Increasing hospital fees must go hand in hand with quality of medical examination and treatment.

(Baonghean) - The Government Office has just issued Notice No. 707/VPCP-KGVX dated February 8, 2012 conveying the Prime Minister's opinion agreeing with the Ministry of Health to adjust the prices of more than 400 medical services. Accordingly, in late February and early March, the Ministry of Health will work with relevant ministries to issue an increase in hospital fees... Public opinion in our province mostly expressed agreement with this project, but also suggested that the quality of medical examination and treatment must also increase accordingly.

Scope of hospital fee adjustment

The basis for the upcoming increase in hospital fees is: The current collection rate for medical examination and treatment services is too low and has not been adjusted in time to suit the actual situation. (Of the approximately 3,000 medical services currently being performed, approximately 350 services have been issued since 1995, approximately 2,700 services have been issued since 2006 but have not been adjusted, causing many services to only collect 30% - 50% of the implementation cost, while the input cost factors to ensure hospital operations have increased many times since 1995 and 2006, the health insurance premium has increased, the minimum wage has increased 6.9 times, the indexConsumer prices increased by about 3.4 times). The adjustments aim at the goal that patients will enjoy better quality medical services because hospitals have more funds to serve patients.

For patients with health insurance cards, the Social Insurance Agency will pay at a higher rate, thus reducing the additional contribution of patients with health insurance cards. For services that were previously low-priced, hospitals must collect from patients the portion that the health insurance fund did not pay. According to the Social Insurance sector, in 2011, the cost of medical examination and treatment was 24,000 billion VND and if the new hospital fee is applied this year, medical expenses will increase by about 26%. With the increase as planned, in the short term, the Health Insurance Fund will balance its own revenue; use a part of the reserve fund to pay when there is a deficit. If the reserve fund is not enough, it will propose to increase the health insurance contribution rate. The adjustment of the contribution rate has not been set in 2012... This year, patients will not have to pay additional health insurance participation fees.

In the current roadmap for universal health insurance, poor households and policy beneficiaries are provided with health insurance cards by the State and only have to pay 5% of hospital fees. And in this hospital fee adjustment project, the poor and policy beneficiaries still maintain the payment level of 5% of health insurance examination and treatment costs. In case of large payment levels, the Medical Examination and Treatment Fund for the Poor will be used to support when the poor use medical services beyond the payment capacity of localities, to support subjects to reduce difficulties, such as people with serious illnesses requiring dialysis or heart surgery, but not completely exempted.

To improve the quality of medical examination and treatment

Immediately after the policy of adjusting medical service prices, public opinion of Nghe An people expressed their agreement and support for this but still could not help but worry. Having been treated at Nghe An General Hospital (the hospital with the largest number of patients in the province) for more than a week, even though she has a social insurance card, Ms. Le Thi Nguyet in Nam Dan Town still has to pay a large amount of hospital fees. Therefore, the information about the increase in hospital fees made her worried: "I often get sick, so I bought voluntary health insurance to save money.

However, when being treated, you still have to pay a part. Now that the hospital fee has increased, it will be more difficult." Many opinions basically agree: The upcoming hospital fee adjustment will cause the greatest difficulty for patients who do not have a card and have not participated in health insurance. And these subjects are mostly low-income people (farmers, fishermen).

Ms. Nguyen Thi Hoa in Nghi Quang commune said: The economy of people in coastal areas still has many difficulties, increasing hospital fees too much makes people and themselves afraid to go to hospitals and medical facilities. However, the family will participate in voluntary insurance to enjoy health care policies and services.

According to this hospital fee adjustment project, the quality of medical examination and treatment for people will be increased. In particular, as with cases of sharing beds, hospitals will not be allowed to collect bed fees per person, meaning that the bed fees will be divided equally among the number of people sharing the bed, unlike the current calculation method of many hospitals... Many people believe that, to achieve the good goals of the project, it requires greater efforts from the health sector, especially the medical team, to improve the quality of medical examination and treatment at medical facilities.

Mr. Pham Gia Van, Deputy Director of the Provincial Social Insurance, commented: "Increasing hospital fees is necessary, creating conditions for medical facilities to invest and upgrade equipment to better serve medical examination and treatment. Along with increasing hospital fees, doctors and medical staff must improve their medical ethics, should not put money first to "attract" health insurance cards, abuse drugs, techniques and tests, create trust for people to actively participate, moving towards universal health insurance."

Some medical staff affirmed: Increasing hospital fees will avoid the situation where hospitals cannot collect enough to cover expenses, improve the lives of doctors and medical staff, thereby improving medical ethics, and hospitals will retain good doctors. And the increase proposed by the Ministry of Health this time is still not close to reality, so it is possible that some hospitals will increase the price of medical examination and treatment services upon request...

There are also opinions that: Currently, hospitals are financially autonomous according to Decree 43/2006 of the Government, but no one is sure whether the revenue and expenditure are public and transparent or not, because the current Health Inspectorate force is still lacking and weak. If there are no measures to manage the revenue and expenditure of hospitals well, increasing hospital fees will lead to overcharging, even creating conditions for hospitals to "break the fence" of hospital fees, following market prices. Obviously, there needs to be a mechanism to closely monitor, avoid overcharging and virtual losses, patients with money are given priority, poor patients, and health insurance patients have to wait, causing overload and cross-line situations.

Increasing hospital fees must go hand in hand with ensuring the rights of patients. Nghe An people are still waiting for the efforts and concrete manifestations of the health sector in general and the medical examination and treatment facilities of the province.

Thanh Chung