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Table 1 Brief characteristics of three health insurance programs in Thailand

From: Thailand’s universal coverage scheme and its impact on health-seeking behavior

Civil Servant Medical Benefit Scheme (CSMBS, 9%): Per capita expenditure in 2010: US$ 367

Target population

Government employees, dependents including parents, spouse and up to two children (age < 20)

Financing source

General tax, noncontributory scheme

Payment method

Fee for service for outpatient services and conventional DRG for inpatient services

Health delivery

Free choice of public providers, no registration required

Benefits package

Slightly higher than SSS and UCS

Social Security Scheme (SSS, 16%): Per capita expenditure in 2010: US$ 71

Target population

Private sector employees, excluding dependents

Financing source

Payroll tax financed, tri-partite contribution 1.5% of salary, equally by employer, employee and government

Payment method

Inclusive capitation for outpatient and inpatient services

Health delivery

Registered public and private competing contractors

Benefits package

Comprehensive: outpatient, inpatient, accident and emergency, high-cost care, with very minimal exclusion list; excludes prevention and health promotion

Universal Coverage Scheme (UCS, 75%): Per capita expenditure in 2010: US$ 79

Target population

The rest of population not covered by SSS and CSMBS

Financing source

General tax

Payment method

Capitation for outpatient services and global budget plus DRG for inpatient services

Health delivery

Registered contractor provider, notably within the district health system

Benefits package

Similar to SSS, including prevention and health promotion for the whole population