Universal health care in Thailand: concerns among the health care workforce.
OBJECTIVE
To investigate the impact of the universal health care policy from the perspective of Thai health care professionals.


METHODS
Semi-structured interviews with purposively selected health care professionals and key informants.


RESULTS
Health care professionals at public hospitals, particularly in rural areas, have experienced up to a doubling in the number of daily out-patients; many with superficial symptoms. While the improved access to health care provisions was welcomed, questions regarding the appropriateness of seeking medical advice were raised. Concern regarding equity: between the universal health care policy and two parallel public health cover schemes; rural and urban areas; and the public and private sector also emerged. There are potentials for health care professionals to congregate in the private sector and urban areas where workloads are perceived to be less demanding.


CONCLUSIONS
The general perception of the health care professionals interviewed suggests that although increased access and health equity was welcomed, this policy has had undesired effects and exacerbated rural-urban and public-private tensions. Universal coverage increased access to health care. However, equity may be further enhanced by consolidating the three public health covers into a single scheme and develop a parallel private income protection insurance scheme.
Thoresen
Stian H
SH
Research Associate, Centre for Research into Disability and Society within the Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. S.Thoresen@curtin.edu.au
Fielding
Angela
A
D001291:Attitude of Health Personnel; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D013785:Thailand; D019472:Universal Health Insurance