Hospital staff members process patients' health insurance paperwork. — VNA/VNS Photo

HÀ NỘI — The Ministry of Health is proposing an expansion of national health insurance to cover screening and early diagnosis for seven types of cancer, hepatitis B and C, high blood pressure and diabetes, in a shift toward prevention that officials say could save the health system billions of đồng a year.

The proposal is part of a draft decree on health insurance benefits currently open for public comment until September 12.

Under the plan, the State health insurance fund would pay screening and early diagnosis costs for cancers of the cervix, breast, lung, prostate, colon/rectum, stomach and liver.

Cervical cancer screening would begin on a trial basis from July 1, 2028, becoming standard coverage two years later.

Coverage for breast, lung, prostate and colorectal cancer screening would follow from 2030, according to a rollout schedule set by the ministry. Patients who test positive would then have their treatment costs covered under existing insurance rules.

Screening for hepatitis B and C, folded into routine health checkups, would be covered starting July 1, 2027, while coverage for hypertension and diabetes screening would begin January 1, 2030.

Officials describe the move as a shift in focus from treating disease to preventing it, arguing that catching illness early is far cheaper than treating it once it has progressed to more severe, complication-laden stages.

The ministry cited Việt Nam Social Security data showing health insurance paid out nearly VNĐ6.2 trillion (US$238 million) in 2023 for six common cancers: breast, lung, liver, colon, stomach and prostate.

According to ministry estimates, nationwide cervical cancer screening would cost about VNĐ3 trillion ($115 million) a year, and breast cancer screening up to VNĐ5.3 trillion ($204 million) a year.

The savings case is strongest for cervical cancer: annual treatment currently costs VNĐ89.8 million ($3,450) for a stage I patient, rising to roughly VNĐ137 million ($5,266) for stages II through IV.

Catching the disease at stage I instead of later stages saves an estimated VNĐ48.6 million ($1,868) per patient a year, the ministry said. Early detection of breast cancer similarly saves VNĐ18.3 million ($703) per patient annually.

Hypertension and diabetes present a bigger, if less visible, problem: both are widespread but often go undiagnosed.

The ministry estimated that about seven million people in Việt Nam have diabetes, with more than half of them unaware of their condition. Roughly three in 10 adults have high blood pressure, many without knowing it, even though hypertension is responsible for up to 85 per cent of cerebral haemorrhage cases.

The Health Strategy and Policy Institute projects that screening for type 2 diabetes would save the insurance fund an average of VNĐ162.3 billion ($6.2 million) a year over the first decade of implementation, while hypertension screening would save about VNĐ1.2 trillion ($46 million) a year.

Officials say early detection lets patients adjust their diet and lifestyle and start proper treatment sooner, heading off costly complications such as heart disease, kidney failure and vision loss that drive expensive hospital stays.

Under the draft decree, the insurance fund would cover screening-related costs, including consultations, tests, imaging and other clinical services, medication, medical equipment, blood products and related supplies, within the limits of each patient's existing insurance benefits. — VNS