Thailand is among one of the first non OECD countries to have successfully introduced a form of Universal Health Coverage (UHC) in 2002. This policy defines a natural experiment for the evaluation of the effects of public health insurance on health behaviours. In the present paper, we look at the impact of the Thai UHC on preventive activities, risky behaviours and healthcare consumption using data from the 1996, 2001 and 2003 Health and Welfare Survey of Thailand. We use double robust estimators combining propensity scores and linear regressions to estimate Difference-in-Differences (DD) and Difference in DD (DDD) models. Results offer important insights. First, previously uninsured men and women increased their preventive activities (check-ups) more than any other groups. At the same time, there is no evidence of either an increase in risky behaviours or a reduction of preventive efforts by the newly insured population. In other words, we find no evidence of ex ante moral hazard. Regarding healthcare consumption, we see that hospital admissions increased by 2% and outpatient visits increased by 13% due to the UHC. Overall, these findings imply positive health impacts among the Thai population who entered in the UHC.

The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

This study examines how a new billing process of the Thai Civil Servant Medical Benefit Scheme affects outpatient care utilization. Unlike policy changes considered in most existing studies, there is no change in cost‐sharing for the scheme considered here. Previously, the beneficiaries had to pay out of pocket and receive their reimbursement later. The new billing system allows hospitals to charge the government directly. Using patient‐level data from a large hospital, we find that the change affects outpatient utilization through both visiting rates and treatment intensity. These positive impacts are moderate, but persistent. The estimates are not sensitive to our choice of a time window, but their magnitudes can be sensitive to model specifications. Our analysis also suggests that patients with lower utilization rates (conditional on illnesses) prior to the change in the billing process increase their healthcare utilization more proportionally.