Abstract
The National Health Security Act 2002 provides health coverage to only “Thai citizens”. The new
universal coverage scheme (UCS) in 2002 deprived people with citizenship problem (mainly stateless
minority around 700,000) of the previous coverage under the low income card scheme. In the past five
years, many attempts from stakeholders were carried out to solve this issue. Eventually, the people with
citizenship problem scheme (PCPS) was approved by the cabinet in 2010 to provide essential health care
for people with citizenship problems. The aim of this study was to compare differences in management
of and benefit packages between the PCPS and the UCS in 2020. We applied a descriptive study to review
and analyze related documents as of 1st January 2020. Results indicated that more than 600,000 children
and students of stateless minorities withheld by the cabinet resolution since 2016 were waiting for the
approval of identity to get health benefit. The budget for PCPS did not cover 7 additional items as the
UCS’s budget, including the no-fault compensation to the users and providers of health care. Only three
public hospitals provided health care to the PCPS beneficiaries in Bangkok. In addition, there were 33
different benefits between the PCPS and the UCS. The UCS covered 21 more health interventions and
services than the PCPS. The similar 12 benefit items had different management. Three items in the health
benefit package had different reimbursement rates. The UCS had 9 special management programs more
than the PCPS. Moreover, the PCPS reimbursed 227 items of equipment and prosthesis while the UCS
reimbursed 316. The policy recommendations include increasing the budget for specific service gaps and
items of reimbursable prosthesis and no-fault compensation in health care, increasing provider networks
in Bangkok, and improving management capacity. Further studies on access, efficiency and quality of care
of the PCPS were recommended.
