"Consumer Council and networks" oppose amendments to the Gold Card Act requiring co-payments, pointing out it sets citizens' rights backward and worsens living conditions; they suggest merging three health funds to reduce inequality.,
In July 2026, the Senate Health Commission proposed amending the National Health Security Act B.E. 2545 (2002) or the Gold Card Act, with discussions about introducing co-payments and expected to present the matter to the parliament between September and October this year.
Today (26 Aug 2026) the Consumer Organizations Council held a press conference titled "Health Rights Must Not Regress," discussing the amendment of the National Health Security Act or Gold Card Act at Don Mueang 1 Meeting Room, Amari Don Mueang Hotel, to oppose changes that would reduce free healthcare rights to a system with "co-payments."
Mr. Laphis Rukdee, Secretary of the Phayao Foundation for Development, questioned whether the rights of 47 million citizens still have a voice, noting that people have faced rights violations such as harm from treatment or lack of services. Those living far from medical facilities face travel expenses, and if co-payments are introduced, they will bear additional burdens without knowing the full amount required. He criticized the drafters of the Gold Card Act amendment for being unaware of the real hardships faced by the people.
Mr. Laphis viewed that the National Health Security Act B.E. 2545 entrusts the Ministry of Public Health to allocate budgets per capita to medical personnel in various areas, rather than concentrating funds only in large hospitals. It is evident that medical staff remain committed through continuous hard work and should be cared for and supplemented in underserved areas rather than drafting new laws.
Ms. Meena Duangrasi, Chairperson of the Gold Card Rights Protection Center in Surin Province, reflected on the original intent of the National Health Security Act B.E. 2545, emphasizing that citizens' expenses should not be charity but a right. If the amendment increases the number of service providers on the NHSO board and reduces civil society's representation, it will diminish citizens' voices. Consequently, decisions, service management, policy-making, and budget use will be controlled by service providers, turning access to care into charity. She suggested opening space for citizen participation in all regions at the policy level to address real issues.
Ms. Meena added that the amendment's proponents use phrases encouraging public agreement, such as "structural adjustment for good governance," implying that the previous structure lacked good governance. In reality, this rhetoric aims to revert to the pre-2002 Gold Card Act structure, where all decision-making power rests with the Ministry, centralizing authority. She anticipates the use of the phrase "basic benefits rights" in the draft law to suggest citizens deserve basic benefits, but new or additional benefits that require extra medication purchases would be subject to co-payment, even though these are "necessary benefits."
Mr. Sunthorn Suriyo, Chairperson of the Kanchanaburi Consumer Rights Protection Center, observed that Thailand is entering an aging society and organizations are seeking ways to respond. However, the amendment cuts public participation, raising questions whether members of parliament will accept citizens in their areas being deprived of basic service rights and receiving poorer care. He also warned of the severe household economic impact from required co-payments.
Mr. Sunthorn further recommended considering merging the three health funds — civil servant welfare, social security, and Gold Card — to reduce inequality and move toward a universal solution where all citizens truly have equal rights, instead of regressive fixes.
Pharmacist Chalom Ketchinda, Vice President of the Songkhla Consumer Association, explained that the Gold Card Act B.E. 2545 originated from public initiatives submitting 50,000 signatures, followed by collaborative drafts from various parties developing into the current Gold Card system benefiting 47 million people. The Ministry of Public Health is responsible for providing and managing medical personnel, while citizens manage their health through local health funds, empowering everyone to own their health.
Pharmacist Chalom believes the government and Ministry of Public Health should focus on increasing the per capita budget to match other agencies that impact public health, and that medical personnel care and support for citizens' self-health management already exist under the National Health Security Act B.E. 2545. These should be improved, emphasizing that she does not seek conflict with medical staff but advocates for a system that develops together.