Thailand is a country of hundreds of islands in Southeast Asia with a population of nearly 70 million people. Thailand has a history of political instability and economic uncertainty along with rising poverty rates. However, the country has made great strides to improve its healthcare. Nearly 7 million of Thailand’s citizens live in poverty and a wealthy few control a large majority of the country’s wealth. With one of the most extreme wealth gaps in the world, universal healthcare in Thailand creates a meaningful movement toward equality for all its citizens.
Switching to Universal Health Coverage (UHC)
In 2002, Thailand made the transition from a combination of various healthcare policies to an all-encompassing, universal health coverage (UHC) system. Under the UHC system, every Thai citizen is entitled to health services — including preventative, curative and palliative care, at any age. Under this system, financial protection for high-cost services also improved.
Challenges in Financing the UHC System
Though universal health coverage in Thailand has allowed increased access for all ages and classes of citizens, the country still faces challenges with funding the program. The UHC system is a predominantly publicly funded program, meaning that it functions mainly through taxation. Because the nearly 7 million Thai citizens live no more than 20% above the poverty line, the UHC budget coming from taxes is relatively inflexible. Therefore, funding the growing demands for healthcare in Thailand often requires reaching into other public funds.
Access to preventative medicine has decreased the rates of many illnesses by keeping them from occurring in the first place. However, medical expenses in other categories are on the rise. As the average age of the population increases, healthcare in Thailand faces an influx in elderly patients needing more care. Unsafe road conditions and unenforced traffic laws in many regions also contribute to high rates of road accidents and result in excessive trauma cases. Also, air pollution in cities and extreme weather conditions in various regions across the many islands contribute to increased utilization of the UHC system. For the UHC system to be an equitable, effective and sustainable service for the country, other avenues of funding must be explored.
Challenges and Looking Ahead
Healthcare in Thailand has had many positive improvements since the national transition to universal coverage in 2001. Yet, like any system, it often faces continued challenges. The system is considered popular among lower-paid citizens that did not previously have access to care. Albeit, higher-income communities hold some distaste for the system due to increased access leading to more crowding in hospitals. Universal healthcare in Thailand has created a much more inclusive environment for the Thai people as it helps to bridge the immense wealth gap. A gap between the nearly 7 million living in poverty and the wealthy 1%.
Positive Impact of the UHC System
This alteration of the previous healthcare system has led to an increase in the utilization of health services and decreased the prevalence of unmet needs in the country. Overall, healthcare in Thailand is improving. Not only did rates of care increase with the introduction of the UHC system, but other metrics of improving healthcare also rose.
Life expectancy from birth rose from 71.8 years before the introduction of the UHC system, to 77.2 years in 2020. Infant mortality rates similarly fell from more than 100 per 1,000 births in 1970 to 7 per 1,000 births in 2020. As citizens have been able to access preventative care and more expensive intervention at lower personal cost, out-of-pocket spending on healthcare needs have decreased. Meanwhile, household savings increased. Though the switch to universal healthcare certainly faces challenges, it has created quantifiable positive change for millions living in Thailand.
– Jazmin Johnson