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Rural health insurance in Thailand: A case study from MAE NA sub‐district, Chiang Mai province
Author(s) -
Adeyi Olusoji
Publication year - 1989
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.4740040406
Subject(s) - business , referral , incentive , subsidy , savings account , socioeconomics , finance , medicine , family medicine , economics , market economy , microeconomics
Abstract This paper reports on a study carried out in July 1988 of the factors associated with membership of the rural health insurance programme in Mae Na, a sub‐district of Chiang Mai province in Thailand. It identifies appropriate interventions for sustaining the membership of the programme. The Health Card Programme in Chiang Mai is the pilot phase of a national health insurance system in Thailand. Possession of a health card entitles the holder(s) to free treatment for a specified number of illnesses per year. The card holder is promised quick services via a ‘green channel’ in referral centres. Funds from card sales are used for reimbursing service providers, for community development, and for soft loans to card holders. The main incentives for households to buy the health card were the expectations of free treatment, reduced waiting time at referral centres, and subsidized drugs. Eligibility for soft loans was not a major incentive for households to buy the health card. The promise of reduced waiting time was often not kept, resulting in consumer dissatisfaction and a preference for private, fee‐charging hospitals by the wealthier households. The timing of health card sales was not planned to coincide with the peak‐income post‐harvest season. The low income card for the poor, which guarantees free access to medical care, was readily available to the wealthy, but its impact on membership of the Health Card Programme is unclear.