Will issue medical service prices according to 5 hospital classes

On December 18, Mr. Nguyen Nam Lien, Director of the Department of Financial Planning (Ministry of Health) said that according to the provisions of the Law amending and supplementing a number of articles of the Law on Health Insurance (HI) which was recently passed by the National Assembly on June 13, 2014, effective from January 1, 2015, the Ministry of Health is urgently coordinating with the Ministry of Finance to issue a unified price frame for health insurance examination and treatment services according to hospital class nationwide.

Specifically, prices will be issued according to 5 hospital classes: Special class, Class I, Class II, Class III and Class IV hospitals; this price still only calculates 3/7 direct cost factors: medicine, blood, infusion, supplies; electricity, water; maintenance and repair costs of assets; the price is calculated on the weighted average of services currently collected according to hospital class nationwide, taking into account the consumer price index but not exceeding the price frame issued by the Ministry of Health - Finance.

(Photo for illustration purposes only. Source: DT)

In addition, the cost of 24/7 on-call allowance is included in the bed day price, and the cost of surgical and procedural allowance is included in the price of surgeries and procedures.

According to Mr. Lien, the price of medical services is not simply for people to pay for hospital costs, but also the basis for the Social Insurance Agency (SI) to pay for hospitals on behalf of the people. The goal set by the National Assembly is to implement universal health insurance, by 2020 at least 80% of the population must participate in health insurance, so the price of services plays an important role in implementing the health insurance policy. It is not like the price of other goods and services, but also the benefit that people enjoy when participating in health insurance.

Mr. Lien affirmed: The roadmap for adjusting medical service prices is not to increase the cost of performing medical services because: the cost of performing medical services is currently regulated in Decree 85/2012/ND-CP of the Government, including 7 factors, currently only 3/7 direct cost factors are calculated in the price; not including salary, house depreciation, equipment depreciation, technical transfer training. Calculating correctly and fully the price of medical services is basically not to increase the cost, but the amounts previously subsidized by the state must now be included in the price to transfer the state budget subsidized for medical facilities to support people participating in health insurance.

Assessing the impact and effectiveness of calculating the full price of medical services, will the quality of medical services be better? Mr. Lien said that calculating the full price of medical services according to the roadmap is a practical and objective requirement. If implemented, people will enjoy better quality medical services. Patients with health insurance cards benefit because health insurance pays at a higher rate, reducing the additional contribution of patients for services that were previously low in price and health insurance did not fully cover the costs. Many services that were previously low in price and hospitals did not have the funds to implement, now have their fees adjusted so they will be implemented, and health insurance patients will benefit because the costs are mostly paid by social insurance, increasing the benefits of people with health insurance cards.

Regarding the concern that many people have that if medical service prices are adjusted, the poor will be affected? Mr. Lien emphasized: According to current health insurance policies, the state has guaranteed the budget to buy health insurance cards for the poor, ethnic minorities in difficult and especially difficult socio-economic areas. From January 1, 2015, people living in island communes and island districts will also be able to buy health insurance cards from the state. The government has supported at least 70% of the face value of health insurance cards for the near-poor, encouraged localities to use local budgets and other capital sources, and the Ministry of Health has also mobilized a number of ODA projects to provide additional support for the near-poor to participate in health insurance.

To date, over 14 million poor people, ethnic minorities and nearly 3 million near-poor people have been purchased and supported by the State to buy health insurance cards. To solve the difficulties for these people, the Ministry of Health has submitted and the Government has agreed to submit and the National Assembly has approved the Law amending and supplementing a number of articles of the Law on Health Insurance, in which from January 1, 2015, the poor and ethnic minorities living in difficult socio-economic areas, especially difficult areas, when going for medical examination and treatment according to the provisions of the Law on Health Insurance will be paid 100% by the Health Insurance Fund, without having to pay a co-payment (previously, they had to pay a co-payment of 5%); the near-poor will be paid 95% by Health Insurance, only having to pay a co-payment of 5% (previously, Health Insurance paid 80%, had to pay a co-payment of 20%); so it can be affirmed that, basically, adjusting the price of medical services according to the roadmap does not greatly affect the poor and near-poor because Health Insurance covers all or most of them.

For farmers, forestry workers, fishers and salt workers with average living standards, the Prime Minister has issued criteria for people with average living standards as a basis to support these subjects to participate in health insurance.

“Calculating the full price of medical services will bring the price of medical services back to its true value, and will encourage people to participate in health insurance because in reality, the price is low, so many people who are not eligible for support to buy health insurance cards will not participate in health insurance but pay out of their own pocket, but when the price is adjusted, people will see the benefits and humanity of health insurance, which is that every year they only have to pay a small amount to buy health insurance, and when they are sick, health insurance will pay, reducing risks,” Mr. Lien affirmed.

In addition, medical facilities are adjusted to charge fees, hospitals have the conditions to buy medicines, supplies, chemicals, tests, and examinations with higher quality, increasing the quality of medical services. At the same time, promote the socialization of healthcare, create conditions for hospitals, especially lower-level hospitals, to have funds to deploy services, especially new services, with higher technology, only then can medical technology be developed, bringing higher quality medical services closer to the people; promote the dynamism and creativity of hospitals in mobilizing resources.

According to the Ministry of Health, in parallel with the innovation of mechanisms and adjustment of medical service prices according to the roadmap, the Ministry of Health has also strengthened the direction of units and hospitals to reform administrative procedures in medical examination and treatment, well implement the code of conduct to reduce inconvenience for patients, strengthen medical ethics education.../.

According toCommunist Party of Vietnam