Increased hospital fees and thousands of medical services

(Baonghean) - The Ministry of Health and Finance is about to issue a circular to adjust and increase hospital fees and medical services.

Increasing hospital fees and medical services is considered inevitable in the development roadmap, however, public opinion is still wondering whether increasing prices and hospital fees go hand in hand with innovation and improving the quality of medical examination and treatment.

Encourage everyone to participate in health insurance

It is expected that in November 2015, the Ministry of Health - Vietnam Social Security - Finance will develop and issue a Circular regulating the unified price of health insurance examination and treatment services among hospitals nationwide. Accordingly, this Circular will stipulate a fixed price instead of a maximum price frame, with localities setting their own specific prices as at present. It is expected that about 1,800 technical services will be adjusted up in this period, and the biggest increase will be for special surgical procedures.

Doctors at Nghe An Obstetrics and Pediatrics Hospital examine patients.

The most recent price adjustment was in August 2012, the price of medical services only calculated 3/7 factors, including: medicine, direct materials; electricity, water, waste treatment and maintenance of assets... This time, the price of medical services will be calculated correctly and fully including 7 cost factors, that is, adding 4 factors: salary, allowances; major repairs of fixed assets; depreciation of assets and training and scientific research costs.

It is expected that this circular will be issued in November and implemented according to a specific roadmap: In 2015, the circular will take effect and implement the price including direct costs and special allowances; in 2016, the price will include salary. In 2015, the new hospital fee price will only apply to people with health insurance cards, people without cards will still apply the current price; in 2016, the joint ministries will review and guide the implementation for people without health insurance cards... By 2018, hospital fees will include additional management costs and in 2020, they will be calculated according to market prices, that is, calculating correctly and fully all 7 factors that make up the hospital fee price.

Basically, this increase in medical service prices will not affect the poor, ethnic minorities, social policy beneficiaries and children under 6 years old. Because according to the new Law on Health Insurance, all of these subjects will have 100% of the cost covered by health insurance when going for medical examination and treatment. For near-poor households, the state currently supports at least 70% of the cost of participating in health insurance and is covered by health insurance for 95%, so the impact is not much.

For those with health insurance cards other than the above mentioned group, the price increase will help them enjoy better quality medical services. Previously, the price of medical services was quite low, many people who were not eligible for health insurance support did not participate but had the habit of paying for medical examination and treatment. Now, with the increase in service prices, those who do not participate in health insurance will be greatly affected if they are unfortunately hospitalized. The point of the 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 humanity of health insurance and participate more.

Hospitals must improve quality

In Nghe An, many people believe that the issuance of new unit prices is a mandatory requirement of practice, the application of new unit prices will create conditions for the quality of medical examination and treatment at medical facilities in the province to be improved, and the rights of patients to be guaranteed. However, there are still many concerns.

Ms. Nguyen Thi Ngoc, in Vinh City, said: “There should be a suitable price adjustment. Many low-priced services are not clearly regulated, so many patients have to buy or pay for some supplies to perform the service, which is time-consuming and cumbersome. When prices increase, the insurance agency will pay at a higher rate, which reduces the additional contribution of patients with health insurance cards for services that were previously low-priced, and the hospital has to collect more from patients. But what I am most concerned about is whether the quality of medical examination and treatment will increase as well, and how. When prices increase, will there still be abuse of medical services?...

Use modern equipment for examination and treatment at Nghe An Oncology Hospital.

The information about the price increase was received positively and enthusiastically by hospitals in the area. Doctor Nguyen Van Hoan, Director of Nghe An Endocrinology Hospital, said: Currently, the hospital still applies the old price for some key specialized technical services, while the costs of testing chemicals, consumables, electricity and water have increased, leading to insufficient costs to meet professional requirements. For example, specific tests to diagnose thyroid diseases such as Basedow's disease, hypothyroidism, goiter; quantification of thyroid and pituitary hormones.

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

Dr. Pham Van Tu, Director of Nghe An Obstetrics and Pediatrics Hospital, said: The prices of some services are currently lower than the actual prices, causing difficulties for the hospital and putting pressure on the people. In addition, the current regulations on prices for medical examination and treatment services are applied to both adults and children, while performing many types of clinical and paraclinical examinations and treatments for children require larger consumables than for adults. The revised prices for medical services will certainly help the hospital develop its facilities and reduce overload.

Dr. Le Thi Thanh Tra, Head of the General Planning Department, Provincial General Hospital of Friendship, expressed her opinion: If patients do not come for medical examination and treatment, the hospital will have no patients and no funds to operate. To attract patients, the hospital will have to recruit high-quality staff to provide better patient care; thereby creating revenue for the hospital; hospital fees will increase, the abuse of health insurance will decrease, public hospitals will not have to "take this amount to compensate for that amount". When service prices are calculated correctly and sufficiently, there will not be too much difference between public and private hospitals; this creates conditions for private hospitals to develop.

Doctor Bui Dinh Long, Director of Nghe An Department of Health, affirmed: The price of medical services has been adjusted to increase, combined with the new Law on Health Insurance, towards a common route for all patients. If hospitals want to survive and develop, they must improve the quality of medical services, otherwise patients will not come to see a doctor or receive treatment. The application of the new regulations will open up great advantages for medical examination and treatment facilities and for the people. Changes in some services can be clearly seen: in a surgery, from not having enough money to having to use cheap consumables, now patients will be able to use higher-priced - better-quality consumables. On the health sector side, we will continue to direct medical examination and treatment facilities to improve infrastructure, facilities, invest in equipment and develop techniques to increasingly better meet the satisfaction of patients.

Thanh Chung