The Gap Persists

The Differential Usage Of Healthcare In Urban And Rural Areas In Thailand’s Universal Coverage Scheme

Abstract

Universal health care is often seen as a distant dream for many low- and middle-income countries, but for Thailand, it was achieved through the implementation of its Universal Coverage Scheme (UCS). By 2001, nearly 18 million people were falling through the cracks of Thailand’s healthcare system, serving as the main driving force behind the establishment of the UCS. After implementation of this scheme in 2002, 47 million people received coverage, equating to approximately 75% of the country’s population. The goal of the UCS was to entitle all citizens to quality health care regardless of socioeconomic status, and the scheme provided beneficiaries with a comprehensive benefits package focused on primary health care. Although the impact of the UCS was significant, disparities between rural and urban areas prevail. This case study assesses the impact that implementation of UCS had on the utilization of healthcare in rural areas compared to urban ones by examining health service utilization, rate of catastrophic health expenditure, health indicators, and quality of care. The UCS ultimately increased healthcare coverage for all Thais, but the perpetuated inequity between rural and urban areas remains a persistent issue, demanding the prioritization of equal distribution of resources.