Three features define the UCS:
• a tax-financed scheme free at the point of service
(the initial co-payment of 30 baht or US$ 0.70 per visit
or admission was terminated in November 2006);
• a comprehensive benefits package with a primary care focus;
• a fixed annual budget with a cap on provider payments.
Tax-financed scheme free at the point of service
General tax was chosen as the main source of financing because it was the most
pragmatic option and it was believed to be the most progressive (in Thailand the
rich pay a larger share of their income to taxes than do the poor). Although a few
economists held the view that the rich should pay for their health care separately
and that public involvement should be limited to basic safety-net provision for
the poor, this “targeting ideology” was rejected. Targeting had been applied de
facto since 1975 but still left 30% of the population uninsured. Evidence from a
subsequent assessment of the Medical Welfare Scheme indicated that targeting
remained problematic throughout the implementation period because not all
who qualified were covered and because entitlement cards were issued to the
non-poor14. Moreover, this approach was contrary to the constitutional right and
entitlement of all citizens, not some, to affordable health care. And since the rich
pay progressive personal income tax (37% of net income) as well as corporation
taxes (30% of net income) it was argued that they deserved equal entitlement to
financial risk protection. Thus the weight of opinion in policy circles and among
the public swung decisively in favour of the universality principle.