Will increasing levels of trade in health services thwart the delivery of health equity in Thailand?

The Universal Health Care Policy (UC) was introduced in Thailand in 2001 to address equity concerns by ensuring universal access to quality, affordable health care. In recent years trade in health services has been promoted by the general agreement on trade in service (GATS), bi-lateral and regional trade agreements and government policies. The Thai government has promoted health services trade through Thailand: Centre for excellent health care of Asia. This paper explores the compatibility of these two government policies: universal access to health care and promotion of health services trade. The paper will consider the mode-wise characterisation of trade in health services defined in GATS: cross-border delivery of health services via physical and electronic means; and cross border movement of consumers, professionals, and capital. The impact of trade in health services is shaped by the underlying structural conditions and existing regulatory, policy and the health service delivery framework. An examination of potential positive and negative implications of trade in health services for equity, efficiency, quality and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address 'brain drain', increasing investment in the health sector and prioritising this investment to address socio-economic and spatial disparities in equity outcomes