Universal Health Coverage Scheme impact on well-being in rural Thailand.

Abstract

The purpose of this paper is to investigate the extent to which the Thai Universal Healthcare Insurance Coverage Scheme (UC) has contributed to villagers' well-being in the northeast of Thailand. Public opinion polls specifically advocate the schemes are used to justify its ongoing political support. However, the question still remains as to whether it has made a difference in the lives of poorer rural people. A multi-methods approach and a well-being focused evaluation (WFE) approach are used to understand villagers' experiences of having and using the scheme and investigate the villagers' satisfaction with the scheme and how this satisfaction has contributed to their life as a whole. It is found that the scheme had made a valuable contribution to improving perceived wellbeing amongst villagers. Apart from the direct benefits of having that healthcare when needed, there is also the indirect benefit of increasing villagers' sense of security that healthcare will be accessible if required. There are still pertinent issues for policy consideration; for example, almost 31 per cent of the villagers with the card have never used it. Approximately 22 per cent of people using the card reported dissatisfactions. Although healthcare direct-costs were now more affordable, a range of opportunity costs, geographic, social, cultural and other factors still need to be factored into further policy and service development to make the scheme more equitable and effective. The study proposes "WFE", a new evaluation approach. WFE may also be applied to other forms of social policy particularly concerning the impact of its policy on people's well-being.