Wednesday, October 23 2019


Health insurance is not biased

Update: February, 26/2014 - 09:40

A recent rumour that the rich receive more health insurance benefits than the poor is factually incorrect, Tong Thi Song Huong, director of the Health Insurance Department at the Ministry of Health, told the Sai Gon Economic Times.

What do you think of the rumour that the rich get more benefits from the Health Insurance than the poor?

An important principle of health insurance is that premiums are a percentage of wages, while benefits are based on the seriousness of the case and whether the recipient is a special beneficiary, such as a war veteran.

The health sector conducts examinations and treatment according to doctors' regimens, that's why rumour saying that the rich enjoy better treatment than the poor is groundless.

However, in mountainous provinces, due to various reasons, including poor transport, health providers' lack of professional skills and poor medical facilities, many patients have to ignore health services.

As a result, the money they have paid into the health insurance fund is carried over to the next year in these provinces. The amount is always higher than in the cities.

We are opposed to transferring the money to other localities. Only patients with minor illnesses are treated at grass-roots level while serious cases are transferred to higher levels - provincial hospitals or central hospitals.

An important point is that health-insurance policy is not concerned about how little or much money is spent on a patient. The wise and effective use of the money (such as on medicines) for the patients is more important.

At the end of 2012, the remaining insurance funds in poor provinces nationwide was VND12.8 trillion (US$609 million). Some people have suggested that the Government should allow those provinces to use the funds to invest in medical equipment procurement and training health-care workers. What's your opinion?

Under the 2008 Law on Health Insurance, if a locality does not spend all the money in their fund, it is allowed to use a part of it to invest in improving health services in their locality. But in reality, little use has been made of such provisions.

In the draft amendments to the 2008 Health Insurance Law, there are two suggestions. The first idea is to let local authorities make their own decisions on how to use the money for their own needs, including health facilities rehabilitation and training health workers.

The second idea is that the health insurance fund is only an annual fund and any left over should be centralised and be used as a reserve fund to be shared by all localities nation-wide.

At the year-end meeting of the National Assembly in 2013, deputies were also divided during a debate concerning this issue to make amendments to the 2008 Health Insurance Law. And in the near future, the Ministry of Health will organise a consultation conference on the draft amendments, particularly the two suggestions.

What are your comments on the proposal to put a ceiling on health-insurance payments?

We should not impose a ceiling on health-insurance payments, particularly for seriously ill patients at the grass roots level. In such cases, the central health insurance should share the financial difficulties with the local health insurance funds.

On the other side, a ceiling would limit cases of patient referral from a lower level to a higher level health facility as well as the abuse of health insurance funds from the higher levels.

At present, the limit is not applied at the district level - only at the provincial level. In other words, no ceiling is imposed on the treatment cost for inpatients at district hospitals.

Why are doctors at city hospitals allowed to prescribe foreign manufactured medicines for their patients?

The Ministry of Health has encouraged all hospitals to use Vietnamese medical products instead of foreign medical products performing the same functions. However, during their rounds at higher level hospitals, doctors often have to treat patients resistant to some drugs. That's the key reason the doctors have to select foreign products.

In addition, at specialised hospitals, for example, the heart hospital in Viet Nam, we have not been able to manufacture drugs for heart diseases. So we have to import them.

What are some of the main amendments to the 2008 Health Insurance Law?

The proposed revised 2008 Law contains quite a lot of changes. Firstly, it is compulsory for everyone to participate in health insurance. Secondly, some participants pay for themselves, but in such cases, they have to participate in a family group. However, they enjoy a special treatment.

For example, the first family member pays a premium of 6 per cent of their basic salary; but the second, third and fourth will pay much less than this, declining from 70 per cent of the first member's paid premium for the second family member to 50 per cent for the fourth, and for the fifth member, the premium is equal to only be 40 per cent of the first member's.

In the draft revised law, the Provincial People's Committee and the Communal People's Committee will make a list of people in their localities participating in the health-insurance scheme and issue them the health-insurance cards.

And special treatment will be given to people having rendered services to the nation, to the poor, ethnic minorities and children under the age of six years. — VNS

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