สวัสดิการด้านสุขภาพของรัฐวิสาหกิจและองค์การมหาชนในประเทศไทย: สิทธิประโยชน์ ความคุ้มครอง และความท้าทาย

Chatpot Lairungruang; Woranan  Witthayapipopsakul

Authors

Chatpot Lairungruang International Health Policy Foundation
Woranan Witthayapipopsakul International Health Policy Foundation

Keywords:

health benefit, state-owned enterprise, public organizations, health inequity, health policy

Abstract

This study aimed to examine and understand the health welfare systems of state-owned enterprises (SOEs) and public organizations (POs) in Thailand, an area that has received limited attention compared to the three main public health insurance schemes. A mixed-methods approach was employed, including document reviews, questionnaire surveys, and focus group discussions. The findings indicated that SOEs provided the most comprehensive benefits for employees and their families, particularly services in public hospitals got full reimbursement, while private hospital care was subject to financial caps and limited family coverage. In contrast, POs exhibited high heterogeneity and inequalities, especially those established under the 1999 Public Organization Act, where entitlements varied by position and employment status. Key challenges identified include the rising cost of health welfare, budgetary constraints, out-of-pocket payments affecting employees’ financial liquidity, and the lack of access to the universal coverage for emergency patients (UCEP) benefit in public hospitals. Policy recommendations include integrating these schemes into the existing large public health insurance schemes, extending protection mechanisms to families and older persons, and establishing sustainable financing mechanisms. This study highlights structural inequities and limitations within the health welfare system and proposes a fairer inclusive, and sustainable system.

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