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Health insurance fund should be well-managed: Deputy PM

Update: April, 14/2018 - 09:00
Deputy Prime Minister Vũ Đức Đam at a dialogue held on Thursday in Hà Nội between leaders of the Ministry of Health (MoH), Việt Nam Social Security (VSS). — Photo VGP

HÀ NỘI — Deputy Prime Minister Vũ Đức Đam called for boosting cooperation in social insurance fund management to ensure both benefits and savings are maximised.

“Balancing the health insurance fund is very important in the context of increasing medical costs and lowering health insurance premiums,” he said.

He spoke at a dialogue held on Thursday in Hà Nội between leaders of the Ministry of Health (MoH), Việt Nam Social Security (VSS) and the Vietnam Private Hospital Association (VPHA) on problems related to private medical facilities.

Deputy PM Đam stressed that the policy of the Party and the State was to encourage the private health sector to develop and implement policies on protecting and improving the people’s health in accordance with the law and to ensure that policy makers take into account real-life conditions.

Currently, the number of private hospital beds accounts for about 5 per cent of the total number of hospital beds nationwide. There are more than 30,000 private clinics.

The VSS has signed medical examination and treatment contracts with more than 600 private medical facilities. In 2016, the health insurance program paid VNĐ 6.6 trillion (US$286 million) for 17 million medical examinations and treatments in private sector.

Last year, as much as VNĐ8.6 billion (approximately 10 per cent of total national health insurance spending) was paid for 24.8 million medical treatments in the sector.

At the dialogue, Nguyễn Văn Đệ, chairman of the VPHA, raised 10 proposals that should be discussed. These included questions about the health insurance contract and the untimely payment for medical examinations and treatment, causing difficulties for private medical facilities. The fact that patients in private hospitals don’t get the same support as public ones in terms of health insurance payment was also a matter of concern.

Đệ suggested a number of mechanisms and regulations should be adjusted to support private health facilities, ensuring equity between private and public health care and better serving patients. He cited the signing of health insurance contracts as a typical example of discrepancies between public and private care.

Đệ said a number of private health facilities were “inferior” in signing health insurance payment contracts with the social insurance agency or had their contracts suspended suddenly after violations were detected.

Phạm Lương Sơn, deputy general of VSS, acknowledged that shortcomings in the signing and implementation of health insurance contracts had occurred in a number of localities.

 

He said the VSS would soon issue guidance documents and request health insurance offices at provinces and cities strictly follow articles in the signed contracts.

Sơn stressed that VSS always encouraged private hospitals to participate in medical examination and treatment so that people would have more choices and public hospitals wouldn’t develop a monopoly in the health sector.

In response to opinions from representatives of private hospitals and clinics who expressed their anxiety over the delay in payment of health insurance for examinations and treatments, Phúc said it took a long time to reach an agreement between health insurance claims assessors and private health facilities.

He said due punishment had been imposed on health insurance offices at localities which experienced delays in making payments.

Đệ also admitted that a number of private hospitals had submitted reports to the health insurance agency too late, leading to low payment, adding that the association has requested its members abide by approved regulations.

At the end of the dialogue, the Deputy PM said that in the future, the MoH, the VSS and the private medical facilities should increase dialogue and information in order to immediately handle problems which arise.

Hospitals urged to improve management of health insurance costs

Also on Thursday, the Việt Nam Social Security and Department of Health in HCM City instructed hospitals and other health facilities to improve management of health insurance funds used to cover insured patients.

Speaking at a meeting to review the year’s first quarter, Lưu Thị Thanh Huyền, deputy director of VSS, said the fund this year would total around VNĐ9.5 trillion (US$416.7 million). 

Last year, the fund totalled VNĐ14.3 trillion ($627 million), but the covered amount was VNĐ16.4 trillion. As many as 273 hospitals and other health facilities, including 70 public and 73 private hospitals, exceeded insured costs last year.

The fund went over the allocated budget last year because too many patients were allowed to stay over at hospitals, especially for diseases related to eyes and for traditional treatment, she said.

Medicine prescribed at high prices was also a problem, while the monitoring was weak of patients who seek care at multiple facilities in a single day, according to Huyền.

Đinh Thị Liễu, head of the city’s Department of Health’s finance and planning division, said expenditures should be better managed as some hospitals would achieve financial autonomy this year.

“If the situation does not improve, unlike in previous years, it will take time to be reimbursed to cover the excess costs because authorities will want to ask questions about why the costs were too high,” she added.

Dr Đinh Thanh Hưng, director of Tân Phú District Hospital, said that medical staff at the hospital were worried about what they see as unavoidable costs. “As many as 200,000 outpatients, including those who are insured, who come from other areas in the city and provinces visit the hospital every day,” Hưng said.

He said the insurance fund payments for insured patients were too low. "The cost for surgery to remove a tumour in the chest, for instance, is VNĐ120,000," he said.  — VNS

 

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