And this slide, we will conclude about the health insurance system in Thailand.
1.Universal Coverage Scheme (UCS)
-It’s a State welfare
-and benefit for Thai citizens without the coverage of Civil Servant Medical Benefit Scheme & Social Security Scheme
-the Source of financing is General tax
-It has 2 Methods of payment
#if you are an Out Patient you should pay using Capitation method
#if you are an In Patient you should pay using Diagnostic Related Groups (DRGs) with global budget
-Universal Coverage Scheme (UCS) is covered about 75% of population
-However these will cause major problems about Inadequate budget
2. Social Security Scheme (SSS)
-It’s a Compulsory health insurance with state subsidies
-and benefit for Employees in private sector and temporary employees in public sector
-the Source of financing is Tri-party (Employee,Employer and govt. budget)
-It has 1 Method of payment you should pay using Capitation with additional payments for high utilization rate and chronic illness patients
-Social Security Scheme (SSS) is covered about 16% of population
-However these method will cause major problems about Covering while being employed only
3. Civil Servant Medical Benefit Scheme (CSMBS)
-It’s a State/Employer welfare
-and benefit for Civil servants,state enterprice employees and dependents
-the Source of financing is General tax noncontributory scheme
-It has 2 Methods of payment
#if you are an Out Patient you should pay using Fee-for-service methods
#if you are an In Patient you should pay using Diagnostic Related Groups (DRG) (Piloted for only 2 years)
-Civil Servant Medical Benefit Scheme (CSMBS) is covered about 9% of population
-However these 2 methods will cause major problems about Rapidly and constantly rising costs
4. Private Health Insurance
-It’s a Voluntary health insurance
-and benefit for General public
-the Source of financing is Insureance buyers;as per contract
-It has 1 Method of payment you should pay using Fee-for-service method
-Private Health Insurance is covered Estimate 6-9 Mn of population
-However these method will cause major problems about Redundant eligibility and slow disbursement