Reviewing the draft Law amending the Law on Health Insurance

On the morning of September 25, at the 6th Plenary Session, the National Assembly's Committee on Social Affairs listened to the draft report on the results of the supreme supervision of the implementation of policies, laws and health insurance in the 2009-2012 period and examined the draft Law amending and supplementing a number of articles of the Law on Health Insurance.

Medical examination and treatment using health insurance. (Photo: Duong Ngoc/VNA).

The report on the implementation of policies and laws on health insurance in the 2009-2012 period shows that the expansion of groups of subjects participating in basic health insurance has been carried out in accordance with the roadmap of the Law on Health Insurance.

In 2010, the total number of people participating in health insurance was 52.407 million, reaching a coverage rate of about 60% of the population. In 2011, the total number of people participating in health insurance was 57.082 million, reaching a coverage rate of about 64.9% of the population. In 2012, the estimated number of people participating in health insurance was 59.310 million, accounting for about 66.8% of the population. The number of people participating in health insurance increased by about 10 million people compared to the time before the Law on Health Insurance.

Thanks to the increase in health insurance participants and the increase in the minimum wage over the past 3 years, the total revenue of the Health Insurance Fund has increased significantly. The main reason is that the Health Insurance Law has expanded the benefits of health insurance participants, expanded the group of subjects participating in compulsory health insurance as well as voluntary health insurance. In particular, the Government decided to support medical examination and treatment for the poor through the purchase of compulsory health insurance cards using the state budget...
The report pointed out difficulties and obstacles in implementing policies and laws on health insurance, including the limited expansion of health insurance participants, with about 33% of the population still not participating in health insurance. The organization of issuing, exchanging and managing health insurance cards is still overlapping; health insurance medical examination and treatment has not met the demand; payment of health insurance medical examination and treatment costs still has many obstacles; and difficulties in implementing co-payment regulations.

Along with the proposal to amend and supplement a number of articles of the Law on Health Insurance and continue to issue Circulars guiding the implementation of the Law, the Ministry of Health proposed to study the model of the health insurance organization system in the direction of clearly defining the state management responsibilities of ministries, branches, and provincial People's Committees to increase efficiency and responsibility in operation; consolidate the social insurance system in the direction of specialization, professionalism, with full authority and responsibility to implement policies...

Research on simultaneous application of payment methods for medical examination and treatment costs, changing the behavior of medical examination and treatment facilities, limiting service abuse, controlling medical examination and treatment costs, ensuring safety and efficiency of health insurance funds...

Discussing the draft Law amending and supplementing a number of articles of the Law on Health Insurance, delegates discussed issues related to the subjects, contribution levels, responsibilities and methods of health insurance payment; health insurance cards; payment of medical examination and treatment costs under health insurance...

The scope and structure of the draft Law amending and supplementing a number of articles of the Law on Health Insurance remain the same as the current Law. The draft amends and supplements 20/52 articles from Chapter I to Chapter IX, focusing on amending and supplementing contents related to target groups; forms of participation in health insurance by household; health insurance cards; health insurance benefits; advances and payments for medical examination and treatment costs under health insurance; management and use of health insurance funds, and responsibilities of parties related to health insurance.

Delegate Pham Khanh Phong Lan (Ho Chi Minh City) agreed with the amendment of the regulation on subjects “responsible for participating in health insurance” to “health insurance is a compulsory form of insurance.” This regulation aims to affirm that all subjects are required to participate in health insurance, this is a social responsibility to implement the roadmap towards universal health insurance.

To ensure the feasibility of the Law, delegate Phong Lan suggested that the drafting committee should have a roadmap and specific sanctions to ensure the implementation of this provision. Assessing the provision that “health insurance is a compulsory form of insurance” as a humane provision, demonstrating concern and protection for the community, Vice Chairman of the Committee on Social Affairs Nguyen Van Tien said that the drafting committee needs to conduct further research to have a convincing explanation for this new provision.

Delegate Nguyen Thanh Thuy (Binh Dinh) said that in order to have a large number of people participate in health insurance, it is important to research a level of health insurance benefits suitable for the people. According to the delegate, to ensure the feasibility of the new regulation, it is necessary to pay attention to and research this issue.

Delegate Pham Khanh Phong Lan also agreed to add Clause 7, Article 2 on households participating in health insurance, but proposed to remove the regulation “living in the same commune, ward, or town.” According to the delegate, this regulation deprives people of their rights because in reality, there are many cases in the locality where people have the same name in the household registration book, but they do not live in the same area. In this case, if they are not recognized as a household to participate in health insurance, people will be disadvantaged.

Some opinions agreed with the addition of regulations to increase the benefit level of relatives of meritorious people and people in near-poor households from 80% to 95% and to increase the benefit level of people in poor households; ethnic minorities living in areas with difficult or especially difficult socio-economic conditions, and social protection beneficiaries from 95% to 100% to increase access to health services.

Many delegates suggested that more attention should be paid to the quality of medical services and the rights of people when participating in health insurance, considering this a key issue in attracting people to participate in health insurance./.

According to VNA - LT