How was going to the hospital during the subsidy period?

During the subsidy period, people went to see a doctor or buy medicine and then brought the bill back to the office or hospital to pay without having to pay, but treatment conditions were extremely poor.

For minor illnesses such as flu, cough, headache, etc., people pay for their own medicine outside (called common medicines). Emergency and essential medicines usually require a doctor's prescription. The health system includes health stations, district hospitals and regional clinics, provincial and central hospitals. Commune health stations mainly have a general practitioner, an obstetrician and pediatrician, and a traditional medicine practitioner; going to the district is usually for emergency cases, surgeries, etc.

Mr. Nguyen Hau (Dong Da, Hanoi) recounted that if you are a cadre or employee and go to the hospital, you just need to ask for a referral from the medical agency, go to a hospital or clinic, then buy medicine yourself, bring the bill back to the agency to pay. If you are a civilian, ask for a referral from the commune or ward and follow the above procedure. In case you have to stay in the hospital, you just need to sign some papers so that the hospital can settle the bill with the superiors.

A commune health station in the period 1986-1992. Photo archive.

Hospital during the subsidy period

Although subsidized, in the context of not much State money and undeveloped production, the hospital encountered numerous difficulties. Having worked in the general secretary office since the late Minister Dang Hoi Xuan's time in 1982-1988, and then as secretary for the late Minister Pham Song in the period of 1988-1992, Mr. Hoang Trong Quang still remembers clearly the difficulties of the medical industry at that time.

He recalled that at that time, medicines, medical equipment, etc. were mainly donated. The Ministry of Health had both the Planning Department and the Supplies Department in charge of allocating quotas to hospitals. For example, Bach Mai Hospital was given how many mats, blankets, sugar, milk, gasoline, medicines, etc. each year?

Hospitals in the past were small, mostly one-story buildings, the most "fancy" ones were three stories. Rooms were simple, but sharing beds was rare. Doctors also wore scrubs, headphones, and blood pressure monitors. Surgical lights included bright gas lamps, of course not as bright as electric lights. They also used anesthesia, alcohol sterilization, cauterization, and boiling; scalpels were provided with both minor and major surgery kits.

However, medical equipment is primitive and cumbersome. X-ray machines are old and huge. Simple things like counting red blood cells are done manually by eye, without any machines. Doctors treat patients based mainly on experience.

At that time, doctors, even at Viet Xo Hospital (a hospital specializing in taking care of the health of high-ranking officials), also joked: "A person with 2.5 million red blood cells needs the same emergency care as a person with 3.5 million."

Crude, cumbersome medical equipment. Documentary photo.

Viet Duc is a leading hospital, but in 1986, the entire liver and gallbladder department with hundreds of patients only had two foot-operated suction machines. The electric suction machines were large and often had power outages, so they were not used much. CT scanners and MRI scanners were considered “rare” at that time.

Mr. Quang still remembers the time in 1990, he had the opportunity to go with the late Minister Pham Song to France to learn and learned that a CT scanner cost one million USD (equal to the cost of building six five-story office buildings at that time).

Seeing that their country had an MR scanner, the late Minister Pham Song asked if it was possible to buy and order it for Vietnam, but was advised not to buy it because "the machine was extremely expensive, the whole of France at that time only had 6 machines". The first CT scanner our country had was placed at Hospital 108, equipped for the front line to serve medical examination and treatment.

Tetracycline antibiotics - black teeth generation

Medical equipment was old and medicine was also scarce. For many Vietnamese people, at that time, there was probably no one who did not know about tetracycline antibiotics, they took it for every fever and pain... The result was a whole generation of black teeth.

Tetracycline was precious, while other drugs such as amoxicillin, ampicillin, penicillin or lancosin (to treat gonorrhea and syphilis) were even rarer, being very high-end. Only well-off families with some connections could stockpile these drugs. At that time, even though he was working at the Ministry of Health, Mr. Quang himself did not dare to dream of it.

The medicine cabinet of any house considered “fancy” has a few antibiotics, painkillers, cold and flu medicine, stomachache medicine; otherwise, when having a headache, many people just need to boil a pot of water to steam, for stomachache, mugwort, for fever, gotu kola leaves. “Looking back now, one can say that tetracycline is a rubbish medicine, but back then it was very good.

"Antibiotics in the past were truly meant to be saved and stored. Any medicine was valuable, except for moldy or damp ones. As long as they were intact, they could still be used, without paying much attention to the expiration date," Mr. Quang said.

Western medicine was rare and scarce, so traditional medicine was very developed at that time. In the commune, medical staff planted, produced and used a lot of traditional medicine. The production technology was very simple: take the basil and mint plants, grind them, roll them into pills for people to drink. The district could also prepare intravenous solutions for transfusion: salt water, sugar, water mixed with injections...

The doctor also raises pigs and shells peanuts to make a living.

Like many people at that time, medical staff worked for the State and also had to struggle to take care of their own lives: raising pigs, raising chickens, doing extra labor. After graduating from Pharmacy school, Mr. Quang was selected to work in the Ministry. In the morning, he arrived on time for work, at noon he opened his lunch box to heat it up, after eating he took a break, in the afternoon he wrote on the board to go to the base but in reality he was queuing to buy rice, oil, food stamps, picking up his children...

He also had to take on extra jobs like peeling peanuts, pasting candy paper, pasting tiger balm, and golden star balm. Sometimes he still had to go to work on Saturdays, but he asked for leave to dry, wash, and filter medicinal herbs to earn some extra money. On his days off, he asked for leave or skipped work to do extra work.

“In general, life was very simple back then. The cadres of the past were very good. Maybe at that time everyone had difficulties and were equally poor; the difference was sometimes just a radio, a motorbike or a bicycle, nothing more. Life is different now, the difference between rich and poor is like heaven and earth,” said Mr. Quang.

Along with the general transformation of the country, the health sector has also undergone breakthrough changes since 1986. At a health conference in Ho Chi Minh City in November 1988, the late Minister Pham Song proposed two major policies: allowing private medical examination and treatment and opening private pharmacies. This has greatly relieved the people, opening a way out for the health sector.

On June 21, 1989, the late Minister himself wrote an article about health insurance: collecting a portion of hospital fees to move towards universal health insurance. It really created an important change despite causing turmoil in society at that time. Hai Phong was the first locality to volunteer for the pilot. Thanks to that, hospitals gradually had funding.

Up to now, health insurance is still considered the "backbone" of the health system with the goal of universal health insurance. Up to now, it is the main resource to serve the increasingly stable and developing medical examination and treatment work.

According to VNE