Thailand’s EMS budget just 16 baht per person, below WHO standard

Public Health Minister Somsak Thepsutin made the remark after chairing the 8th Emergency Medical Committee meeting of 2025 on Wednesday.

He explained that the committee had discussed key issues, including setting service fees and operational charges for the National Institute for Emergency Medicine (NIEMS), aimed at upgrading the EMS system to ensure wider coverage, reduce inequality, and enhance support for tourism, investment and the economy.

Thailand welcomes an average of 35 million foreign tourists annually, with around 28,463 injured and 616 killed each year. Of these fatalities, 80.73% involved motorcycle accidents. Provinces with the highest tourist deaths include Phuket, Bangkok and Chiang Mai. 

Meanwhile, the mortality rate of critically ill patients outside hospitals stands at 38.23 per 100,000 people, with more than 73% dying before emergency units arrive.

Currently, only 20.39% of critical (red-coded) emergency patients can access services. Nationwide EMS coverage reaches just 64.79%, with shortages across 2,618 sub-districts. 

The Thai Sky Doctor service, which is essential for assisting more than 500 patients a year, can only provide around 220 operations annually due to airport readiness limitations.

To address these gaps, NIEMS proposed two measures:

• Setting emergency medical service fees and NIEMS operational charges.
• Allocating revenue to projects that reduce inequality in access to quality emergency services, helping to cut pre-hospital deaths and disabilities while strengthening Thailand’s economic competitiveness under the concept “EMS for wealth and well-being.”

“The committee agreed in principle to establish the fee structure and instructed NIEMS to prepare detailed rates and collection methods for consideration by the board. A working group has also been set up to study the matter,” Somsak said.

He added that the government has declared this year as the Amazing Thailand Grand Tourism and Sports Year, determined to welcome tourists and investors worldwide with full preparedness, prioritising safety.  

However, the EMS system still faces urgent limitations, particularly in funding, which prevents many communities — especially remote tourist destinations — from accessing standard emergency care.

Funding will not rely solely on the national budget but also on alternative sources such as tourist insurance, life and accident insurance, disaster insurance and public funds. Revenue generated will be invested in four areas:

• Setting rates for emergency land, water and air services.
• Expanding EMS units to cover all sub-districts nationwide.
• Modernising systems with real-time data integration.
• Enhancing training standards and supporting resources for operational units.

“The target within three years is for at least 70% of citizens and tourists to access emergency services, with units available in every area. Thailand must have an EMS system that is safe, modern and reliable,” Somsak said.

“This is not just about saving lives, but also about building confidence for everyone in Thailand, strengthening tourism competitiveness and ensuring stable, sustainable economic growth.”

NIEMS secretary-general Pichet Nongchang said the institute had begun designing a framework to determine EMS service fees. The study is expected to take two to three months, after which the cost structure will be set and negotiations with relevant agencies will begin, a process likely to take a further five to six months. 

However, he noted that discussions with insurance companies could take longer, as legal and national policy issues would also come into play.

• Data on the country’s EMS system shows that the mortality rate for critically ill patients outside hospitals is as high as 38.23 per 100,000 people, with over 73% dying before emergency units arrive. Of those who died, 42% were of working age. Access to EMS for critical, red-coded patients is limited to just 20.39%.
• Emergency response coverage currently extends to 64.79% of the country, leaving 2,618 subdistricts without services. Personnel shortages are also severe: there are only 1,554 emergency medical practitioners nationwide, while the country produces just 210 graduates annually, leaving a shortfall of 22,305 personnel.
• Airborne emergency services are also constrained. Although there is demand for more than 500 cases annually, only 220 missions can be carried out each year due to limitations on aircraft availability.
• Public knowledge of emergency medicine also remains low. Basic first aid, cardiopulmonary resuscitation (CPR), the use of automated external defibrillators (AEDs), and the ability to call the 1669 emergency hotline are poorly understood, leading to delays in timely intervention and preventable deaths or disabilities.

Pichet added that multiple challenges continued to hinder EMS development, largely due to insufficient funding. From 2024 to 2026, the Emergency Medical Fund received only 1.09 billion baht, 1.09 billion baht, and 1.05 billion baht respectively. 

Compensation for emergency operations has been set at below-cost rates for more than 20 years, forcing the fund to request an additional 200–300 million baht in emergency budget each year.

He noted that EMS accounts for less than 0.01% of Thailand’s total health budget, equivalent to just 16 baht per person annually — far below the WHO benchmark of 5–10%. By comparison, countries with strong EMS systems such as Japan, Singapore and South Korea spend between 100 and 1,000 baht per person annually.

“In 2025, Thailand was ranked as having the ninth best healthcare system in the world. However, the EMS system must be strengthened to ensure it does not undermine people’s quality of life or the confidence of investors and tourists,” Pichet said.