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LATEST NEWS UPDATES | Lessons from Thailand: For universal health coverage, invest in public systems and human resources -T Sundararaman

Lessons from Thailand: For universal health coverage, invest in public systems and human resources -T Sundararaman

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published Published on Feb 20, 2018   modified Modified on Feb 20, 2018
-Scroll.in

Thailand spends as much of its GDP on health as India, yet it offers the entire range of healthcare services to all citizens for free.

Finance Minister Arun Jailtley’s Budget speech this year and the subsequent media coverage projected insurance coverage as being almost synonymous with universal health coverage. Nothing could be further from the truth. Health insurance is only a small part of ensuring universal health coverage. Besides, to get health insurance right, it has be designed differently from publicly-funded health insurance programmes of India. A study of health insurance in Thailand helps understand why.

Thailand is the developing world’s beacon when it comes to universal health coverage, which is simply defined as “all people having access to quality healthcare to meet their healthcare needs without financial hardship”. Not only does Thailand have better health outcomes, it also offers almost complete financial protection to its citizens, and is responsive to the entire range of healthcare needs – from common cold to organ transplantation. There are few expressly stated exclusions such as cosmetic surgery. Furthermore, Thailand’s public health expenditure is only about 3% of its Gross Domestic Product. Brazil and Cuba have also achieved universal health coverage but spend close to 8% of their GDP on health. All developed nations spend even more for universal health coverage. Thailand’s level of public health expenditure is one that India can easily afford and so its healthcare model is one for India to emulate.

Thailand’s success has been attributed to what is called the Universal Coverage Scheme, once also called the 30 baht scheme after its popular slogan, “30 baht pays for everything”, referring to the country’s currency. Thailand has three government-run insurance programmes. Like India’s Central Government Health Scheme, Thailand has a comprehensive insurance scheme for civil servants. Like India’s Employees’ State Insurance, Thailand has a social insurance cover for its organised sector employees. The Universal Coverage Scheme covers the rest and is very different from the existing and proposed publicly-funded insurance programmes in India.

People in place

One crucial difference is that when the Universal Coverage Scheme was launched in 2002, the infrastructure and human resource requirements of the public health system had been largely met. The Thai public health system like India’s is built around district health systems, but with important differences. A district in Thailand has a population of about 50,000 to 70,000, which is smaller than an administrative block or tehsil in a district in India. A Thai district is served by a district hospital and several health centres. Each of these centres serves 3,000 to 5,000 people and is staffed by three to five non-medical care providers, either nurses or trained paramedics.

In terms of the population served, the Thai health centre is much like India’s health sub-centre, only India’s have just two staff and provide select services – largely antenatal care, immunisation and access to contraceptives. A Thai health center provides the entire range of primary healthcare needs, including care for all infectious diseases, as well as regular medication and care for hypertension, diabetes, asthma and respiratory diseases, mental illnesses, arthritis and most such chronic illnesses.

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Scroll.in, 19 February, https://scroll.in/pulse/869170/lessons-from-thailand-for-universal-health-coverage-invest-in-public-systems-and-human-resources


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