Public Health Minister Mongkol na Songkhla yesterday announced the immediate abolishment of the Bt30 fee for universal healthcare, a move which he did not clear with the Cabinet.

Holders of gold cards no longer have to pay the Bt30 fee as the National Health Security Office (NHSO)'s board on Monday decided to stop collecting the fee for hospital visits charged under the universal healthcare scheme, Mongkol said.

The ministry will advise hospitals under its supervision of the new policy, while the NHSO would inform the rest.

The move would require a new budget of Bt2,089 per head, to cover income lost from collecting the Bt30 fee. The current budget is Bt1,659 per capita.

Mongkol said the ministry did not propose the move to the Cabinet yesterday as the necessary documents were not ready, but it should be able to do so for the next meeting.

Deputy Prime Minister and Finance Minister MR Pridiyathorn Devakula confirmed that yesterday's Cabinet meeting did not discuss the Bt30 issue. He said the Public Health Ministry had not yet reached a conclusion in its discussions with the Budget Bureau. Those conclusions would be announced later and cover which groups of people would get free medical treatment and which would have to pay. "The idea is not to collect the Bt30 fee from everyone - the poor don't have to pay, while the rich don't need free treatment because they can afford to pay," he said.

Pridiyathorn said later the government would conclude financing of the Bt30 universal health care project in the next couple of days. Speaking after meeting with Mongkol and Ammar Siamwalla, honourary advisor to the Thailand Development Research Institute and a member of the National Legislative Assembly, Pridiyathorn said the government had yet to officially finalise spending per head of Bt2,089.

He said he would ask public hospitals to come up with a figure by reporting their financial liquidity to the government. Nonetheless, the government still had sufficient money to finance programme, he said.

Meanwhile, Salee Ongsomwang, chief of the Foundation for Consumers, urged the government to use the Bt7-billion Protection for Motor Vehicle Accident Victims Act fund to support the universal healthcare scheme.

The fund spends Bt4 billion on administration while the rest was claimed as compensation for accident victims. The fund yielded a profit of Bt300 million a year, she said.

The co-payment for healthcare expenses should be at the hospital level, not at the service units, Salee said. The co-payment at service units could lead to discrimination. The division between those who get free services and those who co-pay was based on income, which was hard to decipher because of various factors including different tax payments, she said.

People also should be able to present their ID cards to receive medical treatment, she said. People should have equal rights to get healthcare no matter what system they are in - be it government retirement, social security or universal healthcare schemes - and hospitals should treat people according to their diseases not according to the systems, she said.

The president of the Medical Council of Thailand, Dr Somsak Lolekha, said he agreed with the NHSO resolution to co-pay for healthcare expenses because it would make the national health security system sustainable.

Somsak urged Thailand to adopt western concepts, such as that used by France where people - except the poor - co-pay at a clearly set level for certain treatment, which helped to prevent nation-wide bankruptcy of public hospitals.

However, he disagreed with free treatment as it could lead to some people taking healthcare for granted and lead to demand for unnecessary treatment, which could result in doctors being sued if they refused to give it.