Table 1.

Characteristics of the HI-PCP and the UCS

Characteristics	UCS	HI-PCP
Population size	47 million	~450,000
Financing source	General tax	General tax
Governing body	NHSO, an autonomous agency regulated by the MOPH	Health Insurance Group, MOPH
Payment mechanism	Capitation for outpatients (~2,800 Baht or US$ 85 per capita) and global budget plus DRGs for inpatients; additional fees for specific high priority services; no copayment by beneficiaries	Capitation for outpatients (varying by year, between 1,000 and 2,000 Baht [US$ 30–61] per capita) and global budget plus DRG for inpatients; no copayment by beneficiaries
Benefit package	Comprehensive: outpatient, inpatient, accident and emergency, high-cost care (including chemotherapy, antiretroviral drugs for HIV/AIDS, renal replacement therapy, organ transplants, etc), and health promotion	Comprehensive, similar to the UCS: outpatient, inpatient, accident and emergency, high-cost care with minimal exclusions (such as organ transplants), and health promotion
Contracted health facilities	All public health facilities under the MOPH, majority of non-MOPH public facilities, some private hospitals, and community clinics voluntarily contracting with the NHSO	Almost all public health facilities under the MOPH

Note: Data from Tangcharoensathien et al⁵ and the Health Insurance Group, the Ministry of Public Health.¹²

Abbreviations: DRG, diagnostic-related group; HI-PCP, Health Insurance for People with Citizenship Problems; MOPH, Ministry of Public Health; NHSO, National Health Security Office, UCS, Universal Coverage Scheme.