The policy for the 1990 issuance aimed to increase coverage for the eligible and to improve efficiency in screening out the non-eligible. Various strategies were used, e.g.
(1) active finding of the target group,
(2) expanding eligibility criteria to the handicapped, the elderly, farmers without their own land, and temporary residents living below basic minimal needs,
(3) dissemination of information,
(4) facilitating the process of application.
There are practical difficulties in assessing the income level of those working in an informal sector, workers with irregular employment, and those engaged in farming. Most village committees used MOPH guideline together with their conversant criteria, e.g. temporary home, landless even for house building, poor health status, chronic diseases. (Oumkrua A, 1989)
The problems on coverage of the Low Income Card are:
(1) appropriateness and adequacy of the eligibility criteria,
(2) application of eligibility criteria during card issuance,
(3) shifting of target population to other competing scheme.
10.1 Social Security Scheme and Workmen Compensation Scheme
During the first 2 years of implementation, the Social Security Scheme covered those enterprises with 20 employees upward. In 1993, the scheme extends to cover the enterprise with 10-19 employees. In 1995, the scheme included voluntary health insurance. The populations covered were 2.93%, 3.87% and 4.62% and the end of calendar year 1991, 1992 and 1993 respectively. However, because of the high rate of turn over of the workers, the actual number of workers covered by the Social Security Scheme at any time was only 70-75% of the above figure (social Security Office, 1993).
There was an abrupt rise in the number of workers registered with the Workmen Compensation Fund from 1.8 millions in 1990 to 2.75 million of the workers under Social Security Scheme was one reason for a higher coverage of the Workmen Compensation Fund.
10.2 Health Card Scheme
The coverage of Health Card Scheme gradually declined after reaching the peak in 1987. After changing to be a health insurance scheme with greater political commitment and the Agriculture and Cooperative Bank (ACB) has been approach to be a partner of the scheme to collect money from the village level, it seems that the coverage is rising up again. Unfortunately, the information system in the Health Insurance Office is lack of the number of card members; only number of cards sold is collected. Estimation of 1.1 million households or 4-5 million people, i.e. 8% of the population, was members of Health Insurance Card in 1994. However, the figure from ACB which is considered to be the most reliable was 3.3% of the population.