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Healthcare Report Thailand March 2018

Healthcare Report Thailand March 2018

  • March 2018
  • ID: 2069945


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  • At an estimated 6.6% of GDP in 2017, Thailand spends proportionally more on healthcare than Singapore, the Philippines and Malaysia, but less than Vietnam. The Economist Intelligence Unit expects healthcare expenditure as a proportion of GDP to rise to 6.8% in 2020-22, propelled by an ageing population, a growing prevalence of chronic diseases and new technologies.
  • The military government, which came to power following the 2014 coup, is more fiscally prudent than its populist predecessors and will continue to dedicate more resources to boosting the flagging economy. However, the government has dismissed concerns, prompted by the debate over the 2016 constitution, that it plans to scale back Thailand's publicly funded health insurance schemes first introduced in 2002.
  • The government has confirmed plans, which predate the 2014 coup, to decentralise the public healthcare system as part of its efforts to improve efficiency. Under the "Thailand 4.0" vision it will also aim to promote the development of telemedicine in order to improve access to care.
  • Total healthcare spending stood at an estimated US$28.5bn in 2017. We forecast a rise to US$36.3bn in 2022. In US dollar terms, total healthcare spending will record an estimated compound annual growth rate (CAGR) of 5% in 2018-22, with pharmaceutical sales rising at a similar rate. In local currency terms, healthcare and pharmaceutical spending will both rise at an estimated CAGR of 5.8%.

Funding sources

  • According to the latest available data from the World Health Organisation (WHO), general government expenditure accounted for 77% of healthcare spending in Thailand in 2015, up from 66% in 2005, but down from 78% in 2013. The proportion has risen over the past decade owing to the roll-out of universal healthcare.

  • Thailand reformed its public healthcare system in 2002, extending coverage to 18m people who were previously uninsured and incorporating a further 29m who had been covered by less-comprehensive schemes. The resulting universal healthcare system was enshrined in the constitution in 2007.
  • The Thai population is now covered by three health insurance regimes with different benefits. The largest is the universal health coverage (UHC) scheme, also known as the 30-baht scheme, which was launched in 2002 and now covers 70% of the population. The remainder of the population, including private-sector employees, is covered by self-financed social security schemes or by a tax-funded Civil Servant Medical Benefit Scheme for state sector employees.
  • The UHC is tax-funded via the Ministry of Health and accounts for around 40% of public healthcare expenditure. However, the government is concerned about the scheme's sustainability in the face of rising old-age dependency and the increasing prevalence of long-term chronic diseases.

  • The public healthcare system provides free outpatient care, preventative health measures, hospitalisation and emergency treatment (including cancer treatments and surgery), as well as free pharmaceuticals. However, it does not cover all categories of inpatient care, giving successive governments leeway to expand or restrict the basket of care.
  • Under the new constitution approved in August 2016 following a referendum, Thailand's military government is still under obligation to provide an "efficient public health system for all citizens". However, where the previous constitution spoke of an "equal right" to care, the new constitution specifies that healthcare should be free of charge for the poor. There are concerns that this will be used by the military government to undermine the principal of universality, although the administration denies this.
  • The government's budget for 2017 saw defence spending rise sharply, while funds for education, healthcare and infrastructure fell. This has prompted concern from the National Health Security Office that the quality of health services will decline, eventually forcing citizens to take out private insurance.

Private health insurance

  • Out-of-pocket payments accounted for around 12% of total healthcare expenditure in Thailand in 2015, down from 25% in 2005. Voluntary health insurance plans accounted for 6% of Thailand's total expenditure on health in 2015, compared with 10% in Malaysia and 13% in the Philippines. This reflects the rollout of the public health system in Thailand.

  • Bupa Thailand, a subsidiary of the UK-based health insurance provider, is estimated to have a share of around 80% of the specialist health insurance market in the country. It caters to over 300,000 members and a network of over 400 healthcare providers in the country. In July 2017 Aetna, a US insurer, said that it had reached an agreement with Bupa to buy the business for an undisclosed sum as part of its plans to expand in Asia.

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