Prof Dr Somsak Tiamkao, a neurologist and director of Khon Kaen University’s Faculty of Medicine’s Srinagarind Hospital, is urging reform of universal healthcare funding, calling for public co-payments to sustain services amid budget constraints and mounting hospital debts.
Prof Dr Somsak on Monday said the National Health Security Office (NHSO) must acknowledge its mismanagement of the “Gold Card” scheme and communicate more transparently with the public.
He stressed that Thailand is not wealthy enough to offer unlimited free healthcare and that laws prohibiting co-payment should be amended to reflect current realities.
He stated that the NHSO must stop promoting misleading slogans like “30 baht treats all diseases” and clarify that only medically necessary treatments listed in the official catalogue are free. Patients should be informed when certain services require out-of-pocket payment.
He criticised the erosion of the referral system, saying campaigns like “one ID card for all hospitals” and “cancer care anywhere” have led to overcrowding and delayed care at major hospitals. He called for a return to the original gatekeeper model in which local health centres were the first point of entry to the service.
He also urged citizens to take greater responsibility for their health by preventing avoidable illnesses and using medication properly, rather than relying solely on government support.
NHSO should cut nonessential benefits and unnecessary spending, he said, noting that the NHSO continues to add new entitlements as if Thailand were among the world’s richest nations.
He also demanded that the NHSO admit its financial difficulties and disclose hospital debts in its annual reports. Only honest acknowledgement and systemic reform, he said, can ensure the sustainability of Thailand’s healthcare system.
Previously, Public Health Ministry permanent secretary Dr Somrerk Jungsaman confirmed that four billion baht from the central budget will be allocated to hospitals struggling under the Gold Card scheme while reforms are considered.