Removing difficulties and obstacles to ensure good health insurance policies and regimes for participants
(Baonghean.vn) - Under the leadership of the Party and the State, in recent times, the implementation of health insurance policies and laws in our country has achieved many successes. The rate of people participating in health insurance is higher year after year and always fulfills the targets assigned by the National Assembly and the Government.
Ensure drug supply, medical examination and treatment costs, and health insurance
With the viewpoint of putting the rights and interests of health insurance participants first, in recent times, Vietnam Social Security has proactively and promptly implemented many solutions such as: proposing and advising on the development of health insurance policies and laws; coordinating with relevant ministries and branches (Ministry of Health; Ministry of Public Security, People's Committees of provinces and cities...) to strengthen direction, guidance, and effective implementation of synchronous health insurance policies from the central to local levels; promoting administrative procedure reform... to facilitate participants and beneficiaries of health insurance policies.
To overcome the shortage of drugs and medical supplies, Vietnam Social Security has promptly advised and coordinated with the Ministry of Health to report to the Government to issue Resolution No. 144/NQ-CP dated November 5, 2022 on ensuring drugs, medical equipment and payment of medical examination and treatment costs under Health Insurance; contributing opinions to Resolution No. 80/2023/QH15 of the National Assembly on "continuing to implement a number of policies in preventing and fighting the Covid-19 epidemic and using drug circulation registration certificates and drug ingredients that have expired from January 1, 2023 to December 31, 2024"... to ensure the supply of drugs and medical examination and treatment costs under Health Insurance to serve patients.
On the other hand, Vietnam Social Security also issued many documents to thoroughly grasp and direct local Social Security to uphold the sense of responsibility, closely coordinate with the health sector to promptly guide the resolution of difficulties and problems.
Remarkable,Social insuranceVietnam has issued Official Dispatch No. 544/BHXH-CSYT dated April 1, 2023 requesting the Social Insurance of provinces and cities, based on the actual situation of the locality, to propose to the Provincial People's Committee to decide to expand the list of drugs for centralized bidding at the local level appropriately to reduce difficulties for medical examination and treatment facilities; at the same time, promptly give opinions to the Department of Health and medical examination and treatment facilities, to avoid the situation of slow bidding organization leading to a shortage of drugs to serve patients...
Accordingly, in many provinces, medical examination and treatment facilities have purchased additional drugs through other forms of bidding such as: designated bidding, direct purchasing, competitive bidding, additional 20% purchase, drug regulation, organizing additional bidding for items that failed to bid, etc. Therefore, the drug shortage has basically been overcome, ensuring the rights of health insurance patients.
In particular, Vietnam Social Security has established working groups led by the General Director and Deputy General Directors to work with 63 provincial and municipal Social Security agencies, including the resolution of difficulties in the work of medical examination and treatment under Health Insurance. Implementing the direction of Vietnam Social Security, provincial Social Security agencies have made quarterly settlements to transfer payment and advance funds for the following quarter, creating favorable conditions for medical examination and treatment facilities to operate.
In 2023, implementing the Government's directions and the Ministry of Finance's instructions, Vietnam Social Security has directed the Social Security of provinces and cities to pay the entire amount approved by the Prime Minister to medical examination and treatment facilities and settle the overspending in 2018, 2019, 2020 in the 2022 financial settlement with a total amount of VND 1,977 billion.
With the initiative and efforts, many difficulties and problems in medical examination, treatment and payment of medical examination and treatment costs under the jurisdiction of Vietnam Social Security have been basically resolved, effectively serving the work of medical examination and treatment and ensuring good health insurance benefits for participants according to the Law.
Benefit from Health Insurance policy
Health insurance benefits are increasingly expanded, the quality of medical services is improved in a modern, professional and friendly direction to the people. According to the assessment of the World Health Organization (WHO), Vietnam is one of the few countries in the world with a relatively complete, comprehensive and expanded drug list compared to the health insurance premium and countries in the ASEAN region.
According to regulations, the List of Health Insurance drugs used in Vietnam includes 1,037 chemical drugs, biological products, 59 radioactive drugs and markers; 229 oriental medicines, herbal medicines, 349 traditional medicines. The selection of finished drugs paid for by the Health Insurance Fund at medical examination and treatment facilities is not limited by the type of drug with cheap or expensive price, domestic or foreign drugs. Based on the disease model, medical examination and treatment needs and the payment capacity of the Health Insurance Fund, medical examination and treatment facilities build a List of drugs used at the unit to purchase and choose appropriate drugs.
Basically, the current List of drugs covered by Health Insurance participants has fully covered all general and specialized medical examination and treatment facilities, hospital classes, specialties, and treatment fields.
In order to meet the increasingly full and quality needs of patients with health insurance cards, the Ministry of Health has issued a Decision to establish a Drafting Committee, an Editorial Team, to develop principles and criteria for amending and supplementing the List of pharmaceutical drugs, biological products, radioactive drugs and markers; oriental medicines, herbal medicines and traditional medicine ingredients within the scope of benefits of health insurance participants. In particular, the focus is on expanding the List of drugs to meet treatment needs, ensuring that the rights of health insurance participants are better cared for while still ensuring compliance with the payment capacity of the health insurance fund.
In addition, Health Insurance participants also increasingly benefit from the quality of Health Insurance services; procedures in Health Insurance examination and treatment are reformed, simplified, and save time for participants.
In particular, reforms such as: using citizen identification cards, Health Insurance card images on the VssID application for Health Insurance examination and treatment instead of paper cards; applying biometrics at Health Insurance examination and treatment facilities... have been responded to and highly appreciated by people and Health Insurance examination and treatment facilities.
With the benefits and conveniences enjoyed from the Health Insurance policy, most people actively and proactively participate in Health Insurance. Therefore, the Health Insurance coverage rate of the following year is always higher than the previous year, increasing from 91.01% of the population (2021) to 92.04% (2022) and 92.4% (first 9 months of 2023). By the end of September 2023, the whole country had 127,475,188 people going to see a doctor for health insurance, an increase of 19.8% over the same period in 2022; the amount paid by the Health Insurance fund was more than 88.3 trillion VND, an increase of 15.9% over the same period in 2022.
With the spirit of being ready to create the best conditions for participants and beneficiaries of the Health Insurance policy according to regulations, in the coming time, Vietnam Social Security will continue to closely accompany the health sector, especially in the development and amendment of the Law on Health Insurance; resolve difficulties and problems in the process of organization and implementation... to fully and promptly ensure the rights of health insurance participants and the ability to balance and develop sustainably the health insurance fund./.
