The country's health insurance system needs improvement, Bui Si Loi, Vice Chairman of the National Assembly's Social Affairs Committee, told Thoi bao Kinh te Viet Nam (Vietnam Economic Times).
It is reported that less than 40 per cent of farmers and fishermen nation-wide are participating in the health insurance scheme. This low percentage speaks of the heavy burden on the nation's health insurance fund. What's your comment?
The Government's contributions account for more than 60 per cent of the health insurance fund. The world economic downturn has heavily impacted our economy, causing many Vietnamese enterprises to declare bankruptcy or temporarily stop production.
As a consequence, many people are unemployed or under employment. Such a situation has negative impacts on their participation in the health insurance scheme, particularly those who participate voluntarily.
According to the latest report, voluntary participants in the health insurance account for about 24 per cent. In some provinces, the figure is about 6-7 per cent.
Although the Government has supported up to 70 per cent of the contributions of poor households in the insurance fund, only 19 per cent of poor households nation-wide have participated.
Under the Health Insurance Law, from January 1, 2010, all students have to participate in the scheme. However, in reality only about 80 per cent of them have participated. For some provinces, the figure is much smaller. For example, in Nam Dinh, some 90km from Ha Noi, the rate is 30.53 per cent, and in the central province of Nghe An it is 75 per cent.
What are the main reasons for such a poor participation?
There are four main reasons. First is the ineffective information, education and communication activities from central government agencies down to grassroots levels.
Second is the poor co-ordination among government agencies and sectors, particularly the ineffectiveness of the decentralisation policy.
Third is the poor law enforcement on the side of employers – the main contributor to the low insurance coverage of their employees. Under the law, all employees are obliged to participate in the health insurance. However, their participation accounts for about 50 per cent nation-wide.
And finally there are the cumbersome administrative procedures that stop people from participating in the scheme, particularly relating to requests for payment advances or settlements for health care facilities and for individuals.
To make the health insurance scheme more attractive to people, what should be changed?
Many things must be done to make it more attractive to the participants, including changes to the judiciary system and the government's policies and mechanisms.
First of all, it is imperative to have an effective insurance oversight mechanism towards individuals who are obliged to participate in the scheme. Parallel with that, for people of poor or near-poor households, the Government should continue to support them until they can stand on their own feet.
In addition, we have to step up our communication campaigns to raise awareness among people of the benefits of joining the health insurance scheme.
And above all, we have to achieve a balance in the fund between input and output – contributions and spending. We hope in the near future we will achieve healthcare fairness for everyone. — VNS