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Increase in healthcheck fees should go hand-in-hand with service quality

Update: August, 25/2012 - 09:47

The Viet Nam Social Insurance Agency's Pham Luong Son spoke to Tuoi Tre (Youth) newspaper about issues relating to new health service prices that took effect earlier this month.

Debates on suitable health service prices intensified when the ministries of Health and Finance raised examination fees from VND3,000 to VND20,000. What are your thoughts on the increase?

Under current calculations, patients and health insurance agencies pay three sevenths of health service prices, while the State Budget covers the rest including depreciation of fixed assets, infrastructure and training costs for medical staff.

Some feel the increase isn't a lot, however, the money isn't used to pay for more doctors, it goes on electricity and water bills and sanitation fees. Therefore, the increase is actually quite high. Obviously, when costs increase patients will demand a better quality health service to match.

To improve the quality of health services, the health ministry rules that every patient reception desk at hospitals nationwide receive a maximum of 35 patients per day. However, the hospitals can't meet this requirement due to staff shortages and insufficient medical equipment. Hospitals at the district level are now overloaded, not to mention hospitals at national and provincial levels.

It's believed that the ruling is being issued too hurriedly because staff and facilities should be taken care of first, followed by price icreases, instead of just issuing new prices when lacking human resources and facilities.

The Viet Nam Social Insurance Agency holds the health insurance fund, which is expected to collect over VND30 trillion (US$1.4 billion) this year. Does the agency want to suppress the new health service prices to maintain its fund?

We actually hope the new prices are in line with the level of infrastructure, equipment and human resources in localities. The new prices shouldn't be applied if localities lack these things.

In my opinion, the social insurance agency doesn't set targets to maintain the fund because, if overspending occurs, both the health and insurance sectors have to take responsibility, especially the health sector.

Our job is to make sure that the new health service prices are in line with the socio-economic development of localities. We don't want to require low prices to maintain the fund.

At present, southern Tra Vinh Province's Health Insurance Agency has agreed to apply the new prices, which are 80 per cent higher than their current prices. However, the provincial People's Committee and Health Department only approved an increase of 53 per cent on top of the current prices because they thought that was more reasonable. Also, the northern Bac Ninh Province applied the new prices at an increase of 84 per cent, approximately the same as in Ha Noi, though the province's economic development is not on par with Ha Noi's.

So what do you deem a reasonable price increase?

I think an increase of 70 per cent should be applied to underprivileged localities. Lowland provinces are recommended to apply a maximum increase of 80 per cent during 2012-13. Others are advised to apply higher increases depending on their socio-economic development.

Where there is a health insurance fund imbalance in a locality, the price increase will be used to improve the quality of its health service. The national reserve health insurance fund will consider addressing the imbalance for localities that overspend.

The number of provinces wanting to apply higher prices for health services has reduced from 16 to six. However, some worry that low prices will lead to low quality health services, what's your opinion?

When the new prices are applied, 15 per cent of the fees from sickbeds and medical examinations will be used to improve facilities. So, the quality of service will also be improved. I think that the Viet Nam Social Insurance Agency makes every effort to find suitable prices for health services and to make suitable adjustments for localities. — VNS

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