The Thai population is around 69.6 million people accounting for 0.9% of the world’s population1
Non-communicable disease (NCD) accounted for 74% of deaths in Thailand in 2018. NCD related deaths included cardiovascular disease (23%), cancers (18%), chronic respiratory diseases (6%), diabetes (4%) and others (23%). Other causes of mortality were communicable, maternal, and nutritional conditions (15%) as well as injuries (10%).2
In 2018 the most common cancers were lung (14%), liver (14%), breast (11%) and colorectal cancers (10%).3
There are approximately 170 500 new cancer cases per year and 114 200 deaths.4
Healthcare System Overview5
Thailand adopted a policy of universal health coverage (UHC) in 2002, following on from the impact of the Asian financial crisis of 1997. All citizens have access to essential health services through public health insurance.
Three separate schemes deliver public national health insurance to the population. These are, (i) the civil servants’ medical benefits scheme under the finance ministry, covering 5.7 million people; (ii) the social security scheme under the labour ministry, covering 12.3 million people; and (iii) the universal coverage scheme under the public health ministry, covering 47.8 million people or 72% of the population.
Extension of coverage of UHC funding to high-cost services, such as renal replacement therapy, cancer therapy and stem-cell transplants, has improved financial protection for patients
Public hospitals account for 75% of health delivery and 79% of total hospitals and beds. Most private hospitals are small, with 69% having fewer than 100 beds.
Patients can seek care or referral at health units close to home through district health services.
The Ministry of Public Health (MOPH) is responsible for the oversight of health care, together with other non-ministerial government agencies. The MOPH and the Health Systems Research Institute (1992), the Thai Health Promotion Foundation (2001), the National Health Security Office (2002), the National Health Commission Office (2007) and the Healthcare Accreditation Institute (2009) form an interdependent governing structure where non-state actors and civic groups also play an increasing role.
The National Health Security Office (NHSO) is the purchaser of health care services, and MOPH is the major service provider.
The Provincial Health Office regulates management decisions for public hospitals. It holds regulatory power, such as licensing and relicensing private pharmacies and clinics, and consumer protection on food, drugs and cosmetics.
Health Costs and Funders6
In 2017 health expenditure was around 4% of GDP (USD 543 billion), equating to approximately USD 247 per person.
The annual rate of growth of health expenditure per capita was 9.6% from 2016 to 2017
General taxation is the primary funding source for the provision of public health care and related public services under the UHC.
Out of pocket expenditure accounted for 11% of health care expenses, while 23% of health care expenses were privately funded.
Only 10% of the Thai population have private health insurance.
The cost of the UHC policy is one of the highest among low-and middle-income countries and constitutes around 17% of total government expenditure7
Major Challenges8
NCD’s and modifiable behavioural factors are a burden on people’s quality of life and on healthcare costs
The prevalence of preventable and controllable infectious and non-infectious illnesses, such as diabetes mellitus, hypertension, renal failure, tuberculosis and human immunodeficiency infection, is showing an upward trend
The non-contributory financing model of UHC challenges the sustainability of the UHC policy in light of rising health care costs and competing demands on financial resources.
UHC model is at risk as revenues from taxation are projected to decline.
Exposure to air pollution is an ongoing health hazard
Thailand has an ageing population, and the workforce is declining to lower the revenue raised through general taxation.
