HCM CITY — The health sector, medical institutions and governments across the country need to closely co-operate with the social insurance agency, which faces a huge deficit, to prevent abuse of the system, the agency’s officials have said.   

Nguyễn Thị Minh, general director of the Việt Nam Social Security, said increased medical claims and the rapid improvement in healthcare have already led to deficits.

The number of insured people getting health checks and treatment have significantly increased over the past few years to an average of 150 million people a year now, she told a conference on resolving obstacles to health insurance held in HCM City on Monday. 

This year the health insurance fund’s premium and other incomes would add up to an estimated VNĐ80 trillion (US$3.50 billion) but the claims would be worth VNĐ85 trillion ($3.74 billion).

She blamed the deficit on the increasing number of in-patients, rising healthcare costs but also abuse of the health insurance.

Some healthcare facilities require patients to undergo unnecessary medical tests and use unnecessary drugs, she said.

The health insurance fund would be used up if drastic measures are not taken to prevent this, she added.

Đặng Hồng Nam, deputy head of the Ministry of Health’s health insurance department, said there is a severe shortage of competent health insurance assessors.

A total of 2,300 have to do the assessment for around 3,000 district-level health facilities and 11,000 health stations, he said.

Every assessor has to handle 5,000 medical records a month, he said.

Minister of Health Nguyễn Thị Kim Tiến said that many medical facilities doctors still prescribe unnecessary tests and expensive drugs and recommend unnecessary hospitalisation to make money. 

The assessment of medical records for health insurance payments should be done jointly by health, social insurance and financial agencies, she added. — VNS