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Despite its low gross national income per capita in Thailand, a bold decision was made to use general taxation to finance the Universal Health Coverage Scheme without relying on contributions from members. Thailand’s health development since the 1970s, focusing on investment on health delivery infrastructure and training of the health workforce, has targeted health insurance schemes contributing to the implementation of the universal coverage scheme in 2002. Empirical evidence shows substantial reduction in levels of out-of-pocket payments, the incidence of catastrophic health spending, and medical impoverishment.