Welfare State Is Not Enough: Health Care Disparities of Homeless People and Informal Workers in Thailand

Thailand has three public health insurance schemes covering almost all of its population. Everyone with Thai nationality has an access to health care services and is protected from catastrophic health spending. However, the health disparities among marginalized population still remain. This paper examines how homeless people are treated different from normal people and why informal workers have to pay for basic health service, which even non-worker could have access for free. In general, homeless people have poor health because of the lack of good nutrition and access to social service. Since homeless issue is quite new for Thai society, homeless people are understood as poor and lazy individual people rather than the evidence of policy failure against social poverty. Hence, the structural intervention using welfare strategy preventing homelessness is less spoken. The recent social safety net could not foresee how it could avoid sending people to homelessness. As well as the informal workers, who work harder than formal workers, but 2 millions of 24 millions informal workers are living in poverty and 6 millions of them are lower paid. Therefore, their incomes are not enough for living and have to co-pay in public health insurance scheme. Welfare system alone has less impact to health disparities among marginalized people. Thailand need more reform in income redistribution as well as wealth distribution.