NHSO Chief: Gold Card budget stable, not in crisis

Thailand’s universal healthcare scheme, widely known as the “30-baht gold card,” has recently become the subject of widespread public debate, as concerns mount over the financial stability of the system. 

Reports have surfaced indicating that several public hospitals are running at a loss, prompting questions about the future of the programme.

On June 6, 2025, executives from the Nation Group welcomed Dr Jadej Thammatacharee, Secretary-General of the National Health Security Office (NHSO), and his team for a fact-finding discussion regarding these pressing issues.

Dr Jadej clarified that on June 5, the National Health Security Board—chaired by Public Health Minister Somsak Thepsuthin—held a key meeting that addressed several major topics, including speculation over the financial viability of the "30-baht healthcare anywhere" policy.

He stressed that, contrary to public concern, the fund remains stable. However, to reinforce public trust and promote long-term development, the board resolved to implement a robust, standardised audit system.

To that end, the NHSO will commission an independent audit of the National Health Security Fund’s financial management and expenditures. This audit will be conducted by four globally recognised private accounting firms, collectively referred to as the "Big Four."

Dr Jadej also addressed outpatient service figures. In the previous fiscal year, the Ministry reported 306 million outpatient visits, with many individuals receiving treatment more than once. Of these, 240 million visits were covered by the NHSO under the universal healthcare scheme.

He noted that public hospitals receive income from multiple sources—not just from the gold card programme but also from civil service welfare, social security funds, and other mechanisms. Based on available data, only 13 hospitals are currently reporting losses. He emphasized that these financial issues are likely unrelated to the healthcare scheme itself and may stem from other factors, which are now under investigation.

To further examine the issue, the NHSO plans to visit Khon Kaen Hospital, currently reported to have the highest deficit, in order to better understand the situation on the ground and explore possible solutions.

Dr Jadej acknowledged that reports of negative cash flow and liabilities at some hospitals have raised fears of a possible collapse of the system.

Speaking at a recent meeting of the NHSO Board on 5 June, he noted that while such concerns exist, the government's annual budget allocation for the scheme has consistently increased, reaffirming its long-term commitment. The board concluded that the overall financial standing of the National Health Security Fund remains secure.

Initial reviews by the NHSO and the Board suggest that discrepancies may stem from differences in how financial data is interpreted and used. For instance, if total cash, collectable debts, and inventories are calculated against liabilities, only 13 hospitals currently show significant financial issues—far fewer than the 218 initially reported.

To address transparency and ensure accountability, the NHSO Board approved the appointment of an independent auditing team composed of globally recognised private firms—the “Big Four.” These firms will audit the NHSO’s budget allocation and distribution systems and examine funding flows to service providers nationwide. Their findings are expected to include recommendations for systemic improvements.

Jadej also acknowledged concerns among hospitals that rising operating costs may not be matched by NHSO reimbursements. To address this, a new committee will be established to review not only the universal healthcare system but all related healthcare funding schemes to ensure fairness and financial sustainability across the board.

Public Health Minister Somsak has emphasised that the issues currently reported are not systemic but rather isolated and manageable. He assured the public that the gold card system remains intact, and services continue to operate as normal.

Public Access to Health Spending and Complaints Data

In a significant step toward greater transparency, the NHSO has begun publishing detailed spending data, showing how funds are disbursed to hospitals and clinics. Citizens can now access information on healthcare service payments, hospital performance, and complaint records via the NHSO website.

Payments are made approximately every 15 days to thousands of service providers across the country. Future plans include expanding this open data system and enhancing public communication to help people make informed choices about where to seek care.

In cases where certain facilities receive high volumes of complaints, the NHSO intends to gradually release more data to help guide public decisions and improve overall service standards.