Health Insurance Fund: Surplus of 47,000 billion still called 'deficit'?
(Baonghean) - The story of the Health Insurance Fund's "overspending" has recently "heated up" again when Vietnam Social Security announced that in 2017, the Fund will "overspend" about 10,000 billion VND, in which Nghe An is the province "with the highest absolute health insurance fund overspending compared to the whole country". So what is the nature of the story of "overspending" and who is the one who suffers when this situation occurs?
Universal health insurance is a top important social policy, with humanitarian significance and profound community sharing, which is highly valued by our Party and State and always promoted in the social security policy system.
In fact, participating in health insurance has brought many practical benefits to people, especially low-income families when they are unfortunately sick. Therefore, in recent years, many health insurance policies have been introduced to increase the benefits for health insurance card holders in medical examination and treatment.
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| There are more and more policies to facilitate health insurance participants' access to medical examination and treatment facilities. Photo: Internet |
These policies have created favorable conditions, helping people with health insurance cards easily access medical examination and treatment facilities, so the increase in medical examination and treatment using health insurance cards and the increase in payments from the Health Insurance Fund are inevitable.
But instead of researching and adjusting the management mechanism of the Health Insurance Fund to suit reality, the Health Insurance Fund management agency (Vietnam Social Security) focuses on the story of "overspending" and "abusing" the Health Insurance Fund and then finds ways to "tighten expenditures" at medical examination and treatment facilities.
For example, in Nghe An, in the first 8 months of 2017, medical examination and treatment facilities requested payment for health insurance cards issued by the province of 2,302 billion VND. According to Nghe An Social Insurance, in balance with the fund allocated by the Central Social Insurance, Nghe An has spent 1,020 billion VND more. Of which, the amount increased due to changes in medical examination and treatment policies (connecting lines, increasing service prices) has increased by 450 billion VND; increased spending for the number of patients coming for examination is 358 billion VND.
Also in the first 6 months of 2017, Nghe An Social Insurance "refused to pay" and "temporarily suspended payment" of over 26 billion VND for medical examination and treatment facilities, causing these facilities to fall into a "half-crying, half-laughing" situation because patients had been examined and medicine had been dispensed, but the money had not been paid!
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| Place to register for medical examination and treatment at Vinh City Hospital. Photo: PV |
Many hospital leaders in Nghe An complained: There are many patients coming for examination, we have no right to refuse, but after the examination, the Social Insurance said we exceeded the ceiling, then asked for "payment". We should have spent time taking care of our profession, now we have to spend time dealing with "payment".
Therefore, nowadays, to avoid "exceeding the ceiling" leading to "being discharged", medical examination and treatment facilities often deal with it by prescribing simple tests and providing cheap medicines to people using health insurance cards for safety!
Therefore, at a recent meeting on the management and use of the Health Insurance Fund between the delegation of the provincial National Assembly and the Nghe An Social Insurance, Colonel Nguyen Huu Cau - Director of the Provincial Police Department frankly stated: "In the "three-way" relationship: Social Insurance - Health Insurance - patients, it is clear that patients are the most disadvantaged"; because the Social Insurance and Health Insurance sectors are the units related to the management and payment of the Health Insurance Fund and are still "struggling" to find ways to ensure the stability of their sectors.
Therefore, when the authorities have not found a way to manage the Health Insurance Fund in a reasonable and scientific manner, but still focus on the story of "overspending" and "abuse" to "distract public opinion", the one who suffers is still the person with the Health Insurance card.
| While wishing to soon have a scientific plan to manage the Health Insurance Fund, a question that medical facilities and patients want the Vietnam Social Security to answer is: Only in the past 2 years, when the "benefits of health insurance card holders" were expanded, did the so-called "overspending" occur; but before, every year, the Health Insurance Funds of provinces and cities had a "surplus" of tens, hundreds of billions of VND and were all transferred to the Vietnam Social Security. What is the "surplus" now, up to 47,000 billion VND, used for? And why is it not put into use now to ensure the benefits of health insurance card holders, but the Vietnam Social Security directs "localities to spend as much as they collect"? |
Duc Chuyen
