Table 1 Key characteristics of the three main public health insurance schemes in Thailand as of 2020
Insurance scheme | Population coverage | Source of revenue | Mode of provider payment | Access to service |
|---|---|---|---|---|
Civil Servant Medical Benefit Scheme (CSMBS) | 9%, government employees plus dependants (parents, spouse, and up to 2 children) | General tax, non-contributory scheme | Fee for service, direct disbursement to mostly public providers and Diagnostic Related Groups (DRG) for inpatient treatment | Free choice of public providers |
Social Health Insurance (SHI) | 16%, private sector employees, excluding dependants | Tripartite contribution, equally shared by employer, employee and the government | Inclusive capitation for both outpatient and inpatient plus additional adjusted payments for accident and emergency and high-cost care | Registered public and private contractors |
Universal Coverage Scheme (UCS) | 75%, the rest of the ‘Thai’ population not covered by the SHI and the CSMBS | General tax | Capitation for outpatients and global budget plus DRG for inpatients | Registered contractors, notably the network of public hospitals (Contracting Unit for Primary Care) |