The Department of Health recommends establishing an independent appraisal agency to avoid abuse of the health insurance fund.

(Baonghean.vn) - This is the solution proposed by Deputy Director in charge of the Provincial Department of Health Hoang Van Hao to the National Assembly's survey delegation to improve management and avoid abuse of the health insurance fund in medical examination and treatment.

According to the report from the Department of Health, in 2016, the Social Insurance signed medical examination and treatment contracts with 520 medical facilities from the provincial level to the health stations. To ensure the rights of health insurance participants, medical facilities, especially provincial and district level facilities, focused on improving facilities, developing and applying modern techniques in medical examination and treatment activities.

Also according to the Department of Health, partly due to the increasing demand for health care of the people; partly due to changing disease patterns, there are diseases that tend to increase (cancer, kidney failure, diabetes...); high-tech services in medicine develop rapidly, leading to increased health service costs, while the health insurance fund is limited...

Regarding payment for health examination and treatment under health insurance, currently there is no agreement between the Social Insurance and the Health sector on regulations on the capacity of medical examination on one examination table; solving the problem of exceeding the capacity/8 working hours for some services of ear - nose - throat endoscopy, ultrasound...

Working scene. Photo: Mai Hoa.

At the meeting, the working delegation and the Department of Health, the provincial Social Insurance, and a number of provincial and district-level medical facilities exchanged and discussed many issues to ensure the best management and use of the health insurance fund.

What many delegates are interested in and give opinions on is the need to promote propaganda work, expand the subjects, move towards universal health insurance, family health insurance, thereby reducing the imbalance in the health insurance fund; pay attention to building appropriate co-payment policies; promote the application of IT in medical facilities to better control patients coming to medical facilities...

Mr. Hoang Van Hao - Deputy Director in charge of the Department of Health proposed that the Central Government should issue a policy on payment for medical examination and treatment costs through the network. In particular, attention should be paid to changing the organizational structure. In addition to the Social Insurance agency assigned to manage the Health Insurance Fund and the health agency implementing it, there should be an additional agency to independently assess, ensure objectivity and transparency in the implementation of the fund, and avoid abuse of the Health Insurance Fund.

Mr. Bui Sy Loi - Vice Chairman of the National Assembly's Committee on Social Affairs noted that the health sector and social insurance agencies need to step up propaganda work, expand the number of people participating in health insurance; research solutions to strengthen management, use this fund for the right purpose, and prevent abuse of the health insurance fund.

Doctors from Vinh International Hospital provide free medical examination and treatment to people in Nam Cuong commune, Nam Dan district.

Mr. Bui Sy Loi also suggested that Nghe An Health sector continue to pay attention toStandardize the medical staff at all levels, improve the capacity and qualifications of the medical staff at health stations, avoid overloading the upper level, and treat diseases while they are still mild, limiting serious or chronic diseases; strengthen coordination between levels and sectors to protect rights and ensure fairness between health insurance participants and non-health insurance participants; ensure equality between public and non-public hospitals.

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