Abstract
This research follows the process outlined in the National Health Act B.E. 2550 (2007)
and the Third Statute on the National Health System (2022), which mandates the National
Health Commission to monitor and evaluate Thailand’s health system and revise the Statute
every five years. A key focus of the Third Statute is health financing. The study aimed to assess
the current state of health financing in Thailand using the Statute’s indicators, refine them,
and provide recommendations for improvement. A mixed-methods approach was used,
including a literature review, analysis of quantitative data from secondary sources, and
stakeholder consultations.
The findings indicate that Thailand’s health financing situation reflects a generally
sustainable trend in health investment, but government health spending remains below
expectations compared to other expenditures. Non-governmental expenditure exceeded
established levels, partly due to increased health spending through voluntary private health
insurance. Household expenditure on health was slightly above established thresholds, but
did not significantly contribute to the incidence of catastrophic health expenditure or healthrelated impoverishment. The financial incidence analysis revealed a progressive distribution
of health expenditures. Low-income groups benefitted more from government subsidies on
health than higher-income groups. However, disparities exist both within and between public
health insurance schemes especially on cost-sharing policies, provider payment methods and
rate, and per capita health spending. There are significant disparities within and between public
health insurance schemes, particularly cost-sharing policies, provider payment methods and
rates, and per capita health spending. Additionally, mandatory health insurance has only been
implemented for migrant workers in the formal employment sector. While all health insurance
schemes have mechanisms in place to improve efficiency, the practices vary.
The review of health financing indicators in the Third Statute identified several
limitations. We propose adjustments to align them with international standards, including
removing unsupported quantitative targets, clarifying qualitative indicators, and adding new
indicators to address unmonitored objectives. These revisions result in 21 refined health
financing indicators.
