During his visit to Bangkok for the United Nations Regional Ministerial Meeting, H.E. Pradip Paudel, Minister of Health and Population of Nepal, met with Dr. Khagendra Raj Dhakal, Chair of the Nepal Policy Institute (NPI), on June 26 at Bow Hotel for a policy-focused discussion on Nepal’s evolving public health priorities and strategic reform pathways.
The meeting focused on Nepal’s Universal Health Coverage (UHC) goals, with particular attention to the expansion of the National Health Insurance Program (NHIP). Minister Paudel shared his government’s efforts to increase health insurance coverage and reaffirmed his commitment to enhancing the program’s reach to underserved populations.
Dr. Dhakal appreciated the Minister’s forward-looking leadership and presented key learnings from Thailand’s public health system, especially the well-known “30 Baht Scheme” which has delivered affordable, equitable, and efficient care across Thailand through tax-based funding.
Learning from Thailand’s ’30 Baht Scheme’: A Practical Model for Nepal
Dr. Dhakal provided background on Thailand’s highly regarded “30 Baht Scheme” to illustrate its potential relevance for Nepal. Officially introduced in 2001 as part of Thailand’s Universal Coverage Scheme (UCS), the program initially allowed citizens to access nearly all essential health services at government facilities for just 30 Baht per visit (approximately 1 USD).
The scheme offers comprehensive coverage—including outpatient, inpatient, maternal and child health, chronic disease management, and essential medicines—at public hospitals and health centers across Thailand. Managed by the National Health Security Office (NHSO), it uses a capitation-based funding model and a primary care gatekeeping system to ensure efficiency and cost control. As a result, Thailand achieved near-universal health coverage and drastically reduced out-of-pocket spending, while maintaining relatively low health expenditure as a percentage of GDP.
When the Minister inquired about the population coverage under the 30 Baht Scheme, Dr. Dhakal explained that it covers approximately 74% of Thailand’s population through the UCS. He elaborated that Thailand’s based on the publicly available sources, Thailand has achieved more than 99% coverage through three complementary public insurance schemes as below:
- Universal Coverage Scheme (UCS) – ~74–75%
- Social Security Scheme (SSS) – ~15–16%
- Civil Servant Medical Benefit Scheme (CSMBS) – ~8–9%
This coordinated system ensures no citizen is left without health protection. Nepal could take inspiration from this multi-scheme model to create a more inclusive and equitable health insurance system.
Eligibility and Services Covered
The UCS (30 Baht Scheme) primarily covers Thai citizens not enrolled in the CSMBS or SSS—mainly informal sector workers, the unemployed, low-income groups, the elderly, and children.
Services covered include:
- Outpatient and inpatient care
- Essential medicines and diagnostics
- Chronic disease management
- Maternal and child health services
- Family planning, immunizations, health promotion
- Basic dental services
- Mental health and rehabilitation care
These are delivered mainly through public hospitals and health centers, though accredited private facilities are also included in specific areas. A gatekeeping system ensures cost-effective referrals.
How the 30 Baht Scheme Is Funded
Dr. Dhakal noted that the scheme is financed through general taxation, with per capita budgeting proposed annually by the Ministry of Public Health and approved by the Ministry of Finance. Funds are managed by the NHSO, and healthcare providers receive payments via a capitation model. There are no premiums or payroll deductions, making it especially effective for informal sector populations.
Comparative Insights for Nepal
Indicator | Nepal | Thailand | Implication |
Health Spending (% of GDP) | 5.4% | 3.8% | Efficient design matters more than volume |
Out-of-Pocket Spending | 55–60% | 10–12% | Nepal needs stronger financial protection |
UHC Service Coverage Index | 53.1 | 83.9 | Enhance access to essential services |
Additionally, Thailand is transitioning from a “treat all diseases” model to a “treatment anywhere” model with multi-sectoral reforms, showing Nepal how flexibility and integration can be embedded in future NHIP development.
Recommendations
- Unify fragmented health schemes under one UHC framework
- Link sin taxes to an autonomous Nepal Health Promotion Foundation
- Digitize NHIP enrollment and tracking
- Pilot UHC reform in digitally advanced provinces
- Introduce minimum mandatory insurance for informal workers
Concluding the discussion, Minister Paudel responded positively and expressed interest in continuing dialogue with NPI to explore best practices from Thailand and beyond. Both parties agreed to deepen collaboration on key areas such as health financing, equity, and public health innovation.
The meeting was also attended by Joint Secretary Mr. Dhundiraj Niraula from the Ministry of Health and Population, Deputy Chief of Mission Mr. Moti Bahadur Shrees from the Embassy of Nepal in Bangkok, and the Minister’s Personal Secretary, Mr. Pawan Poudel.
On this occasion, Dr. Dhakal presented a copy of NPI Newsletter, Knowledge Bridge, to Minister Paudel. NPI extends its sincere appreciation to the Minister for his openness to regional learning and his commitment to evidence-based policy reform in Nepal’s health sector.
(Note: This report is based on the discussion points prepared by the NPI Chair for briefing Minister Paudel.)

