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Title: The political economy of Thailand's '30 Baht' universal healthcare coverage scheme, 2001-07
Author: Thanbancha, Pitak
ISNI:       0000 0004 6061 723X
Awarding Body: SOAS, University of London
Current Institution: SOAS, University of London
Date of Award: 2016
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Shortly after winning a landslide victory in 2001, the Thai Rak Thai Party introduced the 30 baht Healthcare System, also known as the Universal Healthcare (UC) Scheme. For the first time, this made modern health services available to every Thai citizen for a nominal fee of 30 baht (well under one US dollar). Unsurprisingly, there were immediate improvements in healthcare outcomes in Thailand, and the programme was one of a number that consolidated the hold of the Thai Rak Thai Party in Thai politics, a hold that it and its successor parties continue to have. This research argues that these political motivations had a significant impact on the programme's design, and on the problems that emerged with its financial viability. This dissertation examines the background of the UC System (the 30 baht Healthcare System), and assesses its efficiency in the management of resources, equity of access, and service quality, and the long term viability of the UC scheme in terms of financing and the continued participation of private sector service providers. It finds that secondary data is very hard to access and provides neither a comprehensive picture nor satisfactory answers to these questions. The research used a qualitative case study approach to shed light on important aspects of the performance of the scheme, without aiming at comprehensiveness given the limitations of time and resources. The researcher faced significant reluctance from hospitals to reveal internal management strategies and costs and the initial goal of six case study hospitals was reduced to two. Nevertheless, these two provide very useful insights into important aspects of the scheme. The first is B-Care, a private hospital that joined the scheme in its very early days but then opted out when the financial arrangements proved to be unviable. The second was Baanpaew Hospital, a public hospital. Public hospitals are obliged to participate in the scheme but Baanpaew was exceptional in that it devised changes in management and specialisation that enabled it to remain financially viable, unlike many other public hospitals which face ongoing financial problems. The two case studies therefore shed light on the financial stresses to which the scheme led, and the types of responses that may be required to ensure the survival of the scheme in the future.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral