According to the United Nations population forecast, Thailand
will soon face a severe issue of population aging. The old-age dependency ratio (ratio of population aged 65 þ per 100 population
aged 15e64) was 12.4 in 2010, but it is expected to increase quickly
and reach 53.1 in 2050, even higher than those of the US (35.5) and
France (42.2). Fig. 1 shows the trends in the old-age dependency
ratio for Thailand and some selected countries. The effects of
population aging on the health-financing system are twofold. First,
because elderly people need significantly more health care than
young people and the rapid population aging indicates an imminent increase in their numbers in the total population, significant
increases in the aggregate medical cost and in thefinancing burden
of the UHI system cannot be avoided. Table 2 presents the average
medical costs for young and old people in several countries, and it is
obvious that the average annual cost for the old is at least twice as
much as that for the young. Fig. 2 further shows trends in aging and
per-capita medical cost in several countries with similar universal
health insurance coverage. Both factors clearly increased during the
studied time period. Second, aging implies a shrinking working-age
population/tax base, such that the government finds it difficult to
finance the extra burden of UHI using its original tax revenue.
According to the United Nations population forecast, Thailandwill soon face a severe issue of population aging. The old-age dependency ratio (ratio of population aged 65 þ per 100 populationaged 15e64) was 12.4 in 2010, but it is expected to increase quicklyand reach 53.1 in 2050, even higher than those of the US (35.5) andFrance (42.2). Fig. 1 shows the trends in the old-age dependencyratio for Thailand and some selected countries. The effects ofpopulation aging on the health-financing system are twofold. First,because elderly people need significantly more health care thanyoung people and the rapid population aging indicates an imminent increase in their numbers in the total population, significantincreases in the aggregate medical cost and in thefinancing burdenof the UHI system cannot be avoided. Table 2 presents the averagemedical costs for young and old people in several countries, and it isobvious that the average annual cost for the old is at least twice asmuch as that for the young. Fig. 2 further shows trends in aging andper-capita medical cost in several countries with similar universalhealth insurance coverage. Both factors clearly increased during thestudied time period. Second, aging implies a shrinking working-agepopulation/tax base, such that the government finds it difficult tofinance the extra burden of UHI using its original tax revenue.
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