How the contract model becomes the main mode of purchasing: a combination of evidence and luck in Thailand

Overview

Thailand introduced Social Health Insurance (SHI)  for formal  sector private employees  with the promulgation of the Social  Security  Act  of 1990.  The law was published in the Royal Gazette on 1 September 1990, after which there were 180 days  for organizational preparation.  The  1990 Act nullified the  1954 Social Security  Act which was never implemented because of the lack of economic readiness.  SHI is  a tripartite payroll  tax contributory  scheme,  equally  paid for by  the employer, employee and the government. The scheme covers  four  benefits: (1) non-work related sickness, (2) maternity, (3)  invalidity  and (4) funeral grants. It was initially  enforced in all firms having  more than 20 employees, but the scheme extended to companies  with more than 10 employees after three years.

This report is part of a series, The World Health Report 2010 Background Papers, which were written to inform the process of developing the key messages of the World Health Report 2010: Health systems financing: The path to universal coverage.