Regarding the issuance of health insurance cards for coastal areas

May 24, 2016 11:13

(Baonghenan.vn) - According to the Government's regulations, the disadvantaged communes in the coastal plains are one of the special areas that are covered by the State Budget and receive support for the Health Insurance (HI) premium. However, while other areas have decided to recognize the list of particularly disadvantaged communes and villages in the 2016-2020 period to serve as a basis for issuing health insurance cards to people, the disadvantaged coastal plains have not yet received a decision to recognize them, so the issuance of new health insurance cards to these subjects has encountered many difficulties.

Cán bộ BHXH Diễn Châu kiểm tgra hồ sơ cấp thẻ
Dien Chau Social Insurance officers check health insurance card application files for people.

Regarding the issuance of health insurance cards to disadvantaged communes in the coastal areas of Nghe An, according to the Prime Minister's Decision, in the period of 2013 - 2015, Nghe An has 12 communes in 4 districts in the list of particularly disadvantaged coastal communes, of which Dien Chau has the most with 6 communes including Dien Van, Dien Trung, Dien Bich, Dien Hai, Dien Hung and Dien Kim; Nghi Loc has 4 communes Nghi Yen, Nghi Tien, Nghi Thiet, Nghi Quang; Quynh Luu and Cua Lo each district has 1 commune namely Quynh Tho and Nghi Tan.

Of the total 70,830 people in the coastal area who received state budget contributions and health insurance support, Dien Chau had the most with 39,859 people, Nghi Loc 17,851 people, Quynh Luu 3,885 people and Cua Lo 9,235 people.

However, one of the problems that has arisen is that while the subjects in coastal areas have cards and even though they have expired, they have been renewed to enjoy the benefits of the health insurance card, the new subjects in the area have not been issued cards.

In principle, when there is no list of disadvantaged communes in coastal areas and the time limit on the health insurance card (until December 31, 2015) has expired, it means that the health insurance card of people in coastal areas is no longer valid. To solve the above problem, and at the same time ensure that the health insurance policy is not interrupted, based on the guidance of Vietnam Social Security, Nghe An Social Insurance has actively and proactively coordinated with the Department of Labor, Invalids and Social Affairs to promptly issue inter-sectoral guidelines; at the same time, request the Provincial People's Committee to issue an official dispatch agreeing to extend the health insurance card until the Government has new regulations. Thanks to this effort, the rights of people in this area are still guaranteed to operate normally.

Người dân vùng biển Diễn Châu đến làm thủ tục BHYT tại BHXH huyện.
People in Dien Chau coastal area come to do health insurance procedures at the district Social Insurance.

However, in the difficult coastal communes, there are many new subjects arising, so the implementation of issuing health insurance cards faces many difficulties. Dien Chau is one of the districts with the largest number of subjects paid and supported by the budget to pay health insurance in the period 2013-2015 in the province. Mr. Bui Thanh Loc - Director of Social Insurance of Dien Chau district said: through the review and new statistics of the Department of Labor, Invalids and Social Affairs established and approved by the District People's Committee in 2016, 6 difficult coastal communes of Dien Chau district have 53,269 people, of which 51,012 people are paid and supported by the state to pay health insurance cards; the remaining 2,257 people do not have cards or have them but the Social Insurance sector cannot manage them (students, relatives of police officers and soldiers). Through classification, there are 1,693 cases in the difficult coastal areas of Dien Chau district that do not have health insurance cards, on average each commune has 300 new cases that do not have cards.

Similarly, in Nghi Loc, through the investigation of the district Social Insurance, there were 1,266 people, Quynh Luu 591 people and Cua Lo 104 people who had not been issued health insurance cards. The reason for the new cases was mainly because in 2015, some people went to work far away, so the People's Committee of the commune or ward did not establish them, or some people were issued poor or near-poor cards, but by 2016 they had escaped poverty or near-poverty. In addition, there were also some people who in 2015 did not live in the coastal plains, but in 2016 they moved back to their hometowns in these communes to work and live...

In addition to the difficult coastal areas, we learned that currently, in rural areas in general and coastal communes in particular, the rate of people participating in voluntary health insurance is still low and new development is quite difficult. One of the reasons is due to people's awareness when participating in health insurance. Although the benefits of health insurance cards when going to the doctor are quite clear, people are still very hesitant to participate. In addition, because the regulations of the Social Insurance allow 1 member to participate, households often choose people who are often sick or weak to participate in health insurance instead of having all members participate.

Toàn cảnh hội nghị trực tuyến đánh giá công tác lập danh sách tham giai Bảo hiểm y tế từ điểm cầu Nghệ An
Overview of the online conference to evaluate the work of making a list of participants in Health Insurance from Nghe An bridge point

Mr. Chu Van Luong - Director of Nghi Loc Social Insurance shared: In order to promptly resolve difficulties for people in coastal communes, as soon as there are instructions on card renewal from the province, the district Social Insurance promptly sends a document requesting medical facilities to examine and treat people in accordance with the spirit of inter-sectoral instructions from the provincial Social Insurance and Labor, Invalids and Social Affairs; at the same time, direct the communes to review and make a list of missed cases. Through the review, there are 1,266 new people in 4 coastal communes who have not been issued cards. Although there have been campaigns, no one has participated in voluntary health insurance.

Talking to us, Mr. Le Van Thuy - Head of the Department of Labor, Employment, Wages and Social Insurance, Department of Labor, Invalids and Social Affairs said: Currently, the Ministry of Labor, Invalids and Social Affairs and related ministries and branches are in the process of developing criteria to recognize coastal communes with difficulties. Because the classification of poor and near-poor households at this stage is multidimensional, the review and assessment process is quite complicated and takes time, and the issuance of a list of difficult communes along with support resources must be calculated more carefully.

Basically, the subjects who already have health insurance cards have been renewed, but for the new subjects, because the Prime Minister has not yet made a decision, it is not known which communes in Nghe An are recognized as difficult communes in coastal areas. However, the current difficulty is that there is no official decision approving the list of difficult communes in coastal areas of the province in particular and the whole country in the period 2016-2020, so the whole province still has 3,654 new people in coastal communes who cannot yet be issued health insurance cards. These subjects have no other choice but to have a basis to prepare records and issue additional cards after the Prime Minister issues the decision.

Nhân viên y tế giải quyết các thủ tục khám chữa bệnh cho người có thẻ bảo hiểm y tế. (Nguồn: TTXVN)
Medical staff handle medical examination and treatment procedures for people with health insurance cards. (Illustration photo)

To get medical examination and treatment, people in the above areas must choose two ways: to participate in voluntary health insurance or to go to the hospital without a health insurance card. For the above reason, along with mobilizing people to participate in voluntary health insurance, Dien Chau district Social Insurance also said that when the Government has a decision to recognize coastal communes, the Social Insurance will calculate to pay back to the people. With this method of mobilization, from the beginning of 2016 until now, 51 families in Dien Chau coastal communes have participated in voluntary health insurance. However, except for Dien Chau, people in the remaining difficult communes in the coastal areas in the province have not participated in voluntary health insurance.

Faced with the above situation, the Social Insurance sector as well as the Party Committee, government and people hope that competent authorities will soon approve the list of communes in the coastal areas in the new period to promptly issue additional health insurance cards to new subjects, and continue to have solutions to increase the rate of participation in universal health insurance in the coming time./.

Nguyen Hai

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Regarding the issuance of health insurance cards for coastal areas
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