Join hands to achieve the goal of universal health insurance

(Baonghean) - Mr. Le Truong Giang - Director of Nghe An Social Insurance discussed the implementation of the universal health insurance roadmap in the province.

PV:Could you please tell us the basic benefits that patients participating in health insurance enjoy when examining and treating illnesses and how health insurance helps patients overcome their illnesses?

Using modern equipment to examine eyes for patients at Nghe An Eye Hospital. Photo: Tu Thanh

Mr. Le Truong Giang:Participating in health insurance has great benefits in the treatment process, especially for serious illnesses with high costs. Health insurance benefits have now been expanded, including: medical examination, treatment, rehabilitation, periodic pregnancy check-ups and childbirth; transportation costs for some groups of subjects; payment for work-related accidents, occupational diseases, traffic accidents, suicide, self-inflicted injuries and treatment of strabismus, myopia, and refractive errors for children under 6 years old... When participating in health insurance continuously for 5 years or more, in addition to the scope of benefits and benefits according to regulations, health insurance participants are granted a certificate of non-co-payment in the year when the cost of medical examination and treatment in the year exceeds 6 months of basic salary.

In the long term, when the goal of universal health insurance is achieved and the health insurance fund develops sustainably, people will benefit even more: The scope of health services covered by health insurance is expanded, the quality of medical examination and treatment is improved, the co-payment rate for medical examination and treatment of people with health insurance is reduced; contributing to creating a stable financial source for people's health care in the direction of fairness, efficiency and quality.

PV:Could you tell us about the outstanding achievements in implementing the health insurance policy and the roadmap towards universal health insurance in Nghe An province in recent times?

Mr. Le Truong Giang:First of all, the awareness of all classes of people and the responsibility of all levels and sectors in implementing the health insurance policy have been increasingly raised. The organization and implementation of the health insurance policy in the province have had clear changes, especially after the Provincial Party Committee issued Action Program No. 22 dated August 28, 2013 to implement Resolution 21 NQ/TU of the Politburo on strengthening the Party's leadership over social insurance and health insurance work in the period of 2012-2020; the Provincial People's Committee issued plans to implement the Provincial Party Committee's Action Program and Decision No. 538/QD-TTg dated March 29, 2013 of the Prime Minister approving the Project on implementing the roadmap for universal health insurance in the period of 2012-2015 and 2020.

Since 2014, the target of the proportion of people participating in health insurance has been included in the system of economic and social indicators submitted to the Provincial People's Council for approval and specific targets have been assigned to each district, city and town. This is a demonstration of the strong political commitment of the Provincial Party Committee, People's Council and Provincial People's Committee to the implementation of the roadmap towards universal health insurance.

Along with that, the expansion of basic target groups has been carried out in accordance with the roadmap of the Law on Health Insurance and the amended Law on Health Insurance. The rate of people participating in health insurance in Nghe An province has increased over the years. If in 2012, Nghe An had 71.36% of the population participating in health insurance, by the end of 2015, it was 76.95%, and by May 31, 2016, it was 79.5%, corresponding to a total of 2,447,181 participants.

In addition, the health insurance examination and treatment network has been expanded, the quality of medical examination and treatment and the satisfaction of people with health insurance cards when going to the hospital for examination and treatment have been gradually improved. People have been able to access and receive health care from the health insurance fund right in the community and many modern medical services.

Caring for patients at the Department of Resuscitation and Anti-Poisoning - Nghe An General Hospital. Photo: MQ

On the other hand, state management and implementation of health insurance have had positive changes. Many localities have had good and creative ways of doing things and have had the active participation of the entire political system. Party committees, authorities, and organizations have considered leadership, direction, and implementation of health insurance policies as one of the key tasks in implementing policies and laws on social security. Expanding the number of people participating in health insurance has become one of the solutions to complete the criteria for communes meeting new rural standards.

PV:What are the difficulties and challenges in developing health insurance participants, sir?

Mr. Le Truong Giang:Nghe An is a province with a large area, dense population, many businesses operating with a large number of employees, but currently, only 79.5% of the population participates in health insurance. The health insurance coverage rate of localities and the rate of people participating in health insurance among target groups are uneven. Besides localities with a coverage rate of 100% such as Que Phong, Con Cuong, Quy Chau, many localities have a health insurance coverage rate lower than the average, such as Hung Nguyen (60.7%), Hoang Mai (62.2%), Quynh Luu (65.2%), Yen Thanh (63.8%), Nam Dan (66.3%)...

In addition, the quality of medical examination and treatment at some medical facilities is still limited. The situation of health insurance card fraud by some subjects is increasing and becoming more sophisticated, such as: borrowing other people's health insurance cards for medical examination and treatment, using fake health insurance cards, fake ID cards, etc., which significantly affects people's awareness of participating in health insurance for themselves and the health insurance examination and treatment fund.

PV:To implement the roadmap for universal health insurance by 2020, what solutions has Nghe An Provincial Social Insurance had, sir?

Mr. Le Truong Giang:According to the Prime Minister's regulations, by 2020, over 90% of the population in Nghe An province will participate in health insurance. From now until 2020 is not a long time, the Government's goal and to achieve the goal of universal health insurance is an extremely important and extremely difficult task, requiring the cooperation of the entire political system.

In addition to the solutions to develop health insurance participants currently being implemented, in the coming time, Nghe An Social Insurance will promote a number of solutions to rapidly increase the participation rate in groups of subjects with low health insurance participation rates, focusing on propaganda, regularly coordinating with relevant sectors to inspect the implementation of health insurance policies and laws in state-owned and private enterprises, and strictly handling violating enterprises. For near-poor subjects, it is recommended that the Provincial People's Committee promptly submit to the Provincial People's Council a resolution on supporting health insurance premiums for people in near-poor households in the period of 2016 - 2020.

For agricultural, forestry, fishery and salt-making households with average living standards, it is recommended that the Department of Labor, War Invalids and Social Affairs promptly implement Circular No. 02/2016/TT-BLDTBXH dated March 25, 2016 of the Ministry of Labor, War Invalids and Social Affairs guiding the process of identifying agricultural, forestry, fishery and salt-making households with average living standards in the period 2016 - 2020, thereby promptly completing the list of these subjects to mobilize participation and serve as a basis for proposing support for the contribution level.

For the group participating by household, it is recommended that the Provincial People's Committee direct the District People's Committee, Commune People's Committee and the Provincial Post Office to coordinate with the Social Insurance agency to quickly complete the work of compiling the list of households participating in health insurance, and do a good job of reporting the increase and decrease of health insurance participants every month. In addition, the Provincial People's Committee should consider adding the criteria for considering a cultural family as 100% of household members participating in health insurance, and the criteria for considering a new rural commune as the commune's health insurance coverage rate reaching over 80% of the population.

Along with that, Nghe An Social Insurance continues to develop social insurance and health insurance agents to increase people's access to health insurance policies; accelerate administrative reform, apply IT in health insurance examination and treatment and coordinate with the health sector to improve the quality of medical examination and treatment of medical facilities to ensure the rights and satisfaction of health insurance participants.

Minh Quan(Perform)