Thailand’s Universal Healthcare Scheme Faces Budget Hike Amid Calls for Reform

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The National Health Security Office (NHSO) has announced plans to increase the budget for Thailand’s Universal Healthcare Coverage Scheme (UCS) to 272.58 billion baht for the upcoming fiscal year. This represents a 19.51% rise compared to the current fiscal year’s allocation of 235.84 billion baht, which ends on September 30. The proposed increase aims to support expanded coverage and new policies, but concerns over the scheme’s long-term sustainability and management challenges continue to grow.

Launched 22 years ago, the UCS has become Thailand’s largest healthcare initiative, covering 47.5 million citizens and offering a wide range of treatments, including specialized care such as hormone therapy for transgender individuals. While the scheme is highly popular among voters, its soaring budget and operational issues have prompted critics to question its viability.

Despite its growing budget, the scheme has faced criticism from healthcare providers, who highlight overwhelming workloads and reimbursement delays. Hospitals, including leading medical institutions under universities, have called for increased funding to manage staff salaries and improve services.

Nimit Tienudom, a civil society representative on the NHSO board, argued that the real issue lies in the scheme’s management rather than funding. “The NHSO must ensure efficient use of the budget and address disputes with hospitals over reimbursement and workload,” he said.

Dr. Somsak Tiamkao, director of Srinagarind Hospital, voiced concerns over unresolved issues that have accumulated over the scheme’s two decades. “These problems are nearing crisis levels,” he warned, urging the NHSO to prioritize resolving longstanding challenges before introducing new policies.

Rumors that migrant workers from neighboring countries are straining public hospitals have also surfaced, raising fears about the UCS’s sustainability. Nimit dismissed these claims, stating that the number of migrants seeking free treatment is insufficient to pose a significant threat.

To address this issue, Nimit suggested amending the National Health Security Act to allow the NHSO to manage healthcare for foreigners, proposing a national health insurance policy for migrant workers. Such a policy, he argued, would ensure comprehensive coverage and improve risk distribution across the system.

The unequal allocation of resources among Thailand’s three major healthcare schemes—the UCS, the Social Security Scheme, and the Civil Servants’ Medical Benefit Scheme—has been a longstanding concern. The UCS receives around 4,000 baht per person annually, compared to 20,000 baht per person under the civil servants’ scheme.

Nimit advocated merging the schemes to eliminate disparities and create a unified national healthcare system. “Starting with the UCS and Social Security Scheme would pave the way for full integration, ensuring fairer budget distribution and better services for all,” he said.

NHSO Secretary-General Dr. Jadej Thammatacharee emphasized the office’s commitment to addressing feedback from medical facilities while meeting public needs. He noted that the NHSO has expanded coverage and benefits in response to both government policies and public demand.

However, Dr. Somsak cautioned against introducing new initiatives without first resolving existing issues, stating that while expansion plans are beneficial, they should not exacerbate ongoing challenges.

As the NHSO awaits approval for its proposed budget increase, the debate over the UCS’s future continues to highlight the need for effective management and equitable healthcare provision in Thailand.

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