This study compares elderly healthcare access in Thailand and Canada, with particular attention to

economic factors, policy challenges, and labor shortages. Drawing on Welfare State Theory and a Comparative

Policy Analysis Framework, it examines how different governance models and institutional arrangements

shape healthcare delivery for aging populations. Canada’s publicly funded healthcare system has undergone

reforms to improve quality of care and reduce wait times; however, persistent challenges such as long

queues and healthcare worker burnout continue to undermine service efficiency. In contrast, Thailand’s

Universal Coverage Scheme (the “30-Baht Scheme”) provides affordable care but faces inefficiencies and

critical workforce shortages. This study identifies the main barriers in both countries, reviews government

responses, and offers policy recommendations. These include strengthening community-based care, clarifying

government roles, and investing in healthcare workforce development to enhance access and improve

system efficiency for the elderly.

Astego Immigration Consulting Limited. (2024). The Economic Impact of Manpower

Shortages in Health-care: A Canadian Perspective. Retrieved March 2, 2025, from https://www.linkedin.com/pulse/

economic-impact-manpower-shortages-healthcare-canadian-perspective-hqvre/

Boonmavichit, T., & Hobbes, J. D. (2023). The Future of Thailand’s Healthcare Workforce in Light of the

Covid-19 Pandemic: A Retroduction Analysis. Retrieved March 1, 2025, from https://jfsdigital.org/

articles-and-essays/2023-2/vol-27-no-4-june-2023/the-future-of-thailands-healthcare-workforce-in-

light-of-the-covid-19-pandemic-a-retroduction-analysis/

Canadian Health Coalition. (2018). Policy Brief: Ensuring Quality Care for All Seniors.

Retrieved September 14, 2024, from https://www.healthcoalition.ca/wp-content/uploads/2018/11/Seniors-care-policy-

paper-.pdf

Canadian Institute for Health Information. (2024). Keeping pace with changing population needs. Retrieved

December 10, 2024, from https://www.cihi.ca/en/the-state-of-the-health-workforce-in-canada-2022/

keeping-pace-with-changing-population-needs

Chamchan, C., Kaikeaw, S., Prasertkul, P. & Punpuing, S. (2023). Socioeconomic inequalities in health

out-comes among the Thai older population in the era of Universal Health Coverage: trends and

decomposition analysis. Retrieved September 20, 2024, from https://equityhealthj.biomedcentral.

com/articles/10.1186/s12939-023-01952-0

D’Angelo, M. S., Moroz, I., & Moroz, N. (2020). Mental health services in Canada: Barriers and cost-effec-

tive solutions to increase access. Retrieved March 9, 2025, from https://journals.sagepub.com/

doi/10.1177/0840470420933911

Dubuc, N., Durand, P. J., Hébert, R., The PRISMA Group, & Tourigny, A. (2003). PRISMA: a new model of

integrated service delivery for the frail older people in Canada. Retrieved March 1, 2025,

from https://pmc.ncbi.nlm.nih.gov/articles/PMC1483944/

García, A. R., Hudson, E., Pizzo, E., Raine, R., Thomas, J., & Turner, S. (2017). Impact and experiences of

delayed discharge: A mixed‐studies systematic review. Retrieved March 20, 2025, from https://pmc.

ncbi.nlm.nih.gov/articles/PMC5750749/

Government of Canada. (2023). Canada is addressing current and emerging labour demands in health care.

Retrieved September 9, 2024, from https://www.canada.ca/en/employment-social-development/

news/2023/06/canada-is-addressing-current-and-emerging-labour-demands-in-health-care.html

Health Canada. (2005). Canada’s Health Care System. Retrieved September 9, 2024, from

https://publica-tions.gc.ca/collections/Collection/H21-261-2005E.pdf

Health Canada. (2023). The Government of Canada and Ontario Reach Agreement in Principle to Improve

Health Services for Canadians. Retrieved September 20, 2024, from https://www.canada.ca/en/

health-canada/news/2023/02/the-government-of-canada-and-ontario-reach-agreement-in-principle-

to-improve-health-services-for-canadians.html

Health Canada. (2024). Canada Health Act, annual report 2022-2023. Retrieved September 20, 2024, from

https://publications.gc.ca/collections/collection_2024/sc-hc/H1-4-2023-eng.pdf

Health Canada. (2024). Supporting Canada’s health workers by improving health workforce research,

planning and data. Retrieved September 20, 2024, from https://www.canada.ca/en/health-canada/

news/2024/07/supporting-canadas-health-workers-by-improving-health-workforce-research-planning-

and-data0.html

Institute of Medicine. (2008). Evidence-Based Medicine and the Changing Nature of Healthcare: 2007 IOM

Annual Meeting Summary . Retrieved September 23, 2024, from https://www.ncbi.nlm.nih.gov/

books/NBK52825/

Jirathananuwat, A. (2022). Factors affecting access to health services by older adults in an urban community

in Thailand: a cross--sectional study. Retrieved January 15, 2025, from https://f1000research.com/

articles/11-467/v2

Leenoi, P. (2024). Aged Society: Embracing Challenges and Unlocking Opportunities. Retrieved March 10,

2025, from https://www.krungsri.com/en/research/research-intelligence/silver-economy

Luga, L. C., Luga, H., & Nerisanu, R. A. (2024). The impact of healthcare system quality and economic factors

on the older adult population: a health economics perspective. Retrieved March 10, 2025, from

https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1454699/full

MacAdam, M. (2011). Progress toward integrating care for seniors in Canada . Retrieved March 22, 2025,

from https://pmc.ncbi.nlm.nih.gov/articles/PMC3111885/#:~:text=System%20improvements%20

in%20integrating,remain%20weak.&text=Canadian%20provincial%20health%20care,remain%20

weak.&text=delivery%20of%20case%20management,remain%20weak.&text=could%20be%20im-proved.%2

Milligan, K. S., & Schirle, T. (2023). The Economics of Long-Term Care in Canada. Retrieved September 16,

2024, from https://www.nber.org/system/files/working_papers/w31875/w31875.pdf

Mills, A., Panichkriangkrai, W., Patcharanarumol, W., Tangcharoensathien, V., & Witthayapipopsakul, W. (2018).

Health systems development in Thailand: a solid platform for successful implementation of

universal health coverage. Retrieved September 10, 2024, from https://www.thelancet.com/

pb-assets/Lancet/pdfs/S0140673618301983_Thai-1517425266757.pdf

National Health Security Office. (2023). The NHSO’s five measures to reduce medical staff workload. Retrieved

September 10, 2024, from https://eng.nhso.go.th/view/1/Secretary-General/The-NHSOs-five-measures-

to-reduce-medical-staff-workload/552/EN-US#:~:text=World%20Health%20Organization%20set%20

a%20standard%20of,in%20public%20hospitals%20due%20to%20inadequate%20resources.

Ontario Human Rights Commission. (n.d.). Time for action: Advancing human rights for older Ontarians.

Retrieved September 8, 2024, from https://www.ohrc.on.ca/en/time-action-advancing-human-rights-

older-ontarians/health-care-institutions-services#:~:text=“Many%20seniors%20cannot%20access%20

physicians,not%20welcome%20seniors%20as%20patients.”

Ontario Medical Association. (2024). Ontario’s doctors recommend immediate solutions for Ontario’s

health-care crisis. Retrieved March 2, 2025, from https://www.oma.org/advocacy/prescription-

for-ontario/prescription-for-ontario-doctors-solutions-for-immediate-action/#page-top

SELC College. (2025). How HCA Programs Address Workforce Shortages in the Healthcare Industry in Canada?

Retrieved April 10, 2025, from https://selcedu.com/health-care-assistant/shortages-in-the-healthcare/

Statista. (2024). Share of total population older than 60 years old in Thailand between 2022 and 2023,

with a forecast to 2040. Retrieved March 3, 2025, from https://www.statista.com/statistics/713667/

thailand-forecast-aging-population/

Statistics Canada. (2021). Survey on Access to Health Care and Pharmaceuticals During the Pandemic,

March 2020 to May 2021. Retrieved September 20, 2024, from https://www.150.statcan.gc.ca/n1/

daily-quotidien/211123/dq211123b-eng.htm

Statistics Canada. (2024). The older people are all right. Retrieved September 25, 2024, from

https://www.statcan.gc.ca/o1/en/plus/7059-older-people-are-all-right

WHO. (n.d.). Health workforce. Retrieved September 23, 2024, from https://www.who.int/health-topics/

health-workforce#tab=tab_1

WHO. (2023). Thailand’s leadership and innovations towards healthy ageing. Retrieved September 2, 2024,

from https://www.who.int/southeastasia/news/feature-stories/detail/thailands-leadership-and-

innovation-towards-healthy-ageing

World Bank Group. (n.d.). Closing the Health Gaps for the Elderly in Thailand. Retrieved September 4, 2024,

from https://www.worldbank.org/en/country/thailand/publication/closing-the-health-gaps-for-the-

elderly-in-thailand

World Bank Group. (n.d.). Thailand: Sustaining Health Protection for All. Retrieved March 1, 2025, from

https://www.worldbank.org/en/news/feature/2012/07/31/thailand-sustaining-health-protection-for-all

Zimonjic, P. (2023). More money is a must, but health-care delivery also needs a major rethink, doctors

say. Retrieved September 20, 2024, from https://www.cbc.ca/news/politics/healthcare-crisis-doctors-

hospitals-rethink-1.6695642