Patients with health insurance have access to the best services.

PV: Health insurance is a social security policy, aiming to mobilize community contributions, share disease risks and reduce the financial burden of each person when they are sick. Can you tell us more specifically about the benefits of people participating in health insurance?

Dr. Nguyen Huu Le:As we know, when patients access and use medical examination and treatment services at medical facilities, they have to pay related costs such as examination, technical treatment services, medicine, medical supplies, hospital beds, etc. These patients can be divided into 2 groups: patients with health insurance cards and patients without health insurance cards.

For patients with health insurance cards, they will be examined and treated by health insurance at any medical facility that has signed a contract for health insurance examination and treatment nationwide; the health insurance fund and the social insurance agency will pay most of the basic costs of examination and treatment (from 40% to 100%) and will be transferred to a higher-level hospital when the illness is serious.

Medical services and costs covered by the Health Insurance Fund include medical examination, treatment, rehabilitation; periodic pregnancy check-ups; childbirth; medicines, chemicals, medical supplies, equipment, medical technical services in the List of the Ministry of Health... There are many types of medicines and medical services covered by the Health Insurance Fund (stipulated in Circular 30/2018/TT-BYT dated October 30, 2008).

As for patients without health insurance cards, they have to pay for their medical examination and treatment costs out of their own pocket. It should also be added that among patients without health insurance cards, there are those who have participated in life insurance. However, the nature, level of payment, and payment of life insurance are completely different from health insurance. Life insurance has mechanisms and terms that are binding, narrow, and quite strict for specific cases, not all cases of medical examination and treatment.

In Nghe An, in 2023 alone, the Health Insurance Fund and Nghe An Social Insurance paid for health insurance examination and treatment costs for more than 5.6 million outpatient and inpatient health insurance examinations and treatments with a total health insurance examination and treatment cost of VND 4,640 billion. Of which, there were patients whose treatment costs were up to VND 1 billion... In Vietnam, every year, thousands of patients have their medical examination and treatment costs paid by the Health Insurance Fund for over VND 1 billion; in particular, there were patients whose medical examination and treatment costs were up to nearly VND 13 billion.

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The implementation of the health insurance policy in recent times has shown that: Thanks to participating in health insurance, many patients in difficult circumstances have had their medical examination and treatment costs covered by the Health Insurance Fund. Many families have not fallen back into poverty because they do not have to pay the "huge" costs of medical examination and treatment for their relatives...

Dr. Nguyen Huu Le - Deputy Director of Nghe An Department of Health

PV: People participating in health insurance is also aCreate financial resources to support medical activities. Nghe An Health Sector has been and isWhat solutions should be implemented to improve the quality of medical examination and treatment, ensuring the rights of health insurance participants?

Dr. Nguyen Huu Le:Over the years, Nghe An Health Sector has made continuous efforts to improve the quality of medical examination and treatment, increasingly meeting the needs of health protection and care of the people. This ensures the rights of both patients with health insurance cards and patients who do not participate in health insurance. It should be added that there is no distinction between these two groups.

Specifically, the health sector has been focusing on developing a health insurance examination and treatment network, with a full range of general and specialized hospitals. Thereby, whenever people suffer from a disease, they can find a hospital capable of treating the disease. In Nghe An today, the health network has developed evenly with a full range of specialized hospitals and even individual specialized hospitals that other provinces and cities do not have, such as: eye hospitals, maxillofacial hospitals, ear, nose and throat hospitals, dermatology hospitals, orthopedic trauma hospitals, pulmonary hospitals, rehabilitation hospitals, etc.

At present, the provincial level has 13 hospitals, including 4 grade 1 hospitals; 8 grade 2 hospitals and 1 grade 3 hospital. At the district level, there are 7 grade 2 district general hospitals and 21 district health centers (12 health centers perform 2 functions of medical examination, treatment and prevention). At the commune level, Nghe An currently has 460 commune, ward and town health stations. In addition, the province has 3 hospitals under ministries and branches; Vinh Medical University Hospital under Vinh Medical University and 15 private hospitals... It must be said that the medical examination and treatment network in Nghe An is very complete, meeting the medical examination and treatment needs of the people.

Along with that, the health sector also focuses on improving the capacity of medical examination and treatment for medical facilities. In particular, the sector develops human resources to serve long-term interests. If in the past, the sector focused largely on training doctors, now, training activities are expanded to all subjects such as nurses, technicians, and biomedical workers to create a strong and synchronous health human resource system to provide comprehensive care for patients.

An important solution that the medical sector has been implementing is to focus on developing high technology and specialized technology to meet people's needs; along with that is investing in equipment and infrastructure. The goal is to improve medical capacity at all levels and levels. District level technology is closer to provincial level, and provincial level technology is closer to central level. To give patients more opportunities to enjoy provincial level medical examination and treatment techniques right at the district level and patients coming to provincial level facilities can enjoy central level technical services.

Some specialized and typical new techniques have been deployed by hospitals such as: vascular intervention, open heart surgery, assisted reproduction, kidney transplantation, jaw bone transplantation, ECMO technique to save the lives of critically ill patients, organ vascular intervention, endoscopic nasal anastomosis, etc. Most recently, there was the successful implementation of a kidney transplant from a brain-dead donor.

At this time, the health sector has been and will try and make efforts to overcome all limitations, difficulties and shortcomings; focus on asking for opinions from departments, branches, and instructions from the Provincial Party Committee and Provincial People's Committee to have guidance and direction for health units to overcome difficulties to invest in purchasing medicines, supplies, etc. to help health insurance patients access medical examination and treatment services in the most complete way.

PV: In recent times, the health and social insurance sectors have actively implemented digital transformation to create convenience for patients. The latest is the implementation of usingThe chip-embedded citizen identification card replaces the paper health insurance card when going to see a doctor or get medical treatment. Can you tell us more about this utility?

Dr. Nguyen Huu Le:The chip-embedded citizen identification card integrates a lot of information related to the people, including the health insurance card information. This brings convenience when people come to see a doctor or receive health insurance treatment at all medical examination and treatment facilities without having to bring a paper health insurance card; especially for those who need regular medical examination and treatment, those who live far from the place of health insurance registration, those who frequently travel between localities... By the end of 2023, 100% of public and non-public medical facilities in Nghe An will receive patients with citizen identification cards instead of health insurance cards.

After a period of implementation, the use of chip-embedded citizen identification cards in health insurance examination and treatment has minimized the time and types of people when registering for health insurance examination and treatment. Instead of having to wait for their turn to be called by medical staff to present their health insurance card and photo identification as before to register for health insurance examination and treatment, people can now proactively use their citizen identification cards to register for health insurance examination and treatment right at the automatic reception machine without having to go through medical staff. The average time saved for procedures is from 10 minutes to several hours, now only about 6-15 seconds of authentication at the machine per patient.

For social insurance agencies, this utility has overcome the situation of borrowing health insurance cards; saving on printing costs of health insurance cards. At the same time, it creates conditions to strengthen inspection and examination work in the electronic environment; limit fraud and profiteering in health insurance examination and treatment...

PV: It is known that at this time, Nghe An Health sector is focusing on implementing Resolution No. 39-NQ/TW with the goal of developing Vinh city into the core of the specialized medical center of the North Central region. What benefits will this bring to patients?

Dr. Nguyen Huu Le:Resolution No. 39-NQ/TW dated July 18, 2023 of the Politburo on the construction and development of Nghe An province to 2030, with a vision to 2045, clearly stated the development goal of Nghe An health care, which is: "Developing the health care system in Vinh city to become the core of the North Central region's specialized health care center, including developing a number of hospitals into special-class, end-line hospitals". To achieve this goal, Nghe An's health sector has been closely following the Action Program No. 68-Ctr/TU of the Provincial Party Committee and Plan No. 1022/KH-UBND of the Provincial People's Committee for implementation.

Going into detail, Nghe An Health Department has been and is continuing to promote the development of the medical examination and treatment network by building 2 new specialized hospitals, namely the cardiovascular hospital and the tropical hospital; directing the Provincial General Hospital to develop a project to become a special-class hospital; directing the construction of a number of hospitals such as the Oncology Hospital, the Obstetrics and Pediatrics Hospital, the Traditional Medicine Hospital to become the final hospital in the North Central region... Nghe An Health Department is also proposing to the Ministry of Health to allow the development of a project to develop a number of specialized hospitals in the province to become the core hospitals of the region.

In order to have a suitable direction and roadmap, Nghe An Health Department has submitted a proposal to the Provincial People's Committee for organizing a conference on orientation for specialized medical development in Vinh city. The conference will be held in October 2024, with the participation of many scientists and health managers.

At this conference, the health sector will comprehensively assess the current situation and results of developing high-tech and specialized techniques in Vinh city, Nghe An in recent times, in the context of the North Central region; exchange and share experiences and clearly identify the orientation of specialized medical fields and techniques that need to be focused on investment and development in Vinh city from now until 2030, with a vision to 2045.

The conference results are the scientific basis for the Health sector to advise the Provincial People's Committee to develop the Draft "Project to develop Vinh city into a core specialized medical center in the North Central region by 2030 with a vision to 2045" and submit it to the Government for approval in 2025. On that basis, the Health sector will assign tasks to units and hospitals in a specialized direction.

Obviously, with the implementation of Resolution No. 39-NQ/TW, Nghe An health care in general and Vinh city health care in particular will be improved in all aspects, from specialized health care to grassroots health care. Patients in Nghe An and the North Central region will have the opportunity to access many specialized techniques and many types of quality health care in the near future.

PVThank you!