Health in­surance fund in bal­anc­ing act: Deputy PM

Viet Nam News - - NATIONAL -

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 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 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 don’t 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 year’s 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 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 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

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