A leading Thai neurologist has called for urgent reforms to Thailand’s universal healthcare system, warning that continued budget shortfalls and rising hospital debts could threaten the sustainability of public medical services.
Prof Dr Somsak Tiamkao, director of Khon Kaen University’s Faculty of Medicine at Srinagarind Hospital, said on Monday that Thailand’s current funding model under the National Health Security Office (NHSO) must be restructured to reflect economic realities. He urged policymakers to consider introducing public co-payments, arguing that the country cannot afford to maintain entirely free healthcare under the “Gold Card” scheme.
Speaking to reporters, Prof Dr Somsak criticised what he described as mismanagement by the NHSO and called for greater transparency about the programme’s financial condition. He said the office must “acknowledge its mistakes” and communicate more honestly with the public about the limitations of the system.
He also questioned the continued use of promotional slogans such as “30 baht treats all diseases,” calling them misleading. According to him, free care should apply only to treatments listed in the official medical catalogue, and patients should be clearly informed when additional costs apply.
Prof Dr Somsak expressed concern over the weakening of the referral system, noting that campaigns like “one ID card for all hospitals” and “cancer care anywhere” have encouraged patients to bypass local clinics, resulting in overcrowding and longer waiting times at large hospitals. He proposed a return to the original gatekeeper model, where primary health centres serve as the first point of care.
The neurologist also urged citizens to take greater responsibility for their health by adopting preventive measures and using medication appropriately, reducing dependence on state-funded services. He said the NHSO should eliminate nonessential benefits and scale back spending on entitlements that exceed Thailand’s current fiscal capacity.
Prof Dr Somsak further called on the NHSO to disclose hospital debts in its annual reports, stressing that only “honest acknowledgment and systemic reform” could secure the long-term stability of Thailand’s healthcare system.
Public Health Ministry permanent secretary Dr Somrerk Jungsaman recently confirmed that 4 billion baht from the central budget will be allocated to support hospitals facing financial strain under the Gold Card programme while discussions on broader reforms continue.