Abstract
Traffic Victim Protection Act was implemented since 2535. Though it is a mandatory scheme, instead of public sector, the for profit private insurance companies are the carriers of the scheme. The Scheme compensates healthcare based on fee for services and maximum liability, a lump sum death and disability compensation are also granted. Financial report in 2545 indicated a net premium of 7,003 million Baht collected, with very high administrative cost (41%) and low loss ratio (52%), and inadequate cover all traffic victims. There is a need for a major reform in the context of achieving Universal Healthcare Coverage in Thailand in 2545. The objectives of this study are to estimate total resource requirement (for medical care, death and disability compensation) for all traffic accident victims, to estimate how much would the government introduce additional gasoline tax to cover all traffic victims, and provide policy choices for reform. Based on secondary sources of information, it was estimated that total resource requirement for all traffic accident victims would be 7,158 million Baht in 2545, of which 63% for inpatient care, 16% for pre-hospital care, 15% for death compensation, 5% for ambulatory care and 1% for disability. Household consumption of gasoline from the 2545 household socio-economic survey conducted by National Statistical Office was used to compute total litre of different types of gasoline consumed by household categorized by income deciles. To generate the total 7,158 million Baht to cover all traffic victims, the government has to raise 0.32 Baht to a litre of gasoline, given no price elasticity of demand by all household deciles. Several scenario of raising gasoline tax was proposed. We recommend the least regressive option, 0.26 Baht per litre for all type of gasoline except Octane 95, and collection 0.55 Baht per litre of Octane 95. Two goals of reform are identified: to cover all traffic victims (both caused by the insured and non-insured cars) and appropriate Scheme administrative cost. Three reform options were proposed based on sources of finance, option one generate revenue from premium contribution by car owners, option two from general tax and option three from dedicated gasoline tax. Analysis indicates that option two and three are neither politically feasibility nor socially acceptable. Three choices of reform under option one were identified: conservative, minor and major reforms. We recommend a major reform. This is to sub-contract the Department of Land Transport to collect premium while the mandatory annual renewal of car license. The large part of premium would be transferred to the National Health Security Office (NHSO) to cover all victims for medical care, death and invalidity compensations. The second preferred choice is minor reform, sub-contracting private insurance companies to collect premium, the large part of premium would be transferred to the NHSO.
