Nghe An cannot balance its health insurance fund.

(Baonghean) - In the first 9 months of 2016, the health insurance fund in 37 provinces and cities nationwidedeficit of more than 3,400 billion VND, including Nghe An.

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After releasing the above figures that caused a stir in public opinion, Vietnam Social Security affirmed that the Health Insurance Fund 'will not go bankrupt' and will still be balanced until 2017. Nghe An Newspaper reporter had an interview with Mr. Pham Gia Van - Deputy Director of Nghe An Social Security about this issue.

Mr. Pham Gia Van answered an interview with Nghe An Newspaper

PV:Could you please tell us the truth about the current "collapse" of the health insurance fund in Nghe An?

Mr. Pham Gia Van:The Health Insurance Fund is a centralized fund for the entire country. The fund can be “broke” at the central level, but a province cannot “broke” the fund. Whether it is broken or not is for the central level to answer, the locality cannot answer. In my opinion, it is the amount of expenditure that exceeds the revenue at a time or in a year, not the “broke” of the fund.

PV:So can you tell us about the revenue and expenditure situation of the Health Insurance Fund in Nghe An in recent years?

Mr. Pham Gia Van:Our province has many policy beneficiaries, and these beneficiaries are often sick and ill, so they go to the doctor a lot. The contribution level has not changed significantly, but the expenditure level has increased a lot. In 2015, we started to overspend the fund, and this year we have also overspent.

PV:This year 2016, the increase in health insurance fund expenditure is explained as due to the implementation of Circular 40 on connecting routes and Circular 37 on increasing service prices. But in reality, in 2015, Nghe An exceeded expenditure by 129 billion VND. What is the reason?

Mr. Pham Gia Van:Due to the law change since 2015, although the route has not been opened yet and the price has not increased, some benefits of patients have been increased, such as from 80% to 100%, some poor people on dialysis who received 95% now receive 100%.

PV:In 2015, did the inspection and supervision process detect any errors in the use of health insurance funds in our province, sir?

Mr. Pham Gia Van:We always monitor to detect errors, but there are no errors that need to be prosecuted. For example, they prescribe the wrong price a lot, 8 days of treatment, but prescribed 9 days. With thousands of drugs and thousands of services, mistakes and errors are common. I think this always happens and will happen for a long time. Of course, in the future, when information technology is applied, it will be better, but if we do it manually, there will be many mistakes.

PV:During the process of checking and monitoring the use of health insurance funds, do we require medical facilities to pay for violations?

Mr. Pham Gia Van:I don't remember specifically, but not much! Our force was very thin, making it very difficult to monitor.

PV:After the information about the deficit of the health insurance fund, relevant levels and sectors from the central to local levels have issued documents directing to rectify this situation. Is there any progress in the situation in Nghe An, sir?

Mr. Pham Gia Van:After the press and all levels and sectors got involved, the abuse by patients has been greatly reduced, especially in September and October, according to reports, tens of billions of dong in spending has been reduced. In my opinion, after the "opening of the line", everyone took the opportunity to go for medical examination. Now that they have all been examined, the number of people coming to medical facilities has decreased significantly.

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Place of registration for medical examination and treatment at Vinh City Hospital.

PV:It is known that recently, Nghe An Social Insurance has sent delegations to inspect and supervise the use of health insurance funds at medical facilities to rectify. What violations did the delegation discover, sir?

Mr. Pham Gia Van:Mainly the service name is wrong, the declaration is wrong due to calculation. As for the abuse of testing, the doctor explained that "we do it to eliminate this disease or that disease, to ensure patient safety". In my opinion, there are really unnecessary things, we also recommend not doing it because it will be wasteful. The health insurance fund is for people who see a doctor, have a real illness, and when going for a health check-up, there should not be too many services wasted.

PV:If the reported data of overspending on health insurance funds at a medical facility is too large, how will it be handled?

Mr. Pham Gia Van:The main reason for exceeding the fund is because patients go to the doctor too much, if it is exceeded, we have to accept it.

PV:With this situation, can Nghe An balance the health insurance fund?

Mr. Pham Gia Van:With this level of contribution and benefit, it is certainly not balanced. The central government will have to regulate.

In my opinion, to ensure the health insurance fund, we must either reduce benefits or increase the contribution rate. However, in difficult economic conditions, increasing the contribution rate is not possible, but we must manage the fund closely and use the fund properly and effectively.

PV:Thank you!

PV(Perform)