Health insurance fund in balancing act: Deputy PM
HAØ NOÄI Deputy Prime Minister Vuõ Ñöùc Ñam 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 Haø Noäi between leaders of the Ministry of Health (MoH), Vieät Nam Social Security (VSS) and the Vietnam Private Hospital Association (VPHA) on problems related to private medical facilities.
Deputy PM Ñam 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 peoples 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 VNÑ 6.6 trillion (US$286 million) for 17 million medical examinations and treatments in private sector. Last year, as much as VNÑ8.6 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, Nguyeãn Vaên Ñeä, 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 dont get the same support as public ones in terms of health insurance payment was also a matter of concern.
Ñeä 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.
Ñeä 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.
Phaïm Löông Sôn, 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.
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, Sônsaid 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.
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 cut costs
Also on Thursday, the VSS and the 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 years first quarter, Löu Thò Thanh Huyeàn, deputy director of VSS, said the fund this year would total around VNÑ9.5 trillion ($416.7 million).
Last year, the fund totalled VNÑ14.3 trillion ($627 million), but the covered amount was VNÑ16.4 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 Huyeàn.
Ñinh Thò Lieãu, head of the citys Department of Healths 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 Ñinh Thanh Höng, director of Taân Phuù District Hospital, 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 VNÑ120,000, he said. VNS