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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