Hospital fees increase from June 1, 2017: People need to join health insurance soon

(Baonghean) - According to Circular 02/2017/TT-BYT, from June 1, 2017, more than 1,900 medical services for groups of people without health insurance cards and some medical examination and treatment services not covered by the health insurance fund will officially apply new hospital fees.

Many worries and concerns

For the past few months, Ms. Nguyen Thi Lien (Nghi Loc) has been going to the Provincial General Hospital for dialysis three times a week. Recalling the first time when she heard that she had stage 3B kidney failure, Ms. Lien seemed to have completely collapsed because of the serious illness, the cost of treatment was too high compared to her family's income. She confided: "I am a single mother raising a small child. Before I knew about my illness, I worked for restaurants, eateries, cooked at weddings..., earning about 3 - 4 million VND per month, but after being hospitalized, I had to quit because I was not healthy enough to work.

Without health insurance, the cost of dialysis each month is up to 7.8 million VND, not to mention the cost of transportation, accommodation, and medicine. I have been able to endure for the past few months, but what happens next is very uncertain. I am considering mortgaging my house to take care of it when I can, I just feel sorry for my child who is still too young..." Sharing the same situation as Ms. Lien, in many departments and rooms of Nghe An General Hospital, there are people who are struggling with illness every day, shouldering high medical expenses because they do not have health insurance to help.

Patients are treated at the Intensive Care Unit of Nghe An General Hospital. Photo: Phuoc Anh

Talking to patients without health insurance who are being treated at some large and small hospitals in the province about the increase in hospital fees for those without health insurance from June 1, 2017, they said they knew about this information and felt very concerned and worried.

According to the new regulations, there are 3 groups of services for people without health insurance cards that have adjusted the maximum price frame: medical examination and health check-up services; treatment bed day service prices; technical and testing service prices for all hospital classes. In particular, both groups of medical examination services and treatment bed day services have had very strong price increases, 2-4 times higher than the current price. This increase will be a significant burden for patients without health insurance who have to undergo long-term inpatient treatment.

The strongest impact on patients without health insurance cards is the price group of technical and testing services for all hospital categories, regardless of whether the patient is an outpatient or inpatient, or a short or long-term patient. In addition, with 1,916 services whose prices have been adjusted to increase, although the increase is mainly around 20 - 30%, a few have doubled the current price, but the absolute amount of many services is up to hundreds of thousands of VND, even millions of VND for one appointment, because the unit price of technical services already has a high cost structure. Many people ask why the hospital fees are increased for those without health insurance, while these subjects are mainly freelancers, farmers... with difficult circumstances?

Health Insurance “Lifebuoy”

Responding to people's concerns, Mr. Phan Duy Cuong - Deputy Head of the Health Insurance Appraisal Department, Social Insurance of Nghe An province said that for a long time, many people still do not know that people who have not participated in health insurance when going to see a doctor or receive medical treatment are still paying a lower price than those who have a health insurance card, because the price of medical services for people who do not have a health insurance card only includes 3 direct cost elements: Cost of medicine, infusion, chemicals, consumables, replacement materials for medical examination and treatment; Cost of electricity, water, fuel, waste treatment, environmental protection; Cost of equipment maintenance, repair, purchase of replacement tools and instruments.

Meanwhile, last year, the Health Insurance Fund had to pay most of the costs for those who were covered by health insurance, with the price structure including salary and allowances according to Joint Circular No. 37/2015/TTLT-BYT-BTC, which regulates the unified price of health insurance examination and treatment services among hospitals of the same rank nationwide. Therefore, the Ministry of Health's issuance of Circular No. 02/2017/TT-BYT adjusting the prices of more than 1,900 health services is inevitable, aiming to bring fairness to everyone.

Instructions for people to do medical examination procedures at Vinh City General Hospital. Photo: Thuy Hien

In fact, this price increase has a clear roadmap and plan, the propaganda work is one step ahead, not issued suddenly. In 2016, the Ministry of Health adjusted the hospital fees from March for those with health insurance cards, and informed that in 2017, the hospital fees will be adjusted for those without health insurance cards. This gap is to help those who have not participated in health insurance to prepare mentally, improve their understanding and awareness of the importance of health insurance, thereby promoting participation in health insurance to be protected in terms of rights when examining and treating diseases.

In addition, to create conditions for all people to participate in health insurance, the health insurance policy has more and more incentives. The purchase of health insurance is carried out by household, according to Decree 105/2014/ND-CP: "The contribution level of all members of the household according to the provisions of Clause 5, Article 12, amendments and supplements of the Law on Health Insurance is as follows: The first person contributes 4.5% of the basic salary; the second, third, and fourth persons contribute 70%, 60%, and 50% of the first person's contribution, respectively; from the fifth person onwards, the contribution level is 40% of the first person's contribution level".

With the increase in the basic salary from July 1, 2017 to 1.3 million VND/month, the price of health insurance in 2017 for a household is 702,000 VND/year for the first person and decreases accordingly according to the above regulations. Thus, it can be seen that the amount of money to participate in health insurance is not too large, while the benefits are very high. Patients with health insurance cards will have the health insurance fund pay from 80 - 100% of the cost, depending on each beneficiary, reducing the burden of anxiety during the examination and treatment process.

Implementing Circular 02/2017/TT-BYT, Nghe An Department of Health is actively developing a price framework for medical examination and treatment not covered by the Health Insurance Fund in state-owned medical examination and treatment facilities in the province. Mr. Hoang Van Hao - Acting Director of the Department of Health said that it is expected to be completed by July 2017, the Provincial People's Committee will submit it to the Provincial People's Council for approval, after which medical facilities will collect hospital fees according to the new price framework.

It is known that the Ministry of Health has requested localities to allocate budgets and mobilize capital for the Fund to support medical examination and treatment for the poor; and directed hospitals to use the difference between revenue and expenditure to support medical examination and treatment to help cases with difficulty paying hospital fees.

Phuoc Anh