Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking

Watinee Kunpeuk, Pard Teekasap, Hathairat Kosiyaporn, Sataporn Julchoo, Mathudara Phaiyarom, Pigunkaew Sinam, Nareerut Pudpong and Rapeepong Suphanchaimat
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Watinee Kunpeuk: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Pard Teekasap: Faculty of Business Administration and Technology, Stamford International University, Motorway Road—Km2, Prawet, Bangkok 10250, Thailand
Hathairat Kosiyaporn: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Sataporn Julchoo: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Mathudara Phaiyarom: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Pigunkaew Sinam: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Nareerut Pudpong: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand
Rapeepong Suphanchaimat: International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand

IJERPH, 2020, vol. 17, issue 14, 1-19

Abstract: Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants ( n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants’ access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities.

Keywords: systems thinking; migrants; health insurance; health policy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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