Abstract
The ultimate aim of Universal Health Coverage (UHC) is 1) to ensure that all Thai citizens have
access to essential health services when needed without financial barriers, 2) to improve equity in
utilization of health services and 3) to protect households from financial catastrophe and impoverishment
due to medical bills. Thailand has achieved UHC since 2001. However, some are still uninsured
and may face difficulties when they need health services. Objective: This study aims to estimate the
number of Thai population who were at risk of potentially falling into a vicious cycle of “low education,
poverty and illness”, and identify who they are, where they live and whether they suffer from
medical bill? Method: Data from the Health and Welfare Survey 2015 conducted by the National
Statistical Office were utilized. The studied variables included socioeconomic, healthcare utilization
of both inpatient and outpatient services, and the out of pocket payments. Result: There were about
2.4 million Thai populations identified as having lowest economic household status, educated up
to primary school and had no jobs or being economically inactive. Among these vulnerable people,
59,779 had no health insurance. For this subset of population, 86 percent were female, their average
age was 38 years and most of them lived in municipal or urban area, Bangkok or in the central
region. When they were ill, the majority (62 percent) chose self-medication or sought traditional care
or herbal medicines. For hospitalized illness, all (100 percent) admitted to public hospitals, and paid
for medical bills by themselves (i.e., out of pocket) with a higher amount than those insured (Median:
9,999 Baht vs 700 Baht, respectively). Summary: Proactive and passive policies with collaboration
among ministries, especially the Ministry of Public Health, the Ministry of Labour and the National
Health Security Office would mitigate vulnerability of these risk groups and gradually reduce, then
eliminate the vicious cycle.
