Universal health insurance: Need a specific roadmap

(Baonghean) - Up to this point, in our province, only more than 70% of the population has health insurance cards. The remaining 30% are freelancers, small traders, workers in the agricultural sector, rural areas - subjects who are not aware of the necessity of health insurance cards... To achieve the goal of universal health insurance for the period 2012-2015 and by 2020 as prescribed by law, a synchronous solution is needed.

It can be said that thanks to the health insurance policy, many people have been saved. Ms. Tran Thi Le Tinh, 39 years old, from Nam Dan Town, currently being treated at the Oncology Hospital, is one of them. Ms. Tinh was diagnosed with lymphoma (also known as lymphoma) in 2004 and had to undergo continuous chemotherapy and radiation therapy in the lymph nodes at the Central Cancer Hospital. From November 2013 to now, she was transferred to Nghe An Oncology Hospital. Recently, on June 6, Ms. Tinh successfully underwent an autologous hematopoietic stem cell transplant at the hospital. Ms. Tinh confided: “Without health insurance, I and my family would not have known where to get the money for treatment. Health insurance helps patients a lot, everyone needs to participate in voluntary health insurance.”

Perhaps more than anyone else, people with chronic and incurable diseases understand the importance of participating in voluntary health insurance. As shared by Dr. Dang Dinh Bang, Deputy Director of Nghe An Oncology Hospital, cancer treatment is very costly and expensive, for example, a bone marrow transplant usually costs up to 300 - 400 million VND and can be more. Without health insurance, patients cannot be treated well with optimal equipment and medicine... Health insurance policies have practically helped patients. But in reality, there are still many people who have not participated, do not fully understand the value of buying health insurance, and do not understand that health insurance is a joint contribution of the whole community for some patients, not for all people with health insurance cards.

According to a survey in Vinh City, up to now, only 210,000/290,000 people have health insurance cards, accounting for 74% of the population. It is worth mentioning that: Among the 26% of the population that have not participated in health insurance, there are many near-poor people. Although these subjects have been supported by the State with up to 70% of the contribution to ensure social security and reduce the burden, the remaining 30% contribution is still difficult for many near-poor people. And on the contrary, for many well-off people, the overload at hospitals at all levels and the many problems in medical examination and treatment procedures have made health insurance less attractive. Mr. Tran Van Huyen, Director of Vinh City Social Insurance, added: One of the barriers to increasing the rate of people participating in health insurance in the area is that the propaganda work on health insurance policies has not been promoted and widely disseminated to the people. And in essence, local authorities and party committees have not really paid attention to this. Therefore, it is necessary to make the health insurance participation rate a competitive criterion.

Brain tumor surgery at the Provincial General Hospital. Photo: Tu Thanh

As of April 2014, the provincial social insurance has signed health insurance examination and treatment contracts with 53 medical examination and treatment facilities and 480 commune, ward and town health stations; issued over 2,110,000 health insurance cards, bringing the total number of people with health insurance cards to over 70% of the population. The majority of people participating in health insurance are currently mainly policy beneficiaries, retired officials, civil servants, children under 6 years old... private enterprises, households, freelance workers, small traders, agricultural cooperative members, farmers participating in voluntary health insurance are not many, while this is a fairly large group. Expanding the number of people participating in health insurance is still facing many difficulties.

Mr. Le Truong Giang, Deputy Director of Nghe An Provincial Social Insurance, said: Towards the goal of universal health insurance, in recent times, the Provincial Social Insurance has focused on implementing the resolutions of the Provincial Party Standing Committee and the Plan of the Provincial People's Committee to promote all aspects of work to increase the rate of people participating in health insurance; advising the provincial National Assembly delegation on valid opinions contributing to the development of the revised Law on Health Insurance, towards requiring all people to buy health insurance; Strengthening the coordination of functional sectors and localities to propagate to all people the benefits of participating in health insurance; On the part of the provincial social insurance agency, creating all conditions for people to participate in health insurance as well as convenient access to health services.

On June 13, the National Assembly officially passed the amended Law on Health Insurance. The principle emphasized in the law is to continue to ensure the social nature of health insurance - that is, a social security policy that the State is responsible for organizing and implementing with the participation of the people, oriented towards universal health insurance. Many contents in the amended law have aimed at facilitating and encouraging people to participate in health insurance. To ensure the goal of compulsory participation for all subjects, the State uses a mechanism of direct budget support for a part of the population to buy health insurance. The policy on medical service prices also aims to promote the participation of all people in insurance. Universal health insurance, along with the State's budget support for purchasing health insurance according to a roadmap for a number of groups of subjects, will further promote the process of expanding the subjects, realizing the goal of universal health insurance and ensuring social security.

The regulation requiring people to participate in health insurance is in line with the policy of universal health care that our Party and State are aiming for. Compulsory participation in universal health insurance means that when people are sick, they have equal access to health services without having to bear financial risks. This regulation emphasizes the legality to attach responsibility to all people participating in health insurance to avoid the situation of "adverse selection" that has been happening for a long time: healthy people with high incomes do not participate, only sick people participate in health insurance, causing the risk of imbalance, affecting the sustainability of health insurance... While waiting for institutions and sanctions to be implemented, strong enough for people to have the responsibility to participate, Nghe An province's levels and sectors will still implement the roadmap towards universal health insurance that has been implemented for a long time, specifically clearly defining the responsibilities of all levels of government, as well as agencies, departments and sectors. In addition, promote propaganda and dissemination in many forms and with rich content so that people clearly understand their responsibilities and rights when participating in health insurance. The law has clear regulations, but for the law to come into life, citizens' awareness is needed.

Thanh Son - Tu Thanh