48 Quality Control Board, were also appointed to set the national health care policy and to
monitor and control the quality of services up to the international standard accordingly. The details of the boards’ authorities will be elaborated later in this report.
As a results of the reform, at present the health care system in Thailand had been cut down to three major schemes, including Civil Servant Medical Benefit
Scheme CSMBS, Social Security Scheme SSS, and the National Health Security Scheme NHSS. The 30 Baht project had been transformed to be NHSS. Each
scheme targets different groups of Thai populations with different benefit packages. The one in focus of this study is the last one since it covers about 47 million 75 of
population, while 8, 15.8 are in the CSMBS and SSS respectively. As stated above the National Health Security Coverage will target all Thai citizens who
are not currently gain benefits from any other health service funds. It is estimated approximately around 2.3 to 5 million people in Thailand.
5.1.2.6. Benefits
Section 3 of this Act also states that ―Health service expenses‖ refers to any expenses born by a Health Service provided by a Health Care Unit HCU. The Board
has responsibilities to appoint subcommittee to develop benefits scheme, including public health services, types and scope of public health service. The benefits are as
follows: 1
Prevention and promotion services including medical and public health service for supporting people living more longer age and deceasing patient
and disable rate. 2
Diagnosis and investigation services for checking mistakes which occur in medical service.
49 3
Ante-natal care including checking and supporting infant care services as the model of Department of health, Ministry of Public Health andor World
Health Organization WHO. 4
Therapeutic items or services including medical treatment service until the end such as kidney treatment in particular.
5 Drugs, biological, supplies, appliances, and equipment including anti HIV
virus was contained in national core medicine index. 6
Delivery including just first 2 children. 7
Bed and board in the service unit including food and general patient room. 8
newborn care 9
ambulance or transportation for patient 10
Transportation for a disabled person 11
Physical and mental rehabilitation including efficiency of medical service until the end.
12 Other expenses necessary for the Health service as prescribed by the Board.
Table 5.1. Benefit Package And Financing Characteristics Of The Health Benefit Schemes
Scheme characteristics
Low income and public
welfare CSMBS
SSS WCS
Health Card Private
insurance
Benefit package
Ambulance services
Only designated
public hospitals
Public only Public and
private Public and
private Public
MOPH Public and
private
Inpatient services
Public only Public and
private Public and
private Public and
private Public
MOPH Public and
private Choice of
provider Referral line
Free Contrafcrual
basis Free
Referral line Free
Cash benefitws No
No Yes
Yes No
Usually no Inclusive
conditions All
All Non-work
related illness, injuries, except
15 conditions Work-related
illness and injuries
All As stated in the
contracts
Maternity benefit Yes
Yes Yes
No Yes
Varies Annual physical
No Yes
no No
Possible Varies
50
checkup Promotion
prevention Very limited
Yes Health
education and immunisation
No Possible
Varies Services not
covered Private bed,
specia nurse, eye glasses
Spediaql nurse Private bed,
special nurse No
Private bed Varies
Financing Source of fund
General tax General tax
Tripartite contributions,
1.5 of payroll
Employer, 0.2-2 of
payroll with experience
rating Household
purchase 500 baht plus tax
subsidy 500 baht
Premium
Financing body
MOPH Ministry of
finance3 Ministry of
Labour Ministry of
Labour MOPH
Competitive companies
Payment mechanism
Global budget
Fee-for- service
reimburse Prospective
capitation Fee-for-
service reimburse
Limited fee- for-service
Fee-for- service
reimburse Copayment
No Yes, for IP at
private hospital
Maternity and emergency
services Yes, if
exceed the ceiling of
30,000 baht No
Almost none
Source: Pannarunothat and Tangcharoensathien, 1993; Supachutikul, 1996; and Tangcharoensathien and Supachutikul, 1997 cited in Nitayarumphong and Mills, 2005, p. 265.
5.1.2.7. Organizations
