“By 2002 Thailand achieved full population coverage, which helps people to be able to access health services without pushing them to poverty because Thai government subsidized payments. Today all 650 districts were covered by a district hospital.” Dr.Viroj announced.
The key factors which helped Thailand to contribute to universal coverage includes political decision making and leadership, extensive trust base networks, policy networks, research networks and linkages among them.
Government effectiveness in its capacity to translate policy intention into actual implementation also contributed to success. In addition, Civil society involvement which included agenda setting on various policies: ART, renal replacement therapy for example. Health Service platform is vital otherwise Universal Coverage is a ‘citizen right in paper’ and Knowledge management: application of tacit knowledge, Health Systems Research also contribute to the achievement of universal coverage.
Thailand initially offered a favorable health package to low income group of 30 THB (US$ 0.7) and later on patients were not asked to pay anything. The Thai government contracted service providers and paid a certain amount to cover a certain number of people per year, instead of free choice fee for services reimbursement model.
Thailand still faces some serious challenges and these include:
- How to sustain efficiency, equity and quality achievement while strengthen capacity to address new challenges through evidence.
- And the demand for research outpaces the capacity in generating evidence.
- Also demographic and epidemiological transition for example Chronic long term care versus hospital acute care, effective coverage of interventions and primary prevention of risk factors.
- Non-health sector actions against determinants of ill-health such as Tobacco, alcohol, transfat, obesity, physical inactivity, safe environment and injury prevention.
- Institutional capacity to generate evidence on ICER, fiscal impact, equity and ethical considerations of new medicines, interventions.
“We have to prepare the longer term care and ensure that our aging people are healthy and it would be better to encourage them to stay at home with family instead of in the health care centre and links between home care and the health sectors need to be established,” he said.
“Due to the increasing of cost related to health issues we should formulate policy which is related to long term care. On the benefit package we need to improve and strengthen of new intervention and new medicine.” he added.
Jittima Jantanamalaka - CNS
(The author is the Managing Director of Jay Inspire Co. Ltd (JICL), produces radio programmes in northern Thailand and writes for Citizen News Service (CNS). She is also the Director of CNS Diabetes Media Initiative (CNS-DMI) in Thailand. Website: www.jay-inspire.com, Email: firstname.lastname@example.org)
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