Today I went for some treatment at my local government hospital. I was also expecting to pick up my Thai Gold Card. No chance, they've put a block on issuing it to farangs. I can only get free treatment up to the level of care at that particular hospital with the card they initially issued.
I can't complain at that as my card indirectly cost me 4900 Baht and using it today I received about 10,000 Baht of treatment. Hopefully my local will get bigger and the scope of treatment will increase with it.