ABSTRACT
By the norms of contemporary mainstream public management thinking, the Thai healthcare system is a policy disaster. Its already flawed healthcare system, characterized by the dominance of public hospitals, deteriorated, according to this mainstream view, with the adoption of a tax-funded financing scheme for public sector workers in 1980 and health insurance for private sector workers in 1991. The most severe lapse, however, was the adoption of the tax-funded Universal Coverage (UC) for the general population in 2001. As it turned out, healthcare expenditures did not explode, and indeed declined with successive expansion of the state’s role in the sector. The Thai experience casts serious doubts on public sector reform thinking that is sceptical of state intervention to address pressing public problems. The case study shows that there is scope for plenty of innovations by policymakers daring to defy conventional thinking.
