Healthcare is a seemingly constant policy issue coming up in the United States. Frequently, the healthcare systems in other countries are held up as either examples of improvements or as warnings. Healthcare in Thailand is an interesting topic, as the top reason for tourism to the country is actually medical tourism. In addition to the world class medical centers in Bangkok, people in the rural areas are covered by a universal healthcare scheme.
Universal Healthcare
In 2000, the “Thai Rak Thai (TRT)” (Thai loves Thai) party ran on a platform of establishing universal healthcare in a program call the “30 Baht Healthcare Scheme.” Currently, 30 baht is about one US dollar. It was originally campaigned that there would be a 100 baht per month premium. The TRT party did extremely well in the election and had the project implemented throughout the entire country by 2002. After the pilot programs, the 100 baht premium was dropped and the program is supported entirely by taxes.
The 30 Baht Scheme is open to anyone who is not covered by other government forms of insurance, such as civil servants, medical benefit schemes and Social Security Scheme. One of the goals of the program was to shift the focus from treatment to prevention by making preventative care more accessible and affordable. In most every sub-district (think township or neighborhood) there is a medical clinic, colloquially known as the animai, where anyone can go for basic healthcare needs. Some of my fellow volunteers spend time working at the animai: counting pills, making cotton swabs, doing safer sex outreach, etc.
This program was such a success that it won the lasting loyalty of many rural farmers and low-income Thais. There have been criticisms levied from middle- and upper-class Thais. The allegations are that they have been denied care under the premise that they would be drawing too much from the limited funding resources.
Previously, low-income Thais were supposed to be covered and provided a “Low-Income Card,” but many families did not receive the card and thus did not receive the associated benefits. As a result, they had to pay for a 500 baht insurance plan. The publicity of the 30 Baht Scheme solved much of this issue. The number of people who accessed healthcare after implementation rose, with many healthcare providers observing that more people came in earlier than they would have in the past.
For more, you can read this issue of the Thailand Development Research Institute’s Quarterly Review.
Healthcare Options
There is an extensive network of government healthcare available from the animais to large hospitals in the provincial capitols. However, the number one reason people from other countries come to Thailand is not for the beaches or the culture; medical tourism is the number one draw. Most medical tourists are not coming to Thailand for the government hospitals; they are coming for the world class private hospitals for the relative inexpensiveness of the procedures done here.
In fact, Bangkok is the medical hub for Peace Corps countries from Eastern Europe to China and all the Asian countries Peace Corps is in. If the medical system in any of those Peace Corps countries does not have the ability to care for a volunteer up to the standards of Peace Corps, the volunteer is medically evacuated to Bangkok. The hospital that Peace Corps has a contract with, Bumrungrad, is a world class, 5-Star hospital and takes excellent care of people.
I’ve been to a couple of public hospitals, once to visit a supervisor who was in a car accident and once to accompany my co-teacher to an appointment. They are certainly different than hospitals in the States, in the sense that they are sensitive to a lot of the Thai cultural values (which makes sense). The staff seemed very competent and the number of people there did not seem like it was more than it should be. I’ve been to a couple of private hospitals, for the stitches in my lip and for some blood tests, and the care that I received was superb. From talking with some of the villagers and seeing the impact of the universal, low-cost healthcare system, I’d say that overall it has been of great benefit to Thai people.
Idolina Doyka October 14, 2013
I always enjoy learning more about how other health care systems operate in different countries. Working in the health care system myself, I have certainly seen the downfalls of how it operates in the U.S. It’s really interesting that Thailand sees so much in hospital tourism- low-cost care is not always easy to find! My brother is actually living in Taiwan now, and within a week after arriving he had to go to the hospital. Long story short, $100 US Dollars without any insurance covered one night hospital admission through the emergency department, multiple tests, IV fluids, and all medications to take home. I truly hope that some day, even if not in our lifetime, the way health care is managed in the US will be done in such a way that will make it affordable to all people without compromising quality.