Abstract
Thailand is attempting to implement an effective health insurance scheme to cover all migrant workers in the country. One of the remarkable policies is the Social Security Scheme (SSS). This study aims to assess the equity of SSS coverage among migrant workers in Thailand, sorted by types of businesses (agriculture, services and industrial sectors) and Gross Provincial Product (GPP) per capita. A secondary data analysis on time series cross-sectional data was employed. The dataset comprised: (1) the number of migrant insurees under the SSS; (2) the volume of migrant insurees in formal and informal sectors; and (3) provincial economic level and provincial population by years from 2015–2018. Descriptive statistics, Spearman’s rank correlation, and concentration index analysis on the ratio of SSS insurees to all migrants ranked by GPP per capita and business types from 2015–2018 were performed. Results showed that the ratio of SSS insurees to all migrants increased from 38.5% to 58.9%. Spearman’s correlation found a positive relationship between the SSS coverage and GPP per capita and business types in 2018. The statistical significance (p < 0.001) was found only in the industrial sector (rs = 0.346). Significant CIs were found in SSS coverage in the industrial sector in 2016 (CI = 0.147, p < 0.001), and SSS coverage in the industrial sector in 2017 (CI = 0.137, p < 0.001). In conclusion, the trend of CIs displayed a movement towards zero for all business types. This implied that the distribution of migrants in SSS shifted toward the equitable distribution across provinces in Thailand. A possible explanation was a major change in Thai politics in 2014 and a change in employment legislation for migrants in 2017. To expand the insurance coverage, the government should use the CI as a guide to consider specific provinces or target specific economic sectors as a priority to expedite the insurance enrolment for migrants.
Highlights
Migrant health has been recognised as a global concern over decades [1]
Note that for this study, we focused on the Social Security Scheme (SSS) only as it is a compulsory scheme that has a direct obligation on migrant workers and employers whereby for the HICS, as mentioned earlier, the nature of the scheme is still semi-compulsory
The number of SSS insurees increased dramatically in most provinces in 2018 (Figure 1), a year after the promulgation of the new employment law in 2017, which raised the penalty for employers who left their migrant employees unregistered
Summary
According to the International Organization for Migration (IOM), Thailand is one of the major destination countries for international migrant workers in Southeast Asia (SEA) with the total number of migrants in the country numbering about 3.6 million in 2019 [2] Lao PDR, Cambodia, and Vietnam (so-called CLMV nations), working in the construction, agriculture, and fishery sectors. 10% of the entire national labour force [3]. To protect the health of migrants in Thailand, one of most prominent policies of the. Thai government is the promulgation of national insurance scheme for migrants. The first is the Social Security Scheme (SSS). The SSS is managed by the Social Security Scheme of the Ministry of Labour. It is a compulsory scheme financed by tripartite contributions: government, employers, and migrant workers. All migrant workers in the formal sector (like factory workers or workers in business enterprises) are
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