Determinants of Demand for Health Card in Thailand
The health insurance card scheme was introduced as the Health Card Project (HCP) in 1983. This program was based on the risk sharing of health expenditures with no cost sharing in a voluntary health insurance prepayment scheme. Frequent adjustments...
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2001/09/3916825/determinants-demand-health-card-thailand http://hdl.handle.net/10986/13627 |
| Summary: | The health insurance card scheme was
introduced as the Health Card Project (HCP) in 1983. This
program was based on the risk sharing of health expenditures
with no cost sharing in a voluntary health insurance
prepayment scheme. Frequent adjustments in both the
strategies and objectives of the program have included
voluntary risk sharing with cost recovery in addition to
service provision. The HCP needs a large enough number of
enrollees to ensure a sufficient pool of risks. However, the
newly elected government of Thailand has committed to
rapidly extending health care coverage to all Thai citizens.
Even though the HCP was suppressed and replaced by this
program in October 2001, this study of the determinants of
demand for the prepaid health card is still important. The
HCP can be assessed as relatively progressive, serving rural
areas, poor and near poor groups. This study has found that
employment, education, and the presence of illness are
significant factors influencing card purchase. The third
factor is related to the problem of adverse selection of the
program; families with symptoms of sickness are more likely
to buy cards and increase their use of health services. The
results also show an improvement in accessibility to health
care and a high level of satisfaction among cardholders,
both key objectives of the program. Problems of program
performance include issues of program and financial
management: marketing, quality control and cost recovery;
ineffective referral systems, and lack of limits on episodes
and ceilings for expenses. There is a need for an efficient
and consistent health policy, which would involve revised
criteria for card use, standard reimbursement agreements
with hospitals, government subsidies, and an overall
strengthening of the program. |
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