Increased hospital fees and thousands of medical services.

(Baonghean) - The Ministry of Health and the Ministry of Finance are about to issue a circular adjusting and increasing hospital fees and medical services.

The increase in hospital fees and medical services is seen as inevitable in the development process; however, the public remains concerned about whether this price increase will be accompanied by innovation and improvement in the quality of medical examination and treatment.

Encourage everyone to participate in health insurance.

It is expected that in November 2015, the Ministries of Health, Social Insurance, and Finance will jointly develop and issue a Circular stipulating a unified price for medical examination and treatment services covered by health insurance across all hospitals nationwide. Accordingly, this circular will stipulate fixed prices instead of the current maximum price range, where localities independently set specific prices. Approximately 1,800 technical services are expected to see price increases in this round, with the largest increases seen in specialized surgical procedures.

Doctors at Nghe An Obstetrics and Pediatrics Hospital examine patients.

The most recent price adjustment was in August 2012, when the price of medical services only accounted for 3 out of 7 factors, including: medicines and direct supplies; electricity, water, waste treatment, and asset maintenance... This adjustment will calculate the correct and complete price of medical services to include all 7 cost factors, adding 4 more: salaries and allowances; major repairs to fixed assets; asset depreciation; and training and scientific research costs.

This circular is expected to be issued in November and implemented according to a specific roadmap: In 2015, the circular will take effect, implementing prices including direct costs and special allowances; in 2016, the prices will include salaries. In 2015, the new hospital fee rates will only apply to those with health insurance cards; those without cards will continue to pay the current rates; in 2016, the inter-ministerial committee will review and provide guidance on implementation for those without health insurance cards... By 2018, hospital fees will include administrative costs, and by 2020, they will be calculated based on market prices, meaning that all seven components of hospital fees will be accurately and fully accounted for.

Essentially, this latest increase in medical service prices will not affect the poor, ethnic minorities, those receiving social welfare benefits, and children under 6 years old. According to the new Health Insurance Law, all these groups are covered 100% of their medical expenses. For near-poor households, the government currently subsidizes at least 70% of the cost of health insurance, and the remaining 95% is covered by health insurance, so the impact will be minimal.

For those with health insurance cards outside the aforementioned group, the price increase will help them access better quality medical services. Previously, medical service prices were quite low, and many people who were not eligible for subsidized health insurance did not participate, instead habitually paying for medical examinations and treatments. Now, with the price increase, those without health insurance will be greatly affected if they unfortunately need to be hospitalized. The purpose of this increase in hospital fees and medical services is to encourage people to participate in health insurance. And with this price increase, people will see the benefits and humanitarian aspects of health insurance and participate more.

Hospitals must improve quality.

In Nghe An, many people believe that the issuance of new price lists is a necessary requirement of practice, and that applying the new prices will improve the quality of medical examination and treatment at the province's health facilities and ensure the rights of patients. However, there are still many concerns.

Ms. Nguyen Thi Ngoc, from Vinh City, said: “Prices should be adjusted appropriately. Many services are low-priced but not clearly regulated, so many patients have to buy or pay for certain supplies themselves to receive the service, which is time-consuming and involves cumbersome administrative procedures. With the price increase, the insurance agency will reimburse at a higher rate, thus reducing the additional contribution from patients with health insurance cards for services that were previously low-priced and the hospital had to charge extra. But my biggest concern is whether the quality of medical care will improve with the increase in medical service prices, and by how much. Will the price increase also lead to abuse of medical services?”

Modern equipment is used for examination and treatment at Nghe An Oncology Hospital.

The news of the price increase was received positively and enthusiastically by hospitals in the area. Dr. Nguyen Van Hoan, Director of Nghe An Endocrinology Hospital, said: Currently, for some key specialized technical services, the hospital still applies the old prices, while the costs of laboratory chemicals, consumables, electricity, and water have increased, leading to insufficient funds to meet professional requirements. For example, specific tests for diagnosing thyroid diseases such as Graves' disease, hypothyroidism, and goiter; and quantitative measurement of thyroid and pituitary hormones.

In particular, some technical services in diabetes diagnosis are not included in the regulated list, such as various types of hyperglycemia tests, affecting hospital operations and causing difficulties for patients. With increased service prices, more techniques will certainly be applied and developed to better serve patients.

Dr. Pham Van Tu, Director of Nghe An Obstetrics and Pediatrics Hospital, said: "The current prices of some services are lower than the actual costs, causing difficulties for the hospital and putting pressure on the public. Furthermore, the current regulations on medical examination and treatment prices are applied uniformly to both adults and children, while performing many types of clinical and paraclinical examinations and treatments for children requires more consumable supplies than for adults. Revised medical service prices will certainly help the hospital develop its facilities and reduce overcrowding."

Dr. Le Thi Thanh Tra, Head of the General Planning Department at the Provincial Friendship Multi-specialty Hospital, stated her opinion: If patients don't come for examination and treatment, the hospital will have no patients and no funding to operate. To attract patients, the hospital will have to recruit high-quality staff to provide better patient care; thereby generating revenue for the hospital; increased hospital fees will reduce the abuse of health insurance, and public hospitals will not have to "use one source to cover another." When service prices are calculated correctly and comprehensively, there will not be too much difference between public and private hospitals; this will create favorable conditions for the development of private hospitals.

Dr. Bui Dinh Long, Director of the Nghe An Department of Health, affirmed: The adjustment of medical service prices, coupled with the new Health Insurance Law moving towards universal access for all patients, means that hospitals must improve the quality of medical services to survive and thrive. Otherwise, patients will not seek medical care. The application of the new regulations will create significant advantages for medical facilities and the public. Changes in some services are clearly visible: in a surgical procedure, where insufficient funds necessitated the use of cheaper consumables, patients will now be able to use higher-priced, higher-quality materials. The health sector will continue to direct medical facilities to improve infrastructure, invest in equipment, and develop techniques to better meet patient satisfaction.

Thanh Chung