Fight over the health budget: Doctors demand immediate reforms!

Fight over the health budget: Doctors demand immediate reforms!

There is currently a simmering discussion in Thailand about the future financing of the health system. On October 30, 2025, Dr. Supat Hasuvarnkit, director of Sabayoi Hospital in Songkhla and president of the Rural Doctors Association, expressed serious concerns about the proposed IP budget for 2026 in a Facebook post. The budget was approved as an “end of year budget,” which means hospitals have to work under a rigid budget. With the increasing number of patients, it will be difficult to guarantee the necessary reimbursements.

Current projections suggest that reimbursement to hospitals may only be around 7,500 baht per unit of account (RW) - an amount that the affected facilities simply cannot and will not accept. Dr. Hasuvarnkit emphasizes that they are aiming for a guaranteed amount of at least 8,350 baht per RW. However, to achieve this the budget would have to be managed as an open budget, meaning additional funding would be required.

Health care financing reform

The Thai government has recognized this issue and is planning a comprehensive reform of the health system's financing model, according to Deputy Prime Minister and Finance Minister Pichai Chunhavajira. At a meeting on January 27 convened by Prime Minister Paetongtarn Shinawatra, it became clear that there is a need to improve efficiency and address existing inequalities between the four health service models, such as the universal health system (Gold Card) and the Social Security Fund (SSF). There is a need for action, particularly with regard to rising medical costs, which are growing faster than the country's GDP.

Dr. Jadej Thammatacharee, secretary-general of the National Health Security Office (NHSO), reported that about 360 billion baht is allocated annually to healthcare for 64 million citizens. But per capita spending varies significantly depending on the service model. For example, DLA beneficiaries receive an average of 12,000 baht, while civil servants receive as much as 18,000 baht, amid ongoing discussions about how to make funding more equitable.

The challenges of the Thai healthcare system

The healthcare system in Thailand is not only financially but also structurally challenged. Historically, Thailand has developed a comprehensive healthcare system that includes both public and private sectors. However, much patient care comes through government facilities, often resulting in overcrowded hospitals and exhausted staff. The old structures that have helped many Thais receive basic medical care since the beginning of the 21st century are reaching their limits.

The healthcare system has changed significantly since the times of the Siamese monarchy, but challenges remain. These include increasing drug imports, which cost 200 billion baht annually, and dealing with an aging society. While Thailand has made great strides through initiatives such as the 30-Baht Insurance Program, launched over 20 years ago, current healthcare demands have increased and require urgent reform.

In summary, the Thai government faces a challenging task: ensuring that medical care remains accessible to all while ensuring the financial stability of health services. Without a clear strategy to optimize budgets and combat inequalities, there is a risk of significant problems in the healthcare system in the future.

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