Abstract
This research aims to probe the health problems and the access to the healthcare system in a sensitive group of citizens in Thailand, as well as to explore and expand the research topics on health and access to the healthcare system in the mentioned group, which could lead to the development of future proposals of policies. This research is composed using mixed methods which are: 1) Citations from documents, articles, and related academic writings, 2) Qualitative research with the information gathered from insightful interviews with taxi drivers in Bangkok and its vicinities, 3) Quantitative research with 300 sets of queries answered by taxi drivers found at several taxi stops, taxi depots, and rest stops in Bangkok and its vicinities, and 4) Public debates with taxi drivers allowing them to voice their opinions and problems for practical development of policies. The research shows that 97.7 percent of the 300 informants are male, and one-third of them aged over 60 years old. They are from 4 major backgrounds: 1) Internal migrants with 80 percent of them migrating from the provinces in the North-East region for many generations, 2) Workers changing jobs, 3) Part-time taxi drivers, and 4) Retired civil servants, which increase in the past years. With their age and the nature of the job that requires them to sit and drive for an average of 10-12 hours per day, most taxi drivers face multiple health problems – with the majority adopting diseases such as hypertension, diabetes, and hyperlipidemia. On the other hand, more than half of them have never had an annual health check and are afflicted with body, knee, or back pain, urinary tract inflammation, and accumulating depression from the traffic, decreasing income, and behaviors of the passengers. For access to healthcare services and other benefits, we found that the majority have the Universal Coverage Scheme (UCS) which is known for its limitation when used outside of the registered domicile. Moreover, the taxi drivers are found to have limited knowledge of healthcare services and lack fundamental benefits such as unemployment funds, insurance, provident funds, or bank credits. With rising competitiveness and disruptions from either taxi applications or the Covid-19 pandemic, they end up having deficits. These lead to bad driving behavior which is followed by customer complaints aggravating the existing systematic problems such as loosening standards, pressuring government policies that demotivate the compliance of their income and expense, particularism, and conflicts of interest. These problems impact the small-time drivers and are the root of the ongoing dissatisfactory services.
The research hence contains summary and policy proposals. In the short-term we should 1) Promote taxi drivers’ access to the healthcare service and provide health screening, 2) Provide public benefits equivalent to the benefits prescribed in Article 33 of Social Security Rights, 3) Establish a central fund and foundation to look over driver registration and benefits with taxi drivers participating as a part of the establishment, and 4) Improve taxi drivers’ skills and knowledge to prepare them for market competition and service disruption. For the long-term proposals, 1) Develop taxi standards, which could be done in various ways whether to set up driver qualifications (having a public driving license, regular car inspection, and an up-to-date certificate, passing performance tests regularly) and enforce legal requirements for the professional certificate and specific driving license as a part of a quality driver screening, 2) Create alternative taxi systems for central government or in Bangkok such as taxis for the senile, disabled people, and other specific groups in addition to the non-developed typical taxi meters with uneducated and old drivers to improve service and income.
