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fl'l~'YllJ~Bfl1'lufhlh~lJlJa'lJm~~'1V1lJVl ~'J~tl1La'UB~B 1 U 'J~L U'UL~B'Ifl1'lU f1'lU

:..J" , ~"

"

'l~lJlJlJ1fl1'la'lJm~ L Yhu'U

.

~ u,..J.J l>

seuu lJ'lfl1'la'lJm~ L 'U (;11 'UVI 'U'I'lJ B'I'l~lJlJ a'lJm~'Yl'l VllJ Vl seuu

, .

a'lJm~'ldh~B'I~'U '1 5fllJlfllJ1U~hh~En'li'B'Inm~lJlJlJ1fl1'la'lJm~

. .

Yll t:I1lJLL 'lfl~ mlJ~fl 1111lJvl fl'lUl1~U iiVl'UlJ Bfll1 U'l~L 'YlA 1 'Ylf]iiilqJVll

1 it ' ':I '''' "''' ~.J ,~ "'."l d 1 .

lJ 'l!'l~u1.J~'lJmf'jIL3J,Vl ,:::uu~,'1:Imi1'l;Vl~t(l1'i~v:lU\iI:'U'I ILLVl,UUIUt'YM1L'HHfil11J1 JI

uumm» (Inequity) fJT'IJlllii1t!1:Sdn5mw (Inefficiency) mUmT'S'lll(;J flWflTW (Inadequate quality)

•

Ih::t~lJ" "Sf1'lliN nTltlflnh::uUl/1n1"Sff'llfl1'WAfJ fI11J11litffJlfJfI1R

~ .

(Inequity) ii 3 t~B'IVlc;ifl '1 ~B at:l1'U~~'lJm~ (Health status) hhalJBmYln'U

L'1h~'IlJ~fl1'l hltalJflmVln'U(Acccss to services) tti:1~fl1i'l~I'tJiL11!J llJ LalJ BmYln'U (Health financing contribution)

'lJB111Vl11lJt'1l1 hL~B'I Equity LLi:1~ Equality firm Equality VllJ1UU'l fll'mhn'Ul'lflmJl'1 L"li'U f)1,ijUYfI'lrJvlm.h:::"lllfl'l 1: 900 'l:f1~~Vl1Vl ri1'U Equity VllJ1U~'1fl1'lnlV1'UVllJ1Vl'l~1'UVI~'1 11 illl')flVl'U lvhil'UlJ1Vl'!'IJlr~ril'VI'UYI 11 i)(iBl1 iimllJLyh t YiUlJn'U tL~1lJMtyhn'U ri1'U~til'U 1 u'Jlfl~nl\1'UyjHB1'J'JdlJLYhn'U L 'Ii'U Ul'lVl 'U B1'J'J~ lvi''U fl'Ul1 B'IY1lAB tt~Ul'lVl'U hJ1vi''U B'U Lt~M~lJlJ~fl1'lVlc;ifl LVliiB'Un'U

7

I?Il'll-iJ~ 1 mllJ 1,jLalJflmYlL~flVl'ill'HU1'illn 5mlmtJ'lJfl'll'11'mvi1lfn')Lil~ iHl'V'4 1000 'lltJ

Inequity in Infant Mortality (per 1,000 Lbs)

Surveyl National Municipal Non-municipal Non·Mun.lMun.

Period average areas areas difference

-----~------------.
SPC 1 (1964-1965) 84.3 67.6 85.5 1.26
SPC 2 (1974-1976) 51.8 39.6 58.7 1.48
SPC 3 (1985-1986) 40.7 27.6 42.6 1.54
SPC 4 (1989) 38.8 23.6 41.4 1.75
SPC 5 (1991) 34.5 21.0 37.0 1.76
SPC 6 (1995-1996) 26.05 15.24 28.23 1.85
Dr ,Suwit Wi.bulpolpruert 4 'il::L llu M"h Lrimh::lJ10.! 30 n11U~eJ1UlJl1 UL'lJQlL 'YIf1U1nLLn::UflnL'lJl?I L'YIA'Uln 'il::iimllJUQlnvi1'ltluth::lJlO.! 1.3 L'Yh 'I'IlJltJ~'1 L~nUflm'lJvlL'YIA'Uln ii5mll?11tJviflm,)Ln~iitfw 1000 ,)ltJlJlnn11L~nlUL'lJQlL'YIflUln 1.3 L'Yh lu m'V'4'l1lJ'lJfl'lth::L'YIA5m1VlltJ'lJfl'lL~n?1fl 84 'lltJviflm'lLn~ijtf'V'4 1000 'lltJ LL~::i;1~i;1'1 L UU 26 ,)ltJ LLvifllVl'ill,)0.!1m1lJLLVlnvi1'l'lJfl'l5Vl'llVl1tJU flnL'lJVl maina LLi;1::1UL'lJVlL'YlAUli;1'il::LvilJ~U'illn 1.3 L'YhLiJu 1.85 L'Yh LLa~'111 5mlVllE1'lJfl'1L~n ')::~u'_h:: L'YlAU ufln'1 Llvi Yl11lJ LLVl n vi1'1 ')::'1'111'1 LlJ fl'1 tl U~U U'YI mlUlJl n~u l'VI lJ uu L'lfU lfl'l~~ n'il'lJ fl'l 'I.h:: L 'Ylfl 'lltJ 1~'lJ fl'l YlU 1 'YItJ~'l 'I.h:: L 'YlA L vilJ~U LLvi'1ifl'111'1,)~'VIil'1

OJ d .f,Q.,I

YlU'lltJnUYlU'ilUnlJln'lJUL'liUnU

8

Coverage of Health Insurance

• underprivileged

,--------------.-

• civil servants and state enterprise employees

DCompulsory health insurance

.Voluntary health insurance

o Total people without health insurance

10,8

Dr.Suwit Wibulpolprucrt

5

'Il::Ll1-U Mil ~'U lY1Ellh::l.nru 19. 70/0 h.J,ih.,~mJ,'j~Oll<lil~Jl1V'4 ~llJmllJ

'.

LtJ'U'Il~'1jj'lll'Ul'UlJlnnil;f umi'lfl~l'lL'li'U -i'flUn:: U.8 ~il"1a~nl'jrh-rm~1

y.jUlUli:'l Ul'lrl'UfHhl1j'~'ja'1lJl1y.j~lU l~muy.jl~lu~h.,'J~.,'J:~j~ Y4IDLLsJSl~m~tJ

• v

'lll'jl'lfnl'j i:'lnmA'u 1 'U Lii fl'l ~flLL";L1i:'llL~U':hu hhm·nJfl~h'lV'4U1Uila~iLtJ:fl

"

1~' uLa~'Il'.nnr;4'1111i:'lm iln LUma~'Ili:'lnnLnuL~'U 11 hlri'ln~ulul i:vttluil iJ::vt1U

" "

au VI~fl:: 1 'jn~llJ ~'1~fl1j'~'ja'1lJl1y.j Hc:llVi-rU HU~nl'jrJ':hu'Uf)n 1VIltil~rN\m'U

. . "

~n 1 'U h'ly.jiJltili:'l~'1'1l:: H'~YlBL un~'Ua'lti'~ ~'1J'UmllJ L \J'U'Il~'1~'11";1'li 190/0

'1lfl'l~'U lY1u~l";iiVl~nu'j::ti''Ua'1lJl1y.j L~mi1nl'j~l'jl'1l'll::y.ju(i'l 400/0

,

9

.q 'A _I A

t(1rw 1"aNDu'1~1Ct"1f

.J

11 2

.

LL~'Hliiii 2 aYiallJ'lJfl'lLL Ylmr~tll.h~'lflf1'l'llfl'l fllfl~~llJ flflflLUrJ'lL'vliimLCl::

"

f)'j'lLl1Yl)J'VIllJA'j llJU Yl.rI.2521-2542

.

Proportion of Northeast's to Bangkok's population/doctor ratios, 1979-1999

+-- eco~. --+1_ eeon, -I--CC?I.I. 21 recession boom crrsrs

25
'"
""
~
OJ: 20
t:
'"
::.:
.::
" 15
",
'"
<J
-s
...
e 10
7.
....
"
g
',::
S
0-
...
e, 17

14

I ~

II

II

1979 1981 1983 1985 1987 19!i9 1991 1993 1995 1997

11)91)

Dr.Suwit Wlbulpolpraaert

Year

6

>')lflLL~lJflilmlVl'lll-i'L lllJ ml:IJ LL~f)~1'l'llfl'lml:IJtllJ1LL UlJ'llfl'lLL Yll1t11lJ

"

fllfl ~::llJ flflflLUtI'l L tlii mLCl::f)'j'l L l1Yl:IJtlllJm llJU Yl. rI. 2 5 2 2 fllfl ~::llJflflfl

,

LurHL l-1ii fl iiflll)Jl-1lJ1LL UlJ'lJ fl'lLL Yl116vimh::'lflf)'lUfltlf)11f)'j'lL l1Yl:IJ'VIllJm 21

,

Ll'h ~flYlClLflflLU'l)J ~ru~rnlJlJY1 LUlJlJltlfl-r:1)JlJ~~ (Yj.rI. 2522-2529) LUlJ'lil'l

~LA'n=l~n>,) l~fimJ~ 'lifl'l11'lClVlCl'l)J1LVI~fl 9 Ll'h 'lil'ldiifll'lUli~th::lJlJ~'llfllYjfl~'l ,hl"lt)J~l)Jti'lJfll'lW{i)JlJl'lflJlJl1 L'lilJ L~fl'l fl'lf'lf. i:Hl)J. ffi'l'lYjtl1lJ1ClB1LflflllmhLflfl

~ 0' I I .d ..:::.. ...... .J' ~ Q,I Q,I 'V

)Jfl1'lflj::'illt1LL Wl1fJtlfJl'l).)1f) LL~Ll,Jmm":1f)'ilYI'lJU "fIlU fl1'lruf)~lJ~'j'l f)lJ'lll)J

di YI'liil'l11'l sn fl~lJ L i1 tl'l'ill fl rrrsurn u vll tl cil'l)Jl fl'lJ tl'll 'l'l YjfJllJ1Cl L fl nnu 1lJ L'lJ~Li'ifl'l

10

L~fltl Y'I.A. 2529 rifl'U~'UlUrHthlJ"l 'II::VllJVlril'Ul'll l~th::mAHil ~'1 LL~t1 VlUl L U'U ~'U 1 il 'II:: hJiih'l Y'lmUl a 8l LJ1 fl~ii LL Y'I'YIUtJ~::..al L -WU'IYI'UL~£J1 ~'1 VI lJlUYllllJll h'lY'lmUl~ 8lLJ1fl'YIrHL l'I'I~fl'liiLL Y'I'YIU1.h::..alflUl'lU flU 2 YI'U

,

Y'lflvi'U"JJU'UlUrHtJ':llJ"l LnVlLm1=l~n'llvJfl'l"tJ l'UL~fl'ULlJ1=IlEJ'U tI Y'I.A. 2540

u "

LU'U':l::EJ::Ll~l 10 t1V1Il'l'llln,T'U h'lY'l£JlUl~8lLJ1fl'll'UlVl 10 L~U'lLL~:: 30

L~£J'I~l'Ul'U 21 LLl'I'I hJiiLLY'I'YIUtJ':l::~lLLlJLL~YI'UL~Ul ~a'l'llatJ~Wlml~LA~1=I~n'll ~l'h 1 i"tn'Um':lru~t'U l'h 1 iiiLL Y'I'YIUtJ':l::~l'YIn 1 ':l'lY'lUltJl~rilLJ1a 'IIlm~lJ~ii

,

YI'UL~Ulf\ii 2-3 YI'U VllniilmlV1~m~fl'lltJ~n 5-10 tI "m'Um':lruYl'l'll::~~'U YI'I ~ fl'l J,milu n'Uml'Ul urh L ~'11 iLA':l1=l:l n'll~t'U L11U n

LLr.J'U{Jilii 3 fflu~::'lJfl'l~hl'1f~luv1lW~'lJmY'l~fl':llulV11'UtJ Y'I.A. 2535, 2537, 2539 LL~:: 2541

Percentage of houschulrl health expenditure as compare to the ir income in 1992, 199-t, 19%and 1998

2 3 4 5 6 7 8 9 10

Decile of income

Dr.Suwit Wibulpolpraaert

II

7

t:i'lLLU'lf1~~lh:;'lIlf1~1'Ulh:;L'YIA1'Y1EJVll~~lEJ1~LtJ'U 10 51'U 51'U~jj

,

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• 'lJ ~ •

~la~ jj~11'1i~lEJ~1'Ua'IJmyj 80/'0 'lJEl'l~lEJ 1~~'lVt~~ 1 'U'lJru:;~f1~~~jj~lEJ Ma'la~

~ 1 • 'U •

tT'U jj~lEJ~lEJ~l'Ua'IJmyjL VlEJ'l 1 % ~El~'l~lEJ~lf1~'l~lEJttElmdElLYiEJUnmlEJ 1~

,

~'lL~El~ lEJ'lnu~11l~ hhvilLYiEJ~ 1'Uf1l~f11:;'llEJ~lEJ M~lEJ am'Uf1l~ru~11'li~lEJ~1'U

a'IJmyj'IJEl'lf1~~~ij~lEJ 1vlttElEJ~~'U 'l'UO'lU yj.A. 2541 ~'U'l'Ujj~lH~lEJ

, , "

l1l'l n'U 0'1 L fi ElU 4 L vil

51'UL~El'l 30 Ul'YI-rm/l'YIf1h~ i1f1l~~'l'li'm{'lLf1~il ~'U'l'UnjjuVl1

,

~lEJ MUElEJ uVl~ath. ~'U 1ml'l'Uf1jjuma'IJmyj 'li'l~l'llf1l~LLtl:;tlfl'ii'l'lnijala~f1l~

, "

~l-rmllyjEJlUltlLLtl:;lh:;n'Ua'lVl~ ~LVt~El~El~'U~'lilEJvi'lLEl'l1vl "ii'1u01"n1iN 30

Ul't1fntHt1 n f"ifl'J::Ti1EJ 1 Wi 'J::dJu fll"HtnmfiviN flUJ..J "eiU~UU1Ti1 unu

,

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1 .J Q,I' q.J .... .,., r.J 6::1

uruuusnne» UL"iil..J01il..JW'Jl"ifUlilEl 5 L"iil..Jflil 1. metnu

"

,!;) J' Q,I "I ~ I ~ .,.,

fl1"iUilU,,'YIti 2. nl"i'J01ff"i"i..JUu"i::UlfU 3. immntnrnrn 4. etunwantrn

,

,,€I:: 5. U"i::a'YIiimWfl1"ioJVlfl1"i

~ ~.d I d 0 4 l: I~I

tnnnum sueu« 'YItiL yjEl"1l1EJ~'U'l'U L~~~lL'U'U f1l~mVl'lLLVl u yj. A. 2518

alJEJ-r5jUltl ~.~.l.~ml'YI~ tJ~ll~'lI ilf1l~-rm/lyjEJlUltlvJ~ ~'U~()L~ti'vJ~ ms afl'l'l1'U1'U'lI'Uu'YI t:.J~~lMil1'UU yj.A. 2520 ~~L~'l-rml'llf1l~1mj 'l f1l~'l:;LtJ'U ~'U'l'UVt~El h;'l'U~'Um1nu~al'U1EJf1l~ h'lyjEJlUlI'l 1fl~'l'UVt1El hiv'U t:i'lL~'UL'li'1~11 'U

" "

h'lyjEJlUlmdEl M-ru 1u~'lEJl 1 tJ~l1El'lEJlLLc;i'lf1mrU~lVtlLL yj'YIU LLyj'YIUf1Wvl~rul

~il L tJ'U~'Uv'U n L:z!'U El'UlJ&l1 tl flll~v~'l f1 El'UlJ&l111'Y1f1fl'U L yj~l:;~~il~'U 1'li'~1~ ~::1~EJl v~mi~~~'YI1'lf1~~LLyj'YIU l'1l111LtJ~EJ~LtJ'UEJ~'lIu~5'U hJM vl'lt1'U 1'U'lil'l LL sn dL tJ'U~ i;1EJWU'l'IJ El'll11Vt ttl afll'UyjEJl'Ultl

,

12

WEJlUlil hJLU'U5'l'llJ Ll1~-r~flfl'U LLJJ'l~'llEJnh;vJ1M ~'Hlll1'U~h;fI'U~~~"h

"

~lLB'l'l'UlJl'IJmJm l1t1'l'llf)tTunilf11'lBBmJVI'lYlf) 3 tJ ,bUYlf) 3 L&iB'UnLU'U

, ,

ms L U ~EJ'U Um~l1lJ ~ B1EJl1~B L U 'U f11'l'IJ ElL ~lJ L~lJ 'lil'liill'i)1'l'IJEllEJaYlBl U 5

, "

f)~lJ L~ nuae c.Jtt'l mEJ L U U f11'l'IJEllEJfI~'lll1 ru L d B'l'll nil 'll:1ll1 f)'l~,'lttB'I f)~lJii

Of 'U 'U 'iI u 1

~l'Ul'U in f) f11'l'lil EJ L 11 ~ B U 'l~'ll1'll'U c.J~ir'l fllJfIl'l'lilEJL iI/fail L~ ana (atl s.)

~ "

'lJmEJU'l~lJlru 40 - 500/0 'lJB'll1t1f)U'l~tl'Utt'IJmw~'1l1lJ~ 1 'U'lil~diif)1'lU'l~tl'Uir'lfllJ

,

LLil~UVl'ltt'IJmW ~il'IJB'lf11'l~lL iJ'Uf11'liILl1~B~ b~'UU1'l ~'1L~WIU1il~ 4

, "

~ I 11 ·111
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(10
;;y
Q ? II
"if"
III 1J-:(.',lll'Irr :." 11111- ~1.IIIJ1- 111,11111- ;..'([,11111 '111 "':)')£J101

~ 1 , I J II I JIll II II II t' II (J r J [I

l~m: ffitt n'ltluulUUR!:UNW1'!f:ll'HIlC11J.lJm'irl tJl<1 U'IJ <J ~Ht rh.

Dr.Suwi.t Wibulpolprascrt I 10

'l1f)f11'lffl'l1'lc.Jil'llEJ1IDf)~mh'l '1 ~l'UTtJ 7 ~'ll1'1~LiiBUmEJtJ W.A.

u ,

2543 ~Bi'UtJ W.A. 2544 ~lLiJ'Uf11'l1~EJlJ1111YltJl~EJ'lJiillJ~LliU L~BU'l~Lil'U~il

lm'lf11'l~'lJmW~t11'U11t!1 U'lLBtlJiliBl;!m~B'lli ~~trilU,).J'1i'illJ.illJ1H LtJ'Uf11'l ffl'll'lmWl~c.J~ilBlEJ'l~l1il'l 15 -59 tJ LdB'l'llf)c.JijmEJI 6Qi tltl!J l'1.J1nilaYlBc.Ttt'lBlEJ

" Of ~ 'iI " " ,

13

~~ihmJ~lfr:h 15 tJnH~hltl~f) ~Ull ~~jj'n[J M~lf)ll 2,000 Ul'YI ~'lfll'J

" . "

M5'llfl'Jl~l-i''YIf)fllJ jj~lmlJ 46% ~1~jjVli1m.h~tllJi;:I'lJm~1V11 ~'lfllJ~llJllJ 460,0

. ,

dlrifl hfhwmlUli'ln~l[J'llf)f)'J~lthvlllfl'l tlljjl~lJ tlll~jjl~lJn'lJl[Jll 'lJl[JfIll[J

tIlmJllJ Vl1fl hi5llUjjfl'lJflVl~fl l~jj,f'luvmla~ l~jj,f'll~U timr'llf)Vl~f) fl~l'l Vld'l ~fl ~-:jjj'Jl[J Ml~~~lJ~llJ1U{fl[Ja~'lJfl'lf)l'J 1~jjVli1mh~tllJ5'lJm~n~'li'lV1i'l'l 'llJO'l

,

f)~~~jj'Jl[J Mll1u 20,000 tIl'YI'lil[Jvlllfl'l M~'ll~~V1~'l~jjVli1mh~tllJ lV11 {fl[Ji'l~

.

'lJfl-:jf)l'll~ijVl~mh~tllJl ~~~lmlJl UlJ 30%

tV1m\l~m.tll.h~l'YIff ~~1~jjVl~mh~tllJi;:I'lJm~1V11 ~llJllJ 46% if~-:j

" ,

llVl f) ~l'l'll f)~llJllJ 20% ;'ll U lJvllli'l'lJ'll f)'YI:; l U[JlJ ll5V1'l 0'1 f1l'Jjj~'YIt'lhzrfllJ

l.h~mru 2 0% ;'llf)~l~[J'ltlutim;!a'llf)f)l'Jill'Jl'l'lJfl'l illlJf)'lllJ5(\~ lll,i'l'l!l~ uae f1l'lill'D'l'lJfl'lilllJf)lJ t[JUlmLi'l~lll-JlJi'Ilul'Jru~'lJ (Prov incial Survey) ~1vhh~~l ru 30-400,0 l~fll'ill~i'l-:jhJ1lJllvii'l~n~~

,

ll~'UfliJn 5 ll5V1'l{fl[Ja~'lJfl'ltrihh~tl'W(I'lJm~~l'l1 l\l~l~lmL'J'l'll'Wfll[J 15-

'U Q,J 'I 'I

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--- - .0~"I ,",01. C=~U~·.~1J"''''''' Otl'l:ii""'·.JnlJ ."·ii'lri.l'J,~1il~1tnl·' Uu-,:n"'ILln"J'H1

14

.. 'I c:::: ~ a .QI iI <v d " .... ~ iI

L 1m L'Ill inurunws eJ)Jffl L 'UlYl:: L lJU'U inuuaeuers LLffYl'l YI'U nYltl'lllam!JYI~Yli~'I1Li\II

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1 .... .. .,J Q/ t1 ~ .J?I tl ~ il :: 1 . )JfleJU)Jf1l'l~YI(l'lL'leJ'InTJiI~i1'i'J.JU 'i~.u1fUYll)JlJYI'l 'If'lLu'Uf1l'l m fl'l'l Vlfl!

.. oJ 1" 'In ~ ..I 1 ~" .. ... fleJ LLYl'UYl'iJ:: 'lfUYlLiAlffYl'lLLlJlJ )J eJYI)J U'U eJYI)JLYI)JLLYl'l~l'Um::m1'lf)l'lfll;l'l

.

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