Cost containment mechanisms are critical because unless costs are controlled
it will be difficult to cover the whole of the population and to provide adequate
services; such mechanisms ensure long-term financial sustainability. Two such
features of the UCS are the emphasis on primary health care (which was
historically weak in Thailand) as the main first level of care, and the payment
mechanisms, which use capitation and case-based payment within a global
budget to fix the total cost. The third design element, strategic purchasing, is
necessary to manage the rationing of services and to direct the provision of care
to those areas where need is greatest.
Evaluating the universal coverage reform
This assessment demonstrates the Thai desire to learn from experience and to be
open to external scrutiny. While important for Thailand, country case studies of
universal coverage reform are needed to build up the knowledge base about
how best to introduce and strengthen universal coverage. In the interest of