Abstract
This study aimed to serve three principal purposes, first, to review lessons learned in administering health security for migrant workers and non- Thai within the international and local contexts; second, to critically analyze the roles and responsibilities toward health security system governance of central- coordinating agency and finally to synthesize the alternative model of central coordinating agency to ensure organization accountabilities in formulating applicable and accessible health security in Thailand. The study was undertaken by using qualitative research, relevant literature review, detailed semi-structured interview, and group brainstorm session for the data collection process. The study results revealed that socio- economic integration and expanding globalization have substantially influenced upon public health administration for migrant workers and non-Thai nationals, both global and regional contextualization. However, multi- stakeholder alliances in the healthcare system and departmentalism have resulted in problematic situations in governing health security for non-Thai. These four unsolved problems were: first, lack of working integration between political authorities, policy implementers, and responsible agencies; second, conflict of law and overregulation including ambiguity in non- Thai national’ s legal rights to access health security system; third, lack of integration between levels of management across the external organization and inefficient segregation of duties, together with inharmonious relationship between the regulator, user, and service provider in the healthcare system, finally, inefficient service from the unclear guideline on the multinational customer, triggering higher additional cost. Based on previous problem statements, this study presented five options under two frameworks as the solution approaches to establish a central- coordinating agency that governs the health security system for foreign workers and non- Thai nationals. The mentioned frameworks consist of; Framework No. 1: adjusting responsible departments or agencies within the Ministry of Public Health, first option: Promoting Division of Health Economics and Security to be Central Collaboration Office, administering health security system for migrant workers and non-Thai. Second option: Establishing a new division within the Office of the Permanent Secretary, Ministry of Public Health to mainly operate as Central Collaboration Office, working together with the Division of Health Economics and Security as a finance department. Framework No. 2 Promoting organization structures and legal frameworks for related government agencies governing health security systems for migrant workers and non-Thai. First option: Establishing multinational fund as an independent entity working under a government agency or public organization. Second Option: Drafting National Health Security Act for non-Thai nationals. Third Option: Reinterpreting the Law that recognizes the rights holder specified in section no. 5 of National Health Security Act, B. E. 2545 to cover all Thai citizens, including Stateless and People with Citizenship Problems.
