Thailand's National Health Security Office (NHSO) Secretary-General warns against co-payment models for gold card (universal healthcare) services, citing concerns for financially vulnerable populations. The NHSO allocates budgets based on service demand rather than hospitals' deficit claims, but officials caution that increased out-of-pocket costs could revert citizens to pre-gold-card uncertainty about medical expenses. This directly impacts healthcare affordability policy for SMEs and small businesses funding employee benefits.