Abstract
This research project has three main objectives. The first objective is to analyze and assess the health insurance problems, resulting from a lack of national health insurance policy. The second objective is to propose a model for health insurance policy coordination and management system in order to achieve universal coverage. The last objective is to provide the appropriate measures, including policies, law, organizations, as well as plans, to implement a model of health insurance policy coordination and management system. The measures should have sufficient details for the policymakers so that they can make an effective decision. This is a policy research that searches for information necessary to set up alternatives of health insurance policy for policymakers. In addition, this research is an action research. That is, it focuses on pragmatic results. The study employs both qualitative and quantitative approaches. The research sample consists of four groups : policymakers, top executives, managers of health service providers, and rural community leaders. Two types of sampling techniques are used in combination: purposive sampling and snowball sampling. Various kinds of data collection are used such as reviewing literature, indepth-interviewing, focus group, brain-storming, public workshop, and self-administered questionaires. Data compiled is analyzed by both qualitative and quantitative methods. Research findings are as follow: First, there are three main problems to the current health insurance system.There is limited stakeholders awareness regarding the policy formulation of universal health Insurance. 2.) The coverage of health insurance in Thailand is to only about eighty percent of Thai citizens, whereas about twenty percent of them are not covered by any kind of health insurance schemes. Besides, there are overlapping target population among the various kinds of health insurance schemes. Therefore, in reality, the figure of health insurance coverage is less than eighty percent. 3.) Problems of equity and justice of health care services directly affect the quality of health care services. Second, the study proposes a model for health insurance policy coordination and management system in order to achieve universal coverage (Fig. 4.2, page 82). The model recommends the establishment of the Office of the Board of National Health Insurance and the Provincial Health Insurance Offices. The Office of the Board of National Health Insurance is an agency under the administration of central government.
