Suwit Wibulpolprasert

Thailand’s National Health Security Act emerged after a 30-year journey of democratization. "Peace, democracy, and economic growth are very important for public health," said Wibulpolprasert.

From 1973 to 2001, Thailand successively implemented programs that provided health coverage to specific segments of the population, such as the poor, the elderly, children, and civil servants. These plans have utilized a variety of financing models, he said, from out-of-pocket patient fees to taxes on tobacco.

Over the past two decades, Thailand has become more peaceful and economically stable, enjoying the world’s highest economic growth rate from 1985 to 1995, he said. The country froze military spending and reduced domestic debt financing. At the same time, spending on health care more than doubled from 3.5 percent to 8 percent of the national budget.

A landmark in Thai health care reform was the development of a voluntary health card program in the mid-1980s. Under this program, the Ministry of Public Health provided access to an affordable insurance plan through matching payments made by households.

The recent National Health Security Act seeks to provide universal coverage for the provision of health care in the country. Wibulpolprasert explained that implementation has come with complex challenges: registering millions of people for participation, defining a core benefits package, streamlining efficiency, and improving the quality of care.

He credited Thailand’s progress in health care reform to its strong civil society, especially a rural health care movement that has proven key in a country where 68 percent of the population lives in non-urban areas. Wibulpolprasert emerged from the rural health care movement himself, appointed to run a remotely located hospital soon after becoming a doctor. He and other rural administrators organized to provide support to each other and to advocate on behalf of their patients and communities. Wibulpolprasert co-founded the Rural Doctor Society of Thailand and the Rural Doctor Foundation of Thailand. He has since published 10 books and until recently served as vice chair of the board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Wibulpolprasert’s talk was sponsored by the International Health Systems Program, Department of Population and International Health, and Department of Health Policy and Management.

--CC