A Brief Overview of Health Care in Thailand

By Madeline Gere, Megan Poling, and Lyons Wells

During a primary orientation meeting for the May Term Thailand Course, a question regarding the quality of Thai health care was asked. Han Kim replied, “Oh yeah, the Thai health care system is great. In fact, some people travel there for health care. Medical tourism, ever heard of it?” By many measures medical practice in Thailand is laudable. With a rich history of Thai medical care and progressive advancements, Thai health care has emerged as a leader in medicine.

History of Thai Health Care

Medical care has deep roots in the history of Thailand. Dating back to the early 11th century, there is evidence of intentional efforts to provide healing services to the people. Tools to produce medicines and written instructions for a royal medicinal garden suggest that many empires studied and manipulated the healing properties of their natural environments (Hays, 2008). During the 14th to 18th century, health care continued to grow. Some major advancements included royal drug dispensaries, drug stores and royal documents detailing the effects and directions for using specific medicines (Hays, 2008). The study and expansion of medicine was an integral part of many historical eras in Thailand.

Western medicine was slowly incorporated into Thai health care. The French and Portuguese were responsible for introducing international methods of medicine and Western hospitals to the Thai (Hays, 2008). When King Phet Racha banned foreigners from the

kingdom, the flow of Western medicine also diminished (Hays, 2008). However, underScreen Shot 2017-05-13 at 1.12.01 AM the rule of King Rama III, a traveling doctor from America offered the vaccination for smallpox, and international health care practices were again welcomed (Hays, 2008). Rama V incorporated Western medicine through the

installment of a hospital, medical school and textbook offering a blend of traditional Thai and international treatments (Hays, 2008). Thus, Western medical practices supplemented instead of overtaking traditional Thai medicine.

In more recent history, Thai health care has steadily improved to protect Thai lives. Between 1960-1980, life expectancy increased by nearly ten years (Hays, 2008). Additionally, the overall Thai death rate declined from 34.4 deaths per 1000 people in 1920 to 7.7 deaths per 1000 people by 1984 (Hays, 2008). Much of this decline is attributed to the progress in Thai public health in both rural and urban Thailand (Nitayarumphong, 1990). In more recent years, healthcare has improved even more due to universal health care.

Modern Thai Health Care

In recent years, public health officials in Thailand have pushed to make healthcare services more widely available to its people. As of 2002, the people of Thailand now receive 100% full-coverage on health care. (Bulletin of WHO, 2017). Some successful factors of Thailand’s universal health care system have been a dedication to political leadership, community engagement, and stiff budget control. Over the years, Thai health care coverage has expanded (Bulletin of WHO, 2017). Today, Thai health care is still growing and evolving.

Currently, modern Thai healthcare is learned through the teachings of Prince Mahidol. He is considered to be the father of modern medicine and public health in Thailand (Bulletin of WHO, 2017). Prince Mahidol’s teachings say to “put public health interests first and self-interests second.” Every year, Thai health care aims to grow in size and quality (Bulletin of WHO, 2017). Thai hospital accreditation is improving and modern Thai health care is moving forward, as a whole.

Screen Shot 2017-05-13 at 1.12.55 AMModern healthcare in Thailand often incorporates traditional Thai methods. In fact, some hospitals have even integrated this traditional Thai medicine into its systems (Chotchoungchatchai, 2012). The modern Thai health care system aims to utilize herbal medicine in its established and progressive hospitals. A study conducted on the Kabchoeng Hospital shows that the integration of traditional Thai medicine and modern medicine are very sustainable for the Thai community (Chotchoungchatchai, 2012).

Modern Thai health care offers a wide variety of nonprofit health organizations (Health Care in Thailand). These health organizations include, Red Cross and World Vision. As already mentioned, Thailand is also a major medical tourism destination. There is a private medical sector, where a selection of trained doctors and medical facilities are available. On the other hand, it is very common for Thai doctors to be trained in particular fields (Health Care in Thailand). General practitioners are limited, and if seeking medical attention, a person will most likely meet with a specialist.

Overall, modern Thai health care has incredible quality. It is important to recognize that the Thai health care system is separated into three distinct areas (Health Care in Thailand). These areas include, government health services, non-profit health organizations, and the private medical sector. When traveling to Thailand there is an abundance of health care services available at a relatively affordable cost. Amongst other concerns that people may have in Thailand, health care should not be one of them.

Thai Versus American Health Care

The United States of America operates under multiple systems of healthcare, unlike in Thailand where there is only one system: universal healthcare. In the US citizens have a

selection of who to acquire insurance through. It can be purchased in the private marketplace or provided by the government to people who qualify (Ridic, 2012). Approximately 61% of coverage provided in the United States comes from employers (Ridic, 2012). Because there are huge savings associated with receiving benefits from an employer, most people pursue this option. Low-income families with no access to child supervision services are unable to sacrifice their time, and thus may not be able to access insurance through employers. In 2010 when the Affordable Care Act (ACA) was enacted, it amped coverage for impoverished people. “The [ACA] included an expansion of Medicaid eligibility to all those with incomes up to 138% of the poverty line, regardless of family status or place of residence (Blumberg, 2012).” Although the Supreme court voted to make this state optional, it showed that the United States was looking for a more practical and fair system.

Ninety-eight percent of Thailand’s citizens are covered by health insurance (CGD, 2017). In the United States there is a 90.9% coverage rate (USCB). Before the Universal Care Scheme (USC), Thailand had low coverage rates, and out-of-pocket paying was very common. The United States also had reduced rates and increased out-of-pocket spending before the ACA. On the personal level of the health care system in the US, one will find a lot of specialists and also a number of general practitioners. In Thailand, it is not quite the same. At health centers and hospitals specialists are the norm. Most of the doctors in Thailand will attend school in the United States and for tourists visiting the country it can be difficult to a general doctor.

In Thailand there are 21 hospital beds per 10,000 population. In the United States there are 29. The health worker density is also lower in Thailand than it is in the US. ~.4 physicians per 1,000 population vs. ~2.45 physicians per 1,000 population respectively (WHO, 2017). These differences are a symbol of the current advancements Thailand is making. With the USC now in its 17 year of use, we can expect to see if the system proves to be effective for the country.

References

Blumberg, L. (2017). The Affordable Care Act: What does it do for low-income families? . Retrieved 10 May 2017, from https://www.irp.wisc.edu/publications/fastfocus/pdfs/FF15-2012.pdf

Bulletin of The World Health Organization. Thailand’s health ambitions pay off. Retrieved May 10, 2017, from http://www.who.int/bulletin/volumes/92/7/14-030714/en/

CGD. (2017). Thailand’s Universal Coverage Scheme . Millionssaved.cgdev.org . Retrieved 10 May 2017, from http://millionssaved.cgdev.org/case-studies/thailands-universal-coverage-scheme

Chotchoungchatchai, S., Saralamp, P., Jenjittikul, T., Pornsiripongse, S., & Prathanturarug, S. (2012). Medicinal plants used with Thai Traditional Medicine in modern healthcare services: A case study in Kabchoeng Hospital, Surin Province, Thailand. Journal Of Ethnopharmacology , 141 (1), 193-205. doi:10.1016/j.jep.2012.02.019

Hays, J. (2008). Health and Health Care in Thailand: Facts and Details. Retrieved May 10, 2017, from http://factsanddetails.com/southeast-asia/Thailand/sub5_8g/entry-3299.html#chapter-1

Healthcare in Thailand. Retrieved May 10, 2017, from https://www.internationalstudentinsurance.com/thailand-student-insurance/healthcare-i n-thailand.php

Nitayarumphong, S. (1990). Evolution of primary health care in Thailand: what policies worked?. Health Policy & Planning , 5 (3), 246.

Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of Health Care Systems in the United States, Germany and Canada. Retrieved May 10, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633404/

US Census Bureau. (2017). Health Insurance Coverage in the United States: 2015 . Census.gov . Retrieved 10 May 2017, from https://www.census.gov/library/publications/2016/demo/p60-257.html

World Health Organization. (2017). World Health Organization . World Health Organization . Retrieved 10 May 2017, from http://apps.who.int/gho/cabinet/uhc.jsp

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