Based on the information obtained from interviews with key informants and documents studied during
2001-2 (1), this chapter examines the events and factors contributing to the making of the universal
coverage of healthcare (UC) policy, and its agenda setting process, as instigated by Thai Rak Thai Party
(TRTP), which officially became a political party in July 1998. A policy analysis framework is used to
explain the UC policy process in terms of interactions of four main factors: content, context, actors, and
processes (2).
The term “universal coverage” may be defined “as a situation where the whole population of a country
has access to a good quality services (core health services) according to needs and preference, regardless
of income level, social status or residency” (Nitayarumphong, 1998: 4) (3).
With the support from stakeholders, such as bureaucrats, NGOs, and other civil organizations, in 2001,
Thailand introduced the UC policy shortly after the Thai Rak Thai Party (TRTP) government came into
power, with the aim to entitle all Thai citizens to healthcare access by reforming the health care system to
achieve equity, efficiency, quality and accountability. The government’s policy was to establish a
subsidized healthcare scheme or better known as the ‘30 baht Scheme’ or the ‘Universal Coverage (UC)
Scheme’ to replace the two existing schemes, the Medical Welfare Scheme (MWS) and the Voluntary
Health Card Scheme (VHCS), and expanded coverage to the uninsured. The 30 baht Scheme would be
financed largely from tax revenue, with a minimal co-payment of 30 baht per medical visit, and would
provide a comprehensive benefit package for active treatment of illnesses and preventive medicine,
whose main aim is the prevention of disease. The scheme was already covering about 80% of the
population, excluding only those in the formal sector, who were covered by the Social Security Scheme
(SSS) and the Civil Servant Medical Benefit Scheme (CSMBS). At the same time, the government would
have to reform the country’s healthcare-financing and healthcare service systems. The UC policy would
also mobilize resources to primary health care, through contracting and collaborating with the private
sector providers. It was a “big bang” reform in the Thai healthcare system.