The policy intention was to use the UCS (a financing reform) to strengthen
the health system by shifting its focus towards primary health care. Primary
health care is more cost effective than hospital outpatient services and lowers
transportation costs shouldered by patients. In deciding on the financing
mechanism, Thai policy-makers relied heavily on experience gained from earlier
reforms, particularly the SSS and CSMBS. They took note of the cost increases
associated with fee-for-service reimbursement and the fact that capitation,
which had been used by the SSS since 1991, was providing adequate health-care
services to its members. To increase the likelihood of the UCS succeeding, policies
were to be informed by the best available research evidence, and monitoring
and evaluation were to be part of the policy process from the start.