Nghe An Social Insurance: Striving for the rights and health of the people

Health Insurance Helps Fight COVID-19

Since April 27, Nghe An has treated nearly 6,000 Covid-19 patients at medical facilities. Of these, about 10% of patients have severe symptoms and must be transferred to the Center for Tropical Diseases, Nghe An General Hospital for intensive treatment.

All Covid-19 patients have their treatment costs covered by the State budget. Covid-19 patients with health insurance cards will have their treatment costs covered by the Health Insurance Fund for their chronic underlying diseases. According to Dr. Que Anh Tram, Director of the Center for Tropical Diseases: The State budget and the Health Insurance Fund have to spend a huge amount of money to treat Covid-19 patients.

Many severe Covid-19 patients with chronic underlying diseases have been cured in Nghe An. Photo: PV

In 600Covid-19 patientFor severe cases hospitalized at the Center, the lowest treatment cost for each patient is several tens of millions, the highest is over 1 billion VND. The amount of money the Health Insurance Fund pays for each patient is also corresponding, the highest is over 300 million VND...

Dr. Que Anh Tram said: The Health Insurance Fund is truly an important resource to fight the Covid-19 epidemic, especially in medical examination and treatment. When health insurance participants go to the hospital for medical examination and treatment, when they have to use medical technical services related to Covid-19 prevention, if those services are not covered by the guaranteed budget, the Health Insurance Fund will pay according to regulations.

Specifically: In the past, when people with health insurance cards went to the hospital, many cases of Covid-19 screening and diagnosis were covered by the Health Insurance Fund according to the scope of benefits, both rapid and PCR tests. In addition, among those with Covid-19, many people had underlying chronic diseases such as high blood pressure, diabetes, hemodialysis, kidney failure, etc. If they participated in health insurance, the Health Insurance Fund would cover the cost of using drugs and high-tech services with high costs. Thus, the treatment of patients' underlying diseases along with Covid-19 treatment from the resources of the Health Insurance Fund and the state budget, contributes to ensuring professional requirements in medical examination and treatment.

Many severe Covid-19 patients have been cured. Photo: Thanh Chung

In the context of the recent Covid-19 pandemic, a number of guidelines on health insurance examination and treatment have been revised and supplemented to ensure the rights of health insurance participants. According to Dr. Le Van Kham - Director of the Health Insurance Department, Ministry of Health: Firstly, the regulation extends the time for outpatient prescriptions for chronic diseases, increasing from 30 days to 90 days for one prescription. Secondly, in the conditions of social distancing or the medical examination and treatment facility where the patient initially registered for medical examination and treatment is locked down, the patient will be able to go to another medical facility for medical examination and treatment and still be paid by the Health Insurance Fund as if they were in the right place.

Or there are cases where the patient cannot go to the central level but the disease condition has been determined, monitored and the central level hospital has grasped it. In case the provincial hospital does not have the appropriate medicine for the indication, the central level hospital can transfer it to the patient... It can be said that the responses and adjustments of the authorities in the epidemic conditions have been very suitable to reality, timely, contributing to both epidemic prevention and ensuring the rights of health insurance participants.

With the dedicated and devoted treatment of the hospital, up to now, many Covid-19 patients have been cured and returned home. Photo: Thanh Chung

In Nghe An, not only Covid-19 patients, but all patients enjoy the benefits of the health insurance policy, especially poor patients and patients with serious illnesses. Information from the Social Insurance Agency of Nghe An province: From January 1, 2021 to November 30, 2021, the health insurance has paid health insurance medical examination and treatment costs of VND 10 million or more for 33,483 patients examined and treated within the province (the highest payment was over VND 279 million) and 8,151 patients examined and treated outside the province (the highest payment was over VND 883 million). Many people with incurable diseases and serious injuries have been saved thanks to the Health Insurance Fund.

EFFORTS FOR PEOPLE'S RIGHTS

In 2021, digital development workPeople participating in health insurance and social insuranceIn general, especially the development of the number of people participating in health insurance in the province has encountered many difficulties. In addition to the negative impact of the Covid-19 epidemic, the main cause is the impact of Decision No. 131/QD-TTg dated January 25, 2017 and Decision No. 861/QD-TTg dated June 4, 2021 of the Prime Minister. Accordingly, from 2021, in Nghe An province, there are over 61,000 people living in coastal communes and over 187,000 people in ethnic minority and mountainous areas who will no longer be granted health insurance cards by the State Budget from July 1, 2021.

Thanks to the Health Insurance Fund, many patients have received kidney transplants and have a new life. Photo: Thanh Chung

Identifying these difficulties, to ensure people's rights and increase health insurance coverage, Nghe An Provincial Social Insurance has actively and proactively advised and implemented solutions to ensure medical examination and treatment rights for people in coastal areas and areas with difficult socio-economic conditions.

Specifically, the provincial Social Insurance advised the People's Committee of Nghe An province to issue Document No. 9250/UBND-VX dated December 29, 2020 on the extension of health insurance cards in 2021. Accordingly, for coastal communes not on the list of continued extensions, the Provincial People's Committee requested local authorities to coordinate with the Social Insurance agency to mobilize people to participate in health insurance.

Advise the Provincial People's Committee to issue a document directing the sectors and People's Committees of districts and towns No. 4129/UBND-VX dated June 22, 2021 on advising on the implementation of health insurance policies for people living in areas with particularly difficult socio-economic conditions according to Decision No. 861/QD-TTg dated June 4, 2021 of the Prime Minister; The Social Insurance sector, the Department of Labor - Invalids and Social Affairs, and the Ethnic Minorities Committee have provided inter-sectoral guidance on the implementation of health insurance policies.

Medical staff monitor Covid-19 patients at the Tropical Disease Center. Photo: Thanh Cuong

The provincial Social Insurance has issued Document No. 72/BHXH-TT&PTDT dated January 12, 2021 and Document No. 1237/BHXH-TT&PTDT dated June 25, 2021 to direct Social Insurance agencies of districts and towns to focus on propagating and mobilizing people in coastal areas and people living in areas with especially difficult socio-economic conditions according to Decision No. 861/QD-TTg to participate in health insurance.

In addition, in 2021, Nghe An Provincial Social Insurance has also made efforts to synchronously implement solutions to increase the number of people participating in health insurance: advising the Provincial People's Committee to issue Plan No. 311/UBND-KH dated June 4 to implement the target of social insurance and health insurance coverage for the period 2021-2025; Official Dispatch No. 6328/UBND-VX dated August 30 directing Departments, branches, Vietnam Fatherland Front Committee of the province, schools and educational institutions in the province to implement health insurance for students in the 2021-2022 school year to ensure 100% of students participate in health insurance.

Unemployed workers returning home complete documents to receive provincial social insurance payments. Photo: Nguyen Hai's document

Right from the beginning of the year, the provincial Social Insurance has issued a Scenario for developing social insurance and health insurance participants in 2021, in which it assigned targets for developing social insurance, health insurance and unemployment insurance participants in 2021 to each unit; signed the 2021 Coordination Programs with departments, branches, socio-political organizations and unions to strengthen the dissemination of health insurance policies to all classes of people in order to rapidly increase the number of people participating in health insurance.

Review and grasp projects in the area that will come into operation during the year and large companies that will expand their production scale during the year to directly guide and support units to register for social insurance, health insurance, and unemployment insurance for employees in a timely manner; organize reviews, statistics and exploit the number of workers returning from other localities due to the Covid-19 epidemic; review expired health insurance cards of people who have not yet participated in order to transfer them to collection agents to propagate and mobilize them to participate again... coordinate with the People's Committees of wards and communes, Farmers' Associations, Women's Associations, and Post Offices to directly propagate voluntary social insurance and health insurance policies in communes, wards and towns and mobilize people to participate; regularly urge and review students who have not participated in health insurance to promptly mobilize them to participate, ensuring that 100% of students have health insurance cards.

People participating in voluntary social insurance receive and compare information on their social insurance books at the social insurance and health insurance collection agency in Hung Dung ward, Vinh city. Photo: Provincial Social Insurance

Despite great efforts, by the end of November 2021, the number of people participating in health insurance in Nghe An province was 2,797,073, reaching 95.13% of the target assigned by Vietnam Social Security; an increase of 22,058 people compared to the previous month; a decrease of 45,650 people compared to the end of 2020. Notably, there are still about 83,000 people affected by Decision No. 131/QD-TTg and Decision No. 861/QD-TTg who have not been re-issued health insurance cards, mainly people in the household group and students.

This is also a vulnerable group, especially in the face of the complicated developments of the Covid-19 epidemic. If unfortunately encountering risks or illnesses, it will become a burden for society. In the coming time, in addition to the efforts of the social insurance sector, it is necessary to have the cooperation of all levels, sectors, political and social organizations, and unions in mobilizing people to participate in health insurance; especially the sharing of philanthropists who support and give health insurance cards, ensuring the rights of the people.