Situational analysis of the health insurance market and related educational needs in the era of health care reform in Thailand.

ABSTRACT

The purposes of this study were to explore the situation of health insurance in Thailand, to compare public and private perspectives and to identify related educational needs. Between March and April of 1998, the study employed in-depth interviews of 12 public and private major stakeholders of the health insurance systems, including policy makers, providers and insurers. Additional inputs were gathered in a brainstorming session with 41 participants from organizations with important roles in regulating, monitoring, paying, or providing health care services, as well as research and education. The findings indicated the health insurance market was expanding. But there was no national policy on health insurance. Insurance-related law was outdated. Public and private schemes overlapped, and were generally characterized by inadequate risk diversification, overutilization of services, lack of effective cost containment, inconsistent service quality, and poor understanding of health insurance principles. There were needs for more education and training in various aspects of health services management and health-insurance related functions. Consequently, continuing education and training related to health insurance services for policy makers, system administrators, managers, providers and insurers are strongly recommended during the health-care reform process.