UCS: 10 outstanding accomplishments in 2020
 
There’s no doubt that 2020 has been a challenging year for National Health Security Office (NHSO), Thai government’s independent agency overseeing Universal Coverage Scheme (UCS).
 
“With the COVID-19 pandemic raging the world, we’re in the most difficult and unpredictable time since the establishment of UCS nearly two decades ago,” said NHSO Secretary-General Dr.Sakchai Kanjanawatana.
 
“We must adapt our UCS fund management to fight the pandemic and secure people’s access to healthcare in this critical time.”
 
Despite the challenge, the opportunities arise for NHSO to initiate new health programs, health system response and social innovations that strengthen health system. 
Here are 10 outstanding accomplishments in UCS through the year 2020.    
 
1. Mobilize health finance to fight COVID-19 
 
NHSO has mobilized health finance from UCS fund, equivalent to 4.28 billion baht in total, to health emergency response, allowing public hospitals to provide free COVID-19 screening, testing, quarantine, and treatment to Thais.  Part of the fund has been used for isolation room for COVID-19 patients, purchasing and distributing personal protective equipment to health professionals and workers etc. NHSO has financially supported hospital operators who adjust their services in compliance with social measures. Their services include mobile medical units, postal medicine delivery, and telehealth.           
 
2. Set four new upgraded policies to improve health services access
 
Initiated by Public Health Minister and NHSO board’s chairman Anutin Charnvirakul, four new policies are implemented to provide UCS beneficiaries convenience and better health service access. First, UCS members in Bangkok can request services from family doctors in any primary care facilities in designated zones. Second, paperless referral policy which in-patients can request hospital transfer online, a new system that is piloted in the Area Health Region Nine in Northeastern Thailand. Third, cancer patients can request health services from any cancer capable treating hospitals across Thailand. Fourth, UCS members can change their registered hospitals in less than one day, instead of waiting for 15 days to get approval from hospitals. 
 
3. Lead PMAC 2020 UHC Forum 2020
 
The Prince Mahidol Award Conference (PMAC) is an annual international conference focusing on policy-related health issues. The recent conference, held in January 2020, focuses on the theme “Accelerate Progress toward Universal Healthcare Coverage (UHC)” which NHSO took part in leading the discussion panels and on-ground site visits. Thailand is well-known for its UHC achievement since 2002, and the sixth ranking of countries with the best healthcare systems for 2019 (CEOWorld Magazine). Thailand has welcomed multinational delegates and policymakers who commit to introducing UHC in their own countries.  
 
4. Increase UCS fund by 2.2% in 2021 fiscal year
 
Following the NHSO request, Thai cabinet approved the increase of UCS budget from 191 billion baht in 2020 to 195 billion baht in 2021, equivalent to 2.2% increase. This budget covers healthcare services for 46.7 million eligible Thais.  As a result of the increased budget, the capitated budget for each UCS beneficiary will increase from 3,600 to 3,719 baht per head per year.
 
5. Add new items to UCS benefits package
 
New items were added into UCS benefits package through the year 2020, such as treatment for patients with inherited metabolic disorders, non-emergency medical services after office hours, home chemotherapy for patients with colon cancer, octreotide acetate for patients with acromegaly, community-based care for bed-ridden patients, free PrEp given to people at risk for HIV, rotavirus vaccine for children aged two to six months, fluoride varnish for children aged four to 12 years, dental sealants for children aged six to 12 years, and free HPV DNA test.
 
In 2021, NHSO will introduce new more items, including liver transplants for patients with intermediate and final-stage liver cancer, hepatitis C medication, HLA-B*58:01 genetic testing, extracorporeal life support, chest x-ray and molecular test for tuberculosis cases, newborn hearing screening, cochlear implant surgery in children, renal replacement therapy for patients living with HIV, mobile laboratory, CBD oil for patients with cancer, Parkinson's, and migraine.
 
6. Postal medicine delivery
 
Postal medicine delivery service was launched during the COVID-19 pandemic to reduce people’s exposure to coronavirus. Since April 1, NHSO has collaborated with Thailand Post Company Limited to deliver medicines to UCS beneficiaries’ addresses. The delivery service is extended to medical supplies and devices since September 21. Patients can also request free medicines from community pharmacies nearby their homes — a new program in which NHSO, community pharmacists, and public hospital staff join hands to deliver medicines to UCS beneficiaries while reducing hospital overcrowding. More than 130 hospitals and 1,030 pharmacies have participated in the program, starting on October 1.        
         
7. Support local administrative organizations in curbing the coronavirus
 
NHSO adjusts payment system for COVID-19 emergency response at the local government level. Local Administrative Organizations (LAOs) across Thailand can request supporting funds with no more than 100,000 baht from the chairman of UCS local management committee instead of sending the request to NHSO headquarter. This payment system adjustment allows LAOs to quickly and timely obtain the funds and implement activities related to COVID-19 infection prevention and control. Their activities include making reusable face masks, distributing alcohol gel, and health educating local communities about social measures and hygiene.
  
8. Integrate technology in health services
 
Supported by NHSO, some hospitals have introduced mobile telehealth services during the pandemic. NHSO has developed a mobile application in which UCS beneficiaries can review their benefits package and book hospital services. UCS beneficiaries can also reach out to NHSO via other mobile applications, including Line (@ucbkk) which UCS members in Bangkok can reserve free influenza vaccines, and Health Wallet via PaoTang, which UCS members from anywhere can register for getting health promotion and disease prevention services. NHSO has collaborated with Internet Marketing Co. Ltd. to provide healthcare scheme information via Pantip, a popular Thai-language website and discussion forum.     
 
9. Increase health facilities for UCS beneficiaries
 
NHSO has partnered with Thailand Nursing and Midwifery Council to provide first aid, home care, health promotion and disease prevention services to UCS beneficiaries who visit “Nursing and Midwifery Clinic” in Bangkok. Another partnership is formed with disabled care center certified by Ministry of Social Development and Human Security, allowing people living with disability to get free rehabilitation services from the center located across Thailand.  This partnership is NHSO’s response to the request from Disabilities Thailand, Thailand Council for Independent Living, and People with Disabilities Health Network.
 
10. MoU signing to provide healthcare access to undocumented persons 
 
Many people born to Thai parents are undocumented, obstructing them from access free healthcare provided under Thai government's healthcare schemes. Learning their hardships, NHSO and other eight organizations signed a Memorandum of Understanding (MoU) to assist their Thai citizenship application and deliver healthcare to them. The organization are Interiors Ministry, Justice Ministry, Public Health Ministry, Social Development and Human Security Ministry, Bangkok Metropolitan Administrator, ThaiHealth, Pan International Thailand, and Human Settlement Foundation.