Do not let health insurance patients buy drugs on the list of benefits themselves.
(Baonghean.vn) - At this time, many patients who are covered by health insurance when being examined and treated at medical facilities in the province have to pay extra money to buy medicines and medical consumables that are on the list of benefits for health insurance participants.
Not enjoying full benefits
In mid-July 2023, Ms. TDT (in Vinh city) was transferred from a district hospital to a provincial hospital for surgery and treatment. Ms. TDT said: To be admitted to the hospital, my family initially paid 500,000 VND to the hospital's cashier. After being admitted to the hospital and before the surgery, my family was asked to pay an additional 3 million VND...
Ms. TDT was upset: As a civil servant, worker, and employee, I have been participating in health insurance continuously for more than 20 years, but when I have surgery and treatment, I have to buy everything. Before the surgery, the doctor gave the family a list of things to buy, including IV fluids, alcohol, saline, bandages, anesthetics, sutures, antibiotics for injection, surgical caps... The total amount of money the family had to spend to buy supplies and medicines on this list was 1,470,000 VND.
According to Ms. TDT, during her hospitalization after surgery, the hospital only gave Ms. T 2 painkillers. As for other supplies for wound care such as drainage bags and daily dressings, the family had to continue to spend money to buy them... Having the same surgery, the same disease, and sharing the same room with Ms. T at this time were 5 other people (including 3 teachers, 1 medical staff) who also had to spend their own money to buy medicine and medical supplies.
When Ms. TDT and other patients expressed their dissatisfaction because they could not fully enjoy their health insurance benefits, the staff of this provincial hospital explained: "We hope that patients will sympathize and share because the hospital does not have many types of medicines and medical supplies because it could not bid for them"...
Based on Ms. TDT's reflection, the reporter had an exchange with a leader of the hospital where Ms. TDT was treated and was told by this person: "The procurement of medicine and medical supplies through bidding at medical units encountered many difficulties. Many bidding items were rejected; many small items did not have contractors participating in the bidding due to the low demand of the unit and low profit. From that difficulty, the rights of health insurance patients were affected."
Further investigation revealed that it was not just Ms. TDT's case but also many other patients.health insuranceWhen examining and receiving treatment at medical facilities in the province, people had to spend extra money to buy medicine and medical supplies that are on the list of benefits for health insurance participants... because the hospital could not purchase medicine and medical supplies.
Mr. Pham Dinh Luyen, Director of Quy Hop District Medical Center, shared: “Mountain medical units have been unable to purchase a number of medicines and supplies because there are no contractors participating in the bidding. As a result, when patients come to the clinic, the medical facility can only prescribe the medicine for the patient to buy outside. This not only affects the rights of the patients but also damages the brand of the medical facility…”.
Must proactively remove difficulties
According to information from the Nghe An health sector, the Department of Health recently organized a centralized local bidding for 2023-2024 with 232 items with a total value of nearly 522 billion VND. The results selected 182 winning items with a total value of over 429 billion VND (78% of the list, 82% of the value). For the 22% of items that did not win the bid, the Department of Health directed the units to proactively organize bidding.
Medical facilities in Nghe An province have organized plans to select contractors with 186 packages including 24,522 items, total value of over 2,490 billion VND; have invited bids for 115 packages including 11,931 items (48.7%), total value of over 1,492 billion VND (59.9%). The results of the selection of 7,020 winning items (reaching 58.8% of the bid), total value of nearly 1,044 billion VND (reaching 70.0% of the bid value).
The bid rejection rate at medical facilities is 41.2%, of which 32% failed due to no bidders, 5% failed due to exceeding the planned price... There are 20 medical facilities reporting a shortage of medicine with a total of 3,030 items missing, with a total value of over 291 billion VND (accounting for 12% of the total demand of medical facilities in the whole province); 8 facilities are short of over 20%; 8 facilities are short of over 10%; 4 facilities are short of less than 10%...
Nghe An Department of Health has requested medical units to proactively re-organize bidding for items that have not won the bid and have no alternative items; proactively organize contractor selection for 51% of items that have not yet been selected. On the side of the Department of Health, continue to improve the bidding capacity of medical facilities; direct and guide units to proactively plan and organize bidding for items not on the list of centralized procurement; items on the list of centralized procurement but have not yet had results or have used up all the winning quantity.
On July 17, 2023, Nghe An Department of Health issued Official Dispatch No. 2211/SYT-NVD on strengthening the management of prescription and prescription drug sales at health facilities. The content of the dispatch stated: Recently, the Department of Health has received feedback from patients and their relatives about prescribing for patients to buy drugs outside the scope of health insurance payment, treatment support products at some medical examination and treatment facilities...
To ensure the rights of patients participating in health insurance, the Department of Health requests medical examination and treatment facilities in Nghe An province to proactively develop plans and organize procurement bidding, ensuring adequate and timely supply of drugs, chemicals, and supplies for treatment of patients; not allowing patients participating in health insurance to have to buy drugs and medical supplies on their own that are on the list of benefits within the scope of benefits of health insurance participants.
The Department of Health has also clearly requested that medical facilities need to implement necessary measures to avoid shortcomings and limitations in prescribing and selling prescription drugs, specifically prescribing outside drugs for health insurance patients that are within the scope of benefits of health insurance participants while the drugs can be replaced with equivalent drugs currently being supplied at the unit according to the winning bid results.
The instructions of the Department of Health are very clear. However, to ensure the rights of patients in general and health insurance patients in particular, the health sector and the provincial social insurance sector need to have a specific inspection and assessment of the situation so that patients have to buy their own medicines and medical supplies on the list of benefits within the scope of benefits of health insurance participants, especially checking whether the medical facility pays for health insurance for the medicines and supplies that the patient has purchased himself or not. The health sector and the insurance sector need more support so that medical facilities can perform well the bidding and purchasing of medicines, biological products, medical supplies as well as health insurance examination and treatment./.
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