Why Do the Sick Not Use Health Care? The Case of Thailand’s Universal Health Coverage Scheme

Phatta Kirdruang, University of Minnesota

A primary motivation of public health insurance programs is to promote access to and use of health care services in order to improve population health. Yet, a frequently occurring puzzle is that the insured often do not utilize those publicly-provided health services, even though they are provided at little or no monetary cost. This study examines the factors that affect the decision to utilize public health providers in Thailand’s Universal Health Coverage (UC) Scheme, compared to the alternatives of using private providers or self-medicating. With data from the 2007 Health and Welfare Survey, health care choices of individuals are analyzed using a multinomial logit framework and predictors such as individual and household’s characteristics. Preliminary results suggest that age, income, copayment, and area in which the household is located have significant impacts on the individual’s decision in using publicly-provided health services.