• Spending overview
• Policy overview
• Diseases overview

Spending overview

As a percentage of GDP, healthcare spending in Thailand has remained at around 3.3% in recent years, below the estimated level in China, Singapore and Malaysia, but close to that in the Philippines and above that in Indonesia. As the demands on the healthcare system increase, the government may decide to reintroduce treatment charges for more affluent patients. It is also possible that it will introduce a special tax for foreign patients. Before the universal health programme was introduced, an estimated one-third of the population had no health insurance and only one-fifth had full medical coverage (usually through membership of civil service schemes).

The public health ministry has been allocated Bt86bn as part of the stimulus package, most of which will be spent on rural hospitals and healthcare centres, but a procurement scandal has underlined the problem of corruption. According to the Ministry of Public Health, in 2006 around 48% of the population were covered under the universal health programme, 19% enjoyed civil service benefits and 13% were members of the social security scheme. The remaining 20% opted for private healthcare, either because they were not covered by any of the public healthcare schemes or because they chose not to be covered.In tandem with the general increase in insurance provision in Thailand and owing to the fear of declining standards at state hospitals, there has been strong growth in the medical-insurance market.

Policy overview

The standard of healthcare in Thailand is relatively high, but there are considerable regional disparities, as well as differences between publicly provided healthcare and services offered by private hospitals. Thailand's healthcare system is struggling to cope with the pressures arising from ambitious healthcare reforms following the introduction of a universal healthcare programme in 2001. Under the initial programme, the so-called Bt30 scheme, which was implemented by the government of Thaksin Shinawatra in 2001, all Thais were entitled to visit a doctor or hospital for a flat fee of Bt30 (about US$1). Following the coup in September 2006 that ousted Thaksin as prime minister, the military-installed government decided to abolish the fee. Given the popularity of the new scheme, which is now known as the universal healthcare scheme, successive governments have continued with it, despite the pressure that the rise in patient demand is placing on the health service.

Although the universal healthcare scheme has proved popular among patients, the policy has been widely criticised by participating state hospitals and other healthcare providers owing to complaints that the subsidy has not reached a level that reflects the true average cost per patient. Medical staff are reportedly reluctant to work in rural hospitals because of strains on their finances. There are also concerns that the scheme could prove to be a disservice to the poor, as private hospitals will continue to improve their services, whereas state hospitals will shoulder an increased burden with only limited funding. There are signs of an emergence of a dual-track healthcare system, whereby the state portion lacks investment and resources as the private sector invests and upgrades to maintain international competitiveness.

Diseases overview

Demand for healthcare has grown in line with an ageing population, increasing life expectancy and the introduction of a universal healthcare programme. Thailand is ranked 87th in the UNDP’s 2009 Human Development Index, below Singapore and Malaysia, but above the Philippines and Indonesia. Life expectancy at birth stands at around 73 years, up from around 68 years in 1990. Thailand continues to confront the challenge of preventing the spread of HIV/AIDS, which in the early 2000s emerged as the country's leading cause of death. Thailand was one of the first countries in Asia to launch a campaign to raise public awareness of HIV/AIDS, and recent data confirm the campaign’s effectiveness. The Ministry of Public Health has estimated the number of new cases in 2008 at around 13,000, down from 140,000 in 1987.

However, despite the downward trend, the rate of new infections is increasing among several groups. The government has responded to this by announcing a new campaign to combat complacency regarding the disease, but the budget for HIV/AIDS prevention was cut by one-half in fiscal year 2005/06 (October-September). However, the public health ministry is still aiming to reduce the rate of new infections to 7,000 a year by 2011. Thailand is coping relatively well with treating AIDS patients: in mid-2006 treatment was being provided to around 90% of all of those who were in need of it. Other leading causes of death in Thailand include heart diseases, diabetes and traffic accidents. Since early 2004 Thailand has recorded 17 human deaths linked to outbreaks of avian influenza (bird flu), the most recent of which occurred in August 2006.