The Ministry of Public Health has acknowledged that the universal healthcare system is facing a deepening financial crisis, citing mounting losses under the National Health Security Fund.
Public health permanent secretary Dr Somrerk Jungsaman said the universal healthcare system, or Gold Card scheme, is facing financial instability, as public hospitals continue to shoulder losses from providing services under the scheme.
He revealed that while hospitals under the ministry remain solvent overall — thanks to cross-subsidisation from the Civil Servant Medical Benefit Scheme and the Social Security Fund — the Gold Card scheme alone has run at a deficit, with expenditure reaching 110% of revenue, or 18.47 billion baht in 2024.
Meanwhile, hospitals’ liquidity has dropped sharply from 100 billion baht during the Covid-19 period to only 20 billion baht at present.
He said the root cause is the imbalance between service costs and compensation rates. The actual cost per inpatient case has stood at 15,900-16,400 baht since 2021, while the National Health Security Office (NHSO) continues to reimburse only 8,350 baht per case.
“This gap is unsustainable,” he said, noting that rising costs for medication, medical supplies, and personnel have exacerbated the problem.
To address the shortfall, the ministry plans to negotiate with the NHSO to raise the base rate to 13,000 baht, with an initial target of 10,000 baht in the 2027 fiscal year.
In addition, the ministry aims to generate over 86 billion baht annually from non-budgetary sources, including 40 billion baht from tourist health insurance, 16 billion baht from voluntary top-up schemes, and revenue from premium clinics.
Dr Somrerk added that efficiency measures, such as improved cost management, will further strengthen hospital performance and retain skilled medical personnel.
This comes as Mongkutwattana Hospital suspended its “Gold Card” universal healthcare services amid a funding dispute and offered a discount programme for affected patients.