Increasing health insurance card fees: More benefits for patients

(Baonghean) - From July 1, 2017, the fee for participating in family health insurance has increased by 7.4%. Many people are worried about this information, however, the Social Insurance industry affirms that the fee change has been carefully calculated, does not affect people's lives much, and even the benefits of health insurance participants have been significantly increased.

Paying for medical examination and treatment costs at Vinh City General Hospital. Photo: Thanh Son

Increase health insurance premiums

Mr. Vu Van Hong's family in Hamlet 6, Hung Xa Commune, Hung Nguyen District has 5 members. The whole family works in agriculture in the locality. To facilitate medical examination and treatment, Mr. Hong's family decided to buy family health insurance.

Waiting for his turn at Vinh City General Hospital, Mr. Hong said: Last August, the old card expired, he went to the collection agency at the Commune People's Committee to buy new cards for the whole family and learned that the fee for family health insurance participation increased from July 1, 2017.

He was explained that the provisions of the Law on Health Insurance are that the level of participation in family health insurance is built on the "base" of the basic salary. Therefore, after July 1, 2017, the basic salary increased from VND 1,210,000 to VND 1,300,000, which means an increase of about 7.4% in the fee for participation in family health insurance.

Mr. Hong said that the fee increase surprised him and many other people, but when explained like that, it seemed reasonable. If you calculate carefully, you will realize that this fee increase is not significant, only about 20,000 - 50,000 VND/person/year. A family of 5 people, except for the 2-year-old child, 4 people have to buy. Compared to last year, this year the health insurance fee of Mr. Hong's family only increased by 136,000 VND.

Even for poor and near-poor families, this fee increase will not affect them. In fact, poor households have received 100% support from the State budget, and near-poor households have received 70% support.

In addition, according to Decision No. 53/2016/QD-UBND of the People's Committee of Nghe An province stipulating the level of health insurance contribution support for people in near-poor households in Nghe An province in the period of 2016-2020, in addition to 70% of the health insurance contribution supported by the Central Budget, in 2016, the province also supported an additional 10% of the health insurance contribution, in 2017 supported 15%, in 2018 supported 20%, in 2019 supported 25% and in 2030 will support 30%.

Ensuring patient rights

Regarding concerns about whether the fee increase will go hand in hand with ensuring the rights of people when examining and treating patients, Dr. Nguyen Hong Truong - Director of Vinh City General Hospital said: "The rights of patients will be explained carefully by medical staff and insurance when performing medical examinations, treatment and payment. Personally, I think that the increase in the contribution level is reasonable, ensuring the safety of the fund and the rights of the majority of patients."

According to Dr. Truong, this fee increase has a specific roadmap and plan, carefully calculated, so the benefits for patients are very high. Specifically: For people with health insurance cards who go to medical examination and treatment according to regulations, with a total cost of one medical examination and treatment lower than 195,000 VND, they do not have to make co-payments (the regulation before the change in the payment level was lower than 181,500 VND).

Illustration photo.

For cases where patients are assigned by medical facilities to use high-tech services according to Decision 36/2005/QD-BYT of the Ministry of Health on promulgating the List of high-tech services with high costs, the Health Insurance Fund shall pay within the scope of benefits but not exceeding 52 million VND for one use of technical services (the old regulation was not exceeding 48.4 million VND); the Health Insurance Fund shall pay 100% of the co-payment costs exceeding 7.8 million VND for people participating in Health Insurance for 5 consecutive years or more (the old regulation was 7.26 million VND).

In addition, the total payment for medical supplies for one use of technical services shall not exceed VND 58.5 million (the old regulation was VND 54.45 million); this regulation shall not apply to medical supplies with payment rates specified in column 5 of the List of medical supplies in Appendix 01 issued with Circular 04/2017/TT-BYT of the Ministry of Health.

Before applying the new fee, Nghe An Social Insurance has done a good job of propaganda and dissemination of information to all classes of people, minimizing confusion. Ms. Tran Thi Ha - Head of Revenue Management Department, Nghe An Social Insurance said: Nghe An Social Insurance has been and continues to coordinate with media agencies from the province to the grassroots, especially the radio system of communes, wards and villages, to propagate to all people about the change in legal policies on health insurance.

Up to now, the majority of people in the province have accessed the change in health insurance premiums and agreed to support it. This is reflected in the increase in the number of households participating in health insurance. In July 2017, there were 20,825 more households participating in health insurance compared to June 2017; by August 2017, there was a further increase of 8,068 participants compared to July 2017.

Currently, the health insurance policy has covered over 82% of Nghe An's population. To expand the number of participants, Nghe An Social Insurance continues to have solutions to ensure the rights of health insurance participants, which are: continuing to reform administrative procedures to create the most favorable conditions for people to participate in health insurance and health insurance cards to reach buyers as soon as possible; promoting propaganda work so that people see that the health insurance policy is a humane policy, participating in health insurance is not only for themselves, but also for their family members and the community. In addition, Social Insurance will strengthen the supervision of the expenditure of the Health Insurance Fund at hospitals so that participants can see that their funds are spent correctly and effectively.

The provincial Social Insurance Department also hopes that medical examination and treatment facilities will continue to make more efforts to improve the quality of health insurance examination and treatment, and reform administrative procedures so that patients do not have to wait long. Only then will people clearly see the benefits and rights when participating in health insurance.

Thanh Son