Spokesman Isara Suntornwat said nine BMA hospitals - including Vajira, Taksin and Nong Chok hospitals - had been affected most by the fee cancellation.

These hospitals had a total of 812,290 patients registered under the scheme, and they made 686,591 visits in the past year, Isara said. Of those visits, many were free because of exemptions - such as for infants and the elderly - and 373,044 involved the Bt30 fee. Forfeiting the Bt30would therefore cause the BMA to lose about Bt11.2 million per year.

Isara said the fee cancellation would not affect the services provided at the hospitals, but expected the number of users would rise.

"We cannot state exactly the cancellation's impact now, but the BMA Medical Services Department will spend a month looking into problems occurring at these hospitals. Then they will discuss these issues with the National Health Security Office (NHSO) to find solutions," Isara said.

Bangkok deputy clerk Manoch Leetochawalit, who oversees the BMA's public-health services, said that the universal healthcare scheme's main problem was insufficient funding. The BMA hospitals that joined the scheme lost up to Bt278 million last year, which the government had not yet reimbursed, he said.

Manoch urged the government to raise the budget per patient and separate it from the cost of medical-staff payments, which amounted to about 60 per cent of the budget. After removing the cost of medical-staff payment, the budget per patient worked out to just Bt500-Bt700 per year, whereas the cost per treatment was about Bt500, he said.