HEALTH INEQUITY AMONGST HOUSEHOLDS UNDER THAI PUBLIC HEALTH INSURANCE

Abstract

Objectives: The general objectives are to study the progressivity of healthcare financing and equity towards healthcare utilization, and to measure the catastrophic health expenditures after the implementation of Universal Coverage in year 2001. Methods: The dataset of Household Socio-Economic Survey and Health and Welfare Survey of year 2013 was obtained from the National Statistical Office. Kakwani Index was used to measure the progressivity of out-of-pocket payment against the Lorenz curve of income inequality. Index of Horizontal Inequity was used to measure the access of healthcare across quintiles according to the income of population sample. And the methodology proposed by the World Bank and WHO was used to measure the incidence of catastrophic health expenditure. Results: The results of the finding for vertical equity indicate that the poor bears more financial burden than the rich population. And the horizontal equity towards healthcare utilization also favors the rich population. According to the result of this study, health insurance also protects households from catastrophic health expenditure. The urban area dwellers face more catastrophic health payment than the rural area people. Conclusions: The financial burden is concentrated among the poor population and healthcare service still favors the rich population. The financial problem that the poor population faces leads them to the reduction of access towards healthcare utilization. The National Health Insurance system does protect its population from catastrophic health expenditure, but there are still some occurrences of catastrophic health expenditure among Thai households. Further adjustments of policy towards health insurance are required in order to make healthcare service equitable in terms of fairness in financing.