Picture courtesy of Khaosod

 

Community clinics across Bangkok are withdrawing from Thailand’s Universal Coverage Scheme (gold card), citing mounting debts and inadequate government reimbursements that fail to meet real operating costs. The withdrawal has raised concerns about access to primary healthcare, with over 220,000 patients already affected. On 21 October 2025, representatives of the Warm Community Clinic Association submitted a petition to the Ministry of Public Health (MOPH), urging urgent reforms to funding and management under the National Health Security Office (NHSO).

 

Dr. Nuntawan Chor-umthong, president of the Warm Community Clinic Association, led the delegation alongside Dr. Pinai Luanlert, a subcommittee member of Bangkok’s NHSO and Mrs. Sarin Sonthisirikrit, representing private clinic operators. The group demanded a review of the NHSO’s budget allocation system and called for immediate support to prevent further financial collapse among clinics. Out of 324 community clinics originally operating in the capital, only about 260 remain after several withdrew from the programme, leaving large gaps in local healthcare provision.

 

According to Dr. Pinai, the NHSO’s “Point System” payment model severely underfunds clinics. For example, treatment costs of 10,000 baht are reimbursed at only 5,700 baht under a 0.57 multiplier, forcing clinics to absorb nearly half of all expenses. The cumulative deficit among Bangkok providers exceeded 1 billion baht for fiscal year 2024. Many clinics also face demands to refund money due to audit recalculations, mirroring disputes seen with Mongkutwattana Hospital.

 

The MOPH assigned Inspector-General Dr. Sophon Iamsirithaworn and Dr. Kasem Tangkasemsaran, inspector for Health Region 13, to address the situation. Proposals include compensating affected clinics, forming a joint task force to design a sustainable funding model, and adopting the Nopparat Rajathanee Hospital “zonal” system that separates budgets for treatment and patient referrals. Without swift reform, Dr. Pinai warned that more clinics will exit the scheme in 2026.

 

Mrs. Sarin outlined four major proposals: revising budgets for 2023–2024 to ensure fairness and transparency; adjusting payment and referral systems to reflect urban healthcare realities; implementing a risk-adjusted capitation model aligned with true costs and establishing a “Gold Card Plus” network with additional funding for high-capacity clinics.

 

Dr. Nuntawan further called on the Prime Minister and Health Minister to audit NHSO’s financial operations, which manage 260 billion baht annually. She requested an immediate allocation of central government funds to compensate primary care units and urged adoption of the Nopparat model for clear budget separation. Dr. Kasem confirmed the ministry’s intention to form a joint working group and explore central budget options for relief, pending ministerial approval.

 

Key Takeaways

 

• Over 220,000 Bangkok residents are affected as clinics withdraw from the Universal Coverage Scheme.

• Clinics claim NHSO reimbursements cover only about half their actual treatment costs, creating billion-baht deficits.

• The Public Health Ministry plans to form a task force to develop a fairer funding model and consider emergency relief.

 

Related Stories

 

Mongkutwattana-hospital-to-suspend-gold-card-services

 

Gold-card-health-scheme-faces-urgent-reform-demands

 

 

  Adapted by Asean Now from Khaosod 2025-10-22

 

 

 

 

Sadly, not unexpected.

 

Now even more pressure of Thai government hospitals.