Picture courtesy of Bangkokpost - A family reads information about the ‘30 Baht Universal Healthcare Anywhere’ programme that the National Health Security Office kicked off at Government Complex in Bangkok in August. 

 

The 30-baht universal healthcare scheme, known as the gold card system, is facing a severe financial crisis that experts warn could push the national healthcare system to the brink of collapse. Mounting unpaid sums and widening budget deficits have triggered growing tension between hospitals and the National Health Security Office (NHSO).

 

The dispute intensified when Dr Rienthong Nanna, director of the privately owned Mongkutwattana Hospital, revealed that his facility had not received about 100 million baht owed by the NHSO. In protest, the hospital plans to suspend medical services for outpatients holding gold cards. The Ministry of Public Health has also admitted that hospitals under its supervision are struggling, with accumulated deficits now reaching 18 billion baht as expenditures exceed revenue by 110%.

 

Several hospitals have appealed for urgent financial relief, asking the ministry to approve 8 billion baht from the central budget to sustain operations. Medical personnel and hospital directors have renewed calls for reform of the NHSO, criticising its management and slow payment processes. Dr Pawinee Eamchan, director of Saraburi Hospital and chairwoman of the regional and general hospital club, warned that unresolved financial shortfalls will have a “big impact on the national healthcare system”. She added that Saraburi Hospital remains operational only thanks to public donations, despite running a deficit of over 120 million baht.

 

Under the NHSO’s current formula, hospitals receive 8,350 baht per patient per year, far below the actual average treatment cost of 13,240 baht. Some hospitals receive less than 7,000 baht due to a new regulation applying a backward calculation, known as the “re-run system”, from October 2024 to July 2025. The shortfall has forced some state hospitals to cut back on advanced treatments and prescribe cheaper alternatives. Medical associations have demanded that the re-run system be scrapped and that a separate fund be created for in-patients to offset losses.

 

For the 2026 fiscal year, the government approved 265.30 billion baht for the national health security fund. Of this, 198.23 billion baht is allocated for 47.5 million gold-card holders, an increase of 16.38 billion baht from last year. Additional funds include 3.8 billion baht for local administrative organisations, 27.76 billion for disease prevention and promotion, 4.6 billion for Aids patients, and 16.08 billion for kidney disease care. Only 562.22 million baht, however, has been reserved as an emergency fund for health providers.

 

Criticism of the NHSO has intensified among hospitals and clinics that accuse the agency of ignoring frontline concerns. Many are demanding greater representation of medical service providers on the NHSO committee, currently limited to one seat and a more collaborative approach. Without stronger financial support, health experts warn that staff resignations and deteriorating services could follow, leaving millions of Thais dependent on the gold card scheme at risk.

 

Key Takeaways

 

• Hospitals face mounting deficits as NHSO payments fall short of actual costs.

• Medical groups demand reform, cancellation of the re-run system, and fairer funding.

• Experts warn that service cuts or staff resignations could harm millions of patients.

 

Related Stories

 

Bangkok-clinics-quit-universal-coverage-over-mounting-debt

 

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

 

  Adapted  by  Asean  Now from Bangkokpost 2025-11-03

 

 

 

 

Unimportant. No sweat. Only poor people really need it. 

17 hours ago, Georgealbert said:

Experts warn that service cuts or staff resignations could harm millions of patients.

"Thailand’s 2026 Budget, Explained," October 02, 2025

https://thediplomat.com/2025/10/thailands-2026-budget-explained/

• "last year’s appropriated budget of 3.75 trillion, only 90 percent was actually spent in the 2025 fiscal year. The majority of this surplus was realized from the Central Fund, a large spending pot under the control of the prime minister. Much of this savings comes from the government’s decision to cancel the final phase of the digital wallet program earlier this year. The unused funds will reportedly be rolled over to help fund more targeted economic stimulus measures in 2026."

How about rolling over unused funds to the National Healthcare system? 

17 hours ago, Georgealbert said:

The 30-baht universal healthcare scheme, known as the gold card system, is facing a severe financial crisis that experts warn could push the national healthcare system to the brink of collapse.

I wonder why

1 hour ago, mfd101 said:

Unimportant. No sweat. Only poor people really need it. 

 

 

Actually, it is very important, especially to Americans who want government-supplied healthcare.  This is what happens, and it is not just in Thailand. Take a look around the world.  

 

This is another example of the Thai debt system.  What do I owe money? Never mind, I don't have to pay my debts.  Imagine when the 20 baht system gets in place and the government then says to BTS and MRT, 'Sorry, we are not going to give you the money we promised.'  How well will your train run then?

 

 

5 minutes ago, hotchilli said:

I wonder why

 

The doctors want make $ mil /year. ?

2 minutes ago, watchcat said:

10 minutes ago, hotchilli said:

I wonder why

 

The doctors want make $ mil /year. ?

 

Because Thailand's government has been cooking the books for years, and the coffers are empty?

15 minutes ago, kingstonkid said:

 

 

Imagine when the 20 baht system gets in place and the government then says to BTS and MRT, 'Sorry, we are not going to give you the money we promised.'  How well will your train run then?

 

 

 

everyone loves a train wreck.

1 hour ago, mfd101 said:

Unimportant. No sweat. Only poor people really need it. 

That's half the nation

27 minutes ago, hotchilli said:

That's half the nation

 

Not to mention the staff in the hospitals that will eventually lose their jobs as well as the fact that if hospitals can't pay the good doctors will go abrod or will go to the country.

59 minutes ago, kingstonkid said:

2 hours ago, mfd101 said:

Unimportant. No sweat. Only poor people really need it. 

 

 

Actually, it is very important, especially to Americans who want government-supplied healthcare.  This is what happens, and it is not just in Thailand. Take a look around the world.  

 

This is another example of the Thai debt system.  What do I owe money? Never mind, I don't have to pay my debts.  Imagine when the 20 baht system gets in place and the government then says to BTS and MRT, 'Sorry, we are not going to give you the money we promised.'  How well will your train run then?

 

 

Sorry, I was using sarcasm. 

...If You Check The Facts & Figures In Earnest I Am Sure You Can Find Out Where The Money Has Gone...

3 hours ago, CallumWK said:

 

Because Thailand's government has been cooking the books for years, and the coffers are empty?

Empty? 

Isn't there money budgeted to Purchase & Operate Chinese made submarines?

1 minute ago, OneZero said:

Empty? 

Isn't there money budgeted to Purchase & Operate Chinese made submarines?

That money is currently seasoning in overseas bank accounts.🙃🙃

Thailand should get its money back for the submarine, the Swedish jets, and however much they've been hornswoggled out of with that Chinese railroad. Maybe then there will be money for people who need it.

I'm really glad Dr. Take-Out-the-Trash isn't getting the income he expected. He's hurt a great many young people for no other reason than his own arrogance.

 

His hospital is private, not govt. We've never seen a breakdown of the deficits of private vs public hospitals. Maybe it's only the rich crying the blues.

20 hours ago, SOTIRIOS said:

...If You Check The Facts & Figures In Earnest I Am Sure You Can Find Out Where The Money Has Gone...

 

10k per Thai

debt relief

education

 

The challenge is that the Thai government does not consider the costs associated with borrowing to undertake projects that are visible to the public.

 

BMA and the Thai government, under the military government, made a big deal out of the cost of the BTS between Khu Kot and Morchit.  No one thought that the companies might actually want the money the government promised.  Same thing with the new lines.  

 

People make these great promises but do not reallize tht they may actually have to pay for them.