When the whole family buys health insurance...

(Baonghean) - In the amended Health Insurance Law (officially effective from January 1, 2015), one noteworthy issue is family health insurance. Accordingly, instead of some families choosing to purchase health insurance for those who are frequently ill or have chronic diseases, now all family members must participate. This is one of the major policies aimed at sharing the burden with the health insurance sector.

For many years, Ms. Cao Thi Hong in Hung Hoa commune (Vinh City) only bought health insurance for her husband, Mr. Le Van Manh, who is undergoing dialysis at Vinh Transport Hospital. From January 1, 2015, according to the amended Health Insurance Law, not only Mr. Manh but the entire family must purchase health insurance, meaning the couple and their son have to spend over 1.4 million VND. This is a considerable amount. However, Ms. Hong welcomed this new regulation very positively. “Through my husband's treatment, I've come to fully appreciate the value of the health insurance card. Without health insurance, my family would certainly struggle to continue my husband's dialysis treatment. Therefore, despite our family's difficulties, spending that much money to buy health insurance for the whole family is, in my opinion, a very worthwhile thing to do,” Ms. Hong confided. Mr. Ngo Dinh Hoa from Son Hai commune (Quynh Luu district) said: "Currently, with the high increase in hospital fees, participating in health insurance is considered one of the solutions to help families have more resources for medical examinations and treatment and reduce costs when they have to be hospitalized."

Register for medical examination and treatment with health insurance at Cua Dong General Hospital (Vinh City).

In reality, after more than 3 months of implementing the new Health Insurance Law, quite a few difficulties have emerged. Ms. Nguyen Thi Thuong Huyen, an employee at the Social Insurance collection agency in Tien Thuy commune (Quynh Luu district), said: “From January 1, 2015, according to the new law, people are not allowed to buy health insurance individually but must buy it as a household. This means that all members listed in a household registration book must buy it at the same time, except for those whose health insurance is paid by their employer or social insurance organization, or those whose health insurance is subsidized by the State budget. The method of purchasing mandatory health insurance as a household is also completely different from the voluntary health insurance purchase before. To purchase health insurance cards, all procedures must be completed with photocopies of the household registration book, identity cards of all members, marriage certificate (in some cases), health insurance cards (if any) of the remaining members, temporary residence certificate (or temporary absence certificate)… This is not to mention cases where couples have separated or divorced but still share the same household registration book; or those temporarily residing in the family who don't think about buying health insurance, and if just one person refuses to participate, then it's too late.” The whole family… had no choice but to accept it.”

Mr. Ngo Ngoc Thanh, Head of the Collection Department of the Provincial Social Insurance (BHXH), stated: “After three months of implementing the new Health Insurance Law, due to some difficulties and obstacles in implementing the regulations on family health insurance, the number of people participating in health insurance throughout the province has decreased. By the end of the first quarter of 2015, the province had 92,731 people purchasing health insurance, a decrease of 1,200 cards compared to the same period in 2014. Cases facing difficulties in purchasing health insurance often occur in households with many members, with average living standards but not belonging to the groups supported by the State budget (poor, near-poor, elderly, students, etc.). In addition, Vietnam Social Insurance still lacks specific guidance in the implementation process.”

For example, only the People's Committees of wards, communes, and towns, which manage the civil registration and household registration of residents in their area, know exactly how many people are in each household and which health insurance category they belong to. Therefore, according to regulations, the People's Committees of wards, communes, and towns are responsible for compiling a list of households participating in health insurance in their area and sending it to the provincial Social Insurance agency. The provincial Social Insurance agency then sends this list to health insurance agents so that the agents can use it to issue health insurance cards to the people. However, at present, Vietnam Social Insurance has not yet issued specific guidelines, so the People's Committees of wards, communes, and towns have not yet proceeded with compiling lists of household health insurance beneficiaries. To ensure the rights of the people, since March, the provincial Social Insurance agency has instructed all social insurance collection agents to implement the regulation requiring people to declare and purchase health insurance as a household according to the amended and supplemented Health Insurance Law.”

In fact, although the number of people participating in health insurance throughout the province decreased compared to the same period in 2014, in some localities such as Dien Chau, Quynh Luu, Nghi Loc, Vinh City, and Thai Hoa Town, the number of people purchasing social insurance cards under the household scheme in the first quarter of 2015 increased compared to the number of people voluntarily participating in health insurance in the same period of 2014. The reason for this is the active involvement of local authorities, social insurance agencies, and social insurance collection agents in these localities in mobilizing, disseminating information, and supporting the people.

Mr. Dang Ngoc Tho, Deputy Director of the Social Insurance Office of Quynh Luu District, said: “In the first three months of 2015, in addition to those supported by the State budget and students, the entire district had 2,248 people participating in family-based health insurance, an increase of 113 people compared to 2014. Particularly in March, the number of participants increased sharply. While in January and February, the number of newly purchased cards was 465 and 427 respectively, in March there were 1,356 cards. The reason is that in the first two months, people were not yet familiar with the new regulations, but by March, thanks to the active campaigning and dissemination of information by social insurance collection agents, many people understood and participated more.”

In Dien Chau district, Mr. Bui Thanh Loc, Director of the District Social Insurance Office, said: “In implementing the new regulations of the amended Health Insurance Law, the District Social Insurance Office has directed health insurance collection agents to strengthen propaganda and mobilization efforts among the people, and to assist them with administrative procedures. As a result, by the end of the first quarter of 2015, the entire district had 11,421 people participating in health insurance, an increase of 1,938 people compared to the same period of 2014.”

Implementing the universal health insurance roadmap is a correct and timely policy of the Party and State, with a strong sense of community and humanity, aimed at improving the quality of medical examination and treatment services and healthcare for the people. Therefore, although there are still some difficulties and obstacles, if each citizen and the community fulfill their responsibilities, this policy will truly be implemented. Mr. Le Truong Giang, Deputy Director of the Provincial Social Insurance Agency, affirmed: “In the short term, we need to focus on raising awareness so that people understand and are flexible in finding appropriate solutions to ensure their rights. In the long term, relevant agencies at all levels should consider simplifying administrative procedures to create favorable conditions and encourage people to participate in health insurance.”

Furthermore, in order to increase the number of people participating in health insurance under the household scheme, aiming towards achieving universal health insurance, the provincial Social Insurance agency needs to continue coordinating with relevant sectors to develop various implementation solutions. Initially, it is necessary to strengthen communication efforts to all segments of the population regarding the new points of the Health Insurance Law, the meaning and importance of participating in health insurance, considering this a regular, long-term task that requires persistence through various forms to ensure people understand and voluntarily participate. In addition, the Social Insurance agency also needs to continue reforming administrative procedures in receiving applications, printing, and issuing health insurance cards to ensure strict control and avoid errors. Moreover, one of the important solutions to build trust and attract a large number of people to participate in health insurance is to improve the sense of responsibility and attitude of medical staff towards patients in health insurance-covered examinations and treatments.

Text and photos:Minh Quan