International Health Policy Program, Nonthaburi, Thailand.
National Health Security Office (NHSO), Bangkok, Thailand.
BMJ Glob Health. 2022 Jun;7(6). doi: 10.1136/bmjgh-2022-009281.
Despite Thailand having had universal health coverage (UHC) with comprehensive benefit packages since 2002, services are neither listed nor budget earmarked for COVID-19 responses. Policy decisions were made immediately after the first outbreak in 2020 to fully fund a comprehensive benefit package for COVID-19. The Cabinet approved significant additional budget to respond to the unfolding pandemic. The comprehensive benefit package includes laboratory tests, contact tracing, active case findings, 14-day quarantine measures (including tests, food and lodging), field hospitals, ambulance services for referral, clinical services both at hospitals and in home and community isolation, vaccines and vaccination cost, all without copayment by users. No-fault compensation for adverse events or deaths following vaccination is also provided. Services were purchased from qualified public and private providers using the same rate, terms and conditions. The benefit package applies to everyone living in Thailand including Thai citizens and migrant workers. A standardised and comprehensive COVID-19 benefit package for Thai and non-Thai population without copayment facilitates universal and equitable access to care irrespective of capacity to pay and social status and nationality, all while aiming to supporting pandemic containment. Making essential services available, notably laboratory tests, through the engagement of qualified both public and private sectors boost supply side capacity. These policies and implementations in this paper are useful lessons for other low-income and middle-income countries on how UHC reinforces pandemic containment.
尽管泰国自 2002 年以来就已经实现了全民医保(UHC),并提供了全面的福利包,但针对 COVID-19 的服务既没有被列入清单,也没有专门的预算。2020 年首次爆发疫情后,立即做出政策决定,为 COVID-19 全面福利包提供全额资金。内阁批准了大量额外预算,以应对正在展开的大流行病。全面福利包包括实验室检测、接触者追踪、主动病例发现、14 天隔离措施(包括检测、食品和住宿)、野战医院、转诊救护车服务、医院和家庭及社区隔离的临床服务、疫苗和接种费用,所有这些都无需用户自付费用。还为接种后发生的不良事件或死亡提供无过错赔偿。使用相同的费率、条款和条件从合格的公立和私立供应商处购买服务。该福利包适用于所有居住在泰国的人,包括泰国公民和移民工人。为泰国和非泰国人口提供无自付费用的标准化和全面的 COVID-19 福利包,无论支付能力和社会地位如何,都能促进全民平等获得医疗服务,同时旨在支持大流行病的控制。通过吸引合格的公私营部门参与,提供必要的服务,特别是实验室检测,可以增强供应方的能力。本文中的这些政策和实施为其他低收入和中等收入国家提供了有用的经验教训,即全民医保如何加强大流行病的控制。