financial transaction in stock exchange market, as well as land and inheritance taxes; all which have high a potential to boost government revenue and spending on health.
Dr.Winai Sawasdivorn, Secretary General of the National Health Security Office (NHSO), presented the advantage of the UCS purchasing mechanism, capitation, and global budget in order to increase purchasing power and cost control. NHSO has set up its audit unit, and developed different means for public hearingaiming to improve quality of service.
Mr.Jon Ungpakorn, member of quality and standard control of health service by civil society committee, indicated that access to equitable health services is a human right that UCS can provide. He expressed his concern that some, particularly the private sector, use common misconceptions of UCS, such as a large budget and poor quality of health services, to discredit the UCS reputation.
On the whole, participants agreed that the UCS is essential for health financial risk protection and the source of UCS budget should be tax based. A health service costing study for all levels of health service providers should be urgently conducted to reflex the unit cost of health services in order to allocate a sufficient health budget.
The voice of civil society on financing of UCS was echoed by the media. Click here to read more from Manager Online.