Abstract
This study was aimed at assessing the governance and management of purchasing universal health
care services of Thailand’s National Health Security Office (NHSO). The research methodology used was
the quality method; it involved reviewing the literature and related documents, a briefing from the staff of
the NHSO and in-depth interviewing of the representatives of providers and purchasers in each selected
province in four regions of Thailand. The data obtained were analyzed by using content analysis technique
and the result was presented descriptively. The results of the study showed that governance existed
at both the central and provincial levels. At the central level, governance was provided by four important
organizations including the NHSO Board, the NHSO, the Service Standard and Quality Control Board
(SQCB), and the Ministry of Public Health. At the provincial level, governance passed through three
important organizations comprising the Provincial Public Health Office (PPHO), the provincial branch of
the NHSO, and the public and private health-care providers. The regional branch of NHSO and local
government had little to do with governance. Governance was informal in the provinces. The problems
of governance were due to the confusion between the purchasing and providing functions of the PPHO.
The purchasing power of the NHSO provided a great effect on the governance of the provincial health
insurance. There are four important summarizing recommendations for improving service purchasing
governance, including separating the SQCB into an autonomous body, making the division the cutting
between the purchasing and providing roles, delegating more authority to branch offices of the NHSO,
and opening more opportunities to civil society and local organizations for participating in governing the
purchasing functions under the Universal Coverage Scheme.
