BANGKOK, THAILAND – A powerful senator warned that Thailand’s public health system faced a looming financial crisis as hospitals waited for reimbursement sums running into the billions since late last year.
Rising debts under 30-baht scheme
Senator Veerapun Suvannamai, a member of the Senate committee on public health, said hospitals nationwide had not received full repayments for treatments under the “30-baht treatment anywhere” scheme since the end of last year.
Under the National Health Security Office’s (NHSO) points-based reimbursement system, the money many facilities received fell short of actual treatment costs. As a result, hospitals increasingly had to draw on their own maintenance and reserve funds to cover expenses.
Billion-baht gaps and mounting pressure
Some facilities, including hospitals in Khon Kaen province, had already recorded deficits in the billions of baht, according to Veerapun, because operating costs clearly exceeded capped reimbursements.
He said the situation had worsened sharply toward the end of the year, when demand for inpatient and outpatient services surged, pushing cost pressures even higher.
Advance use of 2026 budget and political gridlock
To provide short-term relief, the NHSO allowed hospitals to advance funds from the 2026 budget amounting to around 7–8 billion baht, which were to be later reimbursed from central allocations.
After parliament was dissolved, however, approval of these central funds stalled. This meant part of the 2026 budget had already been spent without the planned compensation being provided.
Warning of service gaps and staff cuts
“This means that part of the 2026 budget was already spent last year, and hospitals will suffer even more from financial pressures this year,”
said Veerapun, who described the situation as a “time bomb” for the system.
He warned that hospitals with a high patient load and facilities in rural provinces were particularly at risk, as their limited maintenance and reserve funds left them with little capacity to absorb further shocks.
Possible impact on medicines and working hours
As an immediate consequence, Veerapun said drug quotas could be cut, for example by issuing prescriptions for only one month instead of the current three months.
Hospital managements might also first eliminate overtime payments to save costs, effectively forcing doctors to work unpaid extra hours or reduce services.
Urgent appeal to decision-makers
Veerapun stressed that any suspension of health services due to unpaid work would directly undermine public confidence in universal health coverage and worsen access to care for many people.
He urged national decision-makers to act quickly to stabilise funding and ensure hospitals could continue to provide services under the universal health system without interruption.