Doctors in state hospitals have voiced concerns regarding the Council of State's interpretation that funds coming from the Universal Healthcare Coverage (UC) scheme could only be used to pay for patients' medical costs.
They argued the decision, which would bar hospital management from allotting part of the funding to pay for daily charges such as water or electricity costs, threatens many hospitals, especially those in rural areas.
Hospitals will find it hard to cover all their costs with such a "narrow" interpretation of the scheme's beneficiaries, said Supat Hasuwannakit, director of Chana Hospital in Songkhla province.
Chana Hospital, with its 10 doctors and 90 nurses, can accommodate up to 72 in-patients and treats about 500 outpatients daily. Most of its revenue comes from the state-sponsored UC budget.
Part of the UC budget covers water and electricity fees, as well as the salaries of security guards, cleaners and several other aspects of the hospital's daily costs, Dr Supat said.
"Aren't functioning electricity, clean laundry or food part of all our patients' care as well?" he asked, after the Council of State declared on Nov 30 that the budget from the UC scheme would only pay for doctors and medicine costs, room and vehicle charges for patients.
He criticised this interpretation, arguing it had no basis in reality.
"I would like the members of the Council of State to leave their air-conditioned rooms and come to observe how a countryside hospital works instead," Dr Supat said.
Hospitals should retain the freedom to decide how their budget is to be used. Imposing limitations on budgets will severely handicap many facilities.
In Khon Kaen province, Prayoon Kowit, the director of Ban Phai district hospital, admitted he would have difficulty managing the budget if the Council of State's ruling is implemented.
Dr Prayoon said part of the budget in Ban Phai goes towards health education work in local communities, and covers employees' salaries during those campaigns, their fuel and vehicle costs, as well as procurement for some medical equipment.
The money set aside for in-patients and out-patients will need to be reapportioned following the interpretation, affecting the quality of the hospital's service, Dr Prayoon said.
Nimit Tienudom, a former board member of the National Health Security Office, said the Council of State's resolution could affect the 30-baht healthcare programme itself.
By imposing limitations on how the UC budget can be used, the state is driving private hospitals away and discouraging them from taking part in the UC scheme, he said.
The controversy arose amid speculation the government may scrap the UC plan altogether, after Prime Minister Prayut Chan-o-cha voiced concerns the scheme was too costly and did not generate revenue.
Although Gen Prayut dismissed the speculation, he admitted the scheme must be tweaked to improve its financial management.
Mr Nimit argued the UC plan would "find itself destroyed" if the National Health Security Office, which manages the UC budget, agreed to follow the Council of State's interpretation in its meeting today.