Situation Analysis Health

There was confusion in target setting for various schemes to be financed by the government in fiscal year 1995.  The author (Supachutikul A) was asked to clarify these numbers.  Estimation of number of population covered by each health benefit scheme in each age group was done.  Table 3-3 demonstrates the result.  Emphasis was put on the important of family scheme over scheme set by age group.  The calculation was based on the assumption that the Free Medical Care for the Low Income and the Health Card Scheme are family scheme, i.e. they will also cover children and elderly.  It was found later that the implementation did not follow the assumption.  The Elderly Cards were issued to all people with age more than 59 years old and the children and the elderly are excluded from Health Card Scheme.  The figure 8.5% of the Health Card Scheme was a target set by the Ministry of Public Health.  The Agriculture and Cooperative Bank gave a figure of 3.3% coverage.  However, true coverage of the Health Card Scheme in 1995 is unknown.

There is a problem of double counting in the group of children under 12 years.  The Ministry of Education is responsible for setting the target of primary school students to be covered.  Even though the figure are students in school under  supervision of the Office of National Primary School only, the summation of children under all health benefit schemes in this age group are more than the total number of children in this age group.

Kiranandana T (1993) did a forecasting the coverage of 8 schemes up to the year 2000 based on the projection of demographic and economic data.  The poverty line for the Low Income Scheme was a previous one, i.e. 2,000 baht/month for households and 1,500 Baht /month for individuals.  Thus the percentage of those who will be covered by the Low Income scheme was underestimated.

Comparing the 4 sources of information (table 3-4), there is a gradual decline of the uncovered groups.  The reliability should be checked across various sources of information, including a national survey.  The coverage figure in 1995 was the last estimation.  The only unreliable data is for the Health Card Scheme.  In the worst case, i.e. the Health Card cover only 3.3%, then the uncovered people should rise to 37.3%.  However, it is still difficult to determine effective coverage, especially for the Medical Welfare Scheme for the Low Income.

The following graph shows numbers of beneficiaries in each scheme from reported data.  There are gradual expansion of CSMBS,SSS, and WCF.  The drop in coverage of Free Medical Care for the Low Income coincided with the promotion and rising of Health Card in 1987.  There was shrinkage of Health Card Scheme during after it reached the peak in 1987.  With political support, it expands again in 1994.  The elderly and children under 12 are not included in this graph.