The Health Insurance Law is effective but it is time for adjustment.
Ms. Tran Thi Trang, Director of the Ministry of Health, said that after 15 years of implementation, the Law on Health Insurance has truly entered life, ensuring social security and international integration.
However, during the implementation process, there have been problems, shortcomings, and limitations that need to be adjusted. Patient Duong Thi Oanh, born in 1963 in Bac Kan province, is being treated for stage 2 colon cancer at a central hospital in Hanoi, and wishes: I really hope that cancer treatment drugs will be included in the list of drugs covered by health insurance to reduce the burden on patients.
According to statistics from hospitals, the average cost of treatment for a cancer patient fluctuates over 176 million VND/year, of which the patient must pay up to 70%. The cost of cancer drugs in 2023 is 7,521 billion VND, ranking first in the total drug payment from the health insurance fund. For patients, the burden of paying out of pocket for cancer treatment is very large. There are currently 69 cancer drugs in the drug list out of a total of 1,037 drugs in the list of chemical and biological drugs covered by health insurance within the scope of benefits for health insurance participants. There are many new generation advanced treatment drugs that are highly effective in treating cancer, meeting the requirements of clinical experts as well as the expectations of patients, but are not yet on the list of drugs covered by health insurance.
Ensuring the rights of participants and the sustainability of the health insurance fund
Ms. Tran Thi Trang added that the Law amending and supplementing a number of articles of the Law on Health Insurance will be submitted to the National Assembly for comments and approval at the 8th Session (October 2024). If approved, it will contribute to ensuring that people can participate in health insurance according to appropriate groups of subjects and ensure health insurance benefits in accordance with people's needs in health care, professional requirements and the payment capacity of the health insurance fund.
Create fairness and convenience for the provision and use of health insurance examination and treatment services; improve the efficiency of grassroots health care activities, pay attention to primary health care, contribute to comprehensive management of people's health, improve the efficiency of management and use of the health insurance fund. The Law amends and supplements 40 articles on subjects participating in health insurance, responsibility for payment, benefits, scope of benefits, organization of health insurance examination and treatment, fund management and some technical regulations... The draft Law on Health Insurance (amended) approved by the Standing Committee of the National Assembly includes 4 groups of policies including: Adjusting subjects participating in health insurance in sync with the provisions of relevant laws; Adjusting the scope of health insurance benefits in accordance with the contribution level, balancing the health insurance fund and health care requirements in each period; Adjusting relevant health insurance regulations according to the level of technical expertise in medical examination and treatment and promoting the role of grassroots health care in primary health care and health insurance examination and treatment; Effective allocation and use of health insurance funds.
Ms. Trang gave an example, specifically about the scope of health insurance benefits for some medical services that are within the scope of medical examination and treatment but are not yet regulated in the scope of health insurance benefits such as health management, examination, diagnosis, risk assessment, health status and early treatment of some diseases, periodic health check-ups, treatment of refractive errors, assisted reproductive techniques, medical supplies used in rehabilitation, nutritional treatment... The regulations on the basic health service package paid by the health insurance fund are unclear in concept, not close to the specific reality of Vietnam, not showing the nature of the basic health service package that must be placed in the balance of the scope of benefits and payment capacity of health insurance...
