The chair of the Senate health committee plans to scrutinise the finances of the National Health Security Office (NHSO) during debate on the government's policy statement to parliament on April 9-10.
Dr Prapon Tangsrikiattikul warned on Sunday that mounting hospital debt could threaten the stability of Thailand’s public healthcare system.
He would raise the issue during the policy debate, with the committee's focus being on the NHSO’s financial management, as hospitals nationwide face a severe liquidity crunch, The Standard reported.
He said funds circulating in the hospital system have dropped from 80 billion baht to just 20 billion, a shortfall of 60 billion baht.
The missing amount corresponds closely to outstanding debts owed by hospitals to pharmaceutical companies, raising concerns about the long-term sustainability of healthcare services.
The NHSO is the state agency responsible for operating the Universal Coverage Scheme (UCS), widely known as the 30-baht gold card scheme.
Dr Prapon said the core problem lies in the NHSO’s use of an Adjusted Relative Weight (AdjRW) payment formula that fails to reflect hospitals’ real costs, leaving hospitals being reimbursed for only about half of their expenses. As a result, facilities have been forced to absorb the remaining costs, leading to mounting cumulative losses.
Beyond funding shortfalls, the senator also questioned the NHSO’s transparency and budget allocation processes, especially its expansion of new benefit schemes without clear financial backing.
One such initiative , the “innovative health services” programme involving private clinics and pharmacies, has already consumed more than 3.7 billion baht. However, no additional funding has been earmarked, prompting fears that resources may be diverted from hospital budgets to sustain the scheme.
To address the crisis, Dr Prapon wants the NHSO to improve transparency and ensure fair budget allocation across all funds. He also wants the government to revise the AdjRW rates to better reflect actual costs, enabling hospitals to remain financially viable.
“If hospitals cannot survive, the entire healthcare system will collapse,” he warned.
Dr Prapon added that rather than seeking additional funding, authorities should first overhaul the NHSO’s management structure, which has been in place for over two decades, and reallocate existing resources more efficiently.
Given the current economic climate, he said, any request for additional budget should come only after ensuring that existing funds are being used fairly and effectively.
