For people with chronic diseases, they cannot wait for medicine. Patients need stability in treatment, not anxiety every time they go for examination to see if they will be given medicine today or have to fend for themselves outside.
Here, it is necessary to clarify: Health insurance policy cannot just stop at having a card, having a fund, and having payment regulations. The core is that patients must have access to medicine right at the examination and treatment place. If hospitals often lack medicine, allowing people to use their own money to buy outside and then complete payment procedures later, then health insurance benefits have been "depleted" a lot in reality. Because not everyone has enough money to buy immediately, and not everyone - especially the elderly and seriously ill - is strong enough to pursue all procedures, papers, and invoices to wait for reimbursement.
Circular 22/2024 of the Ministry of Health allows patients to buy medicine outside when hospitals lack it and are reimbursed by health insurance, which is clearly a necessary mechanism to remove difficulties. This regulation at least opens up another "way out", helping patients. But it must be seen that this should only be a rescue solution, and cannot become a normal thing in the operation of health insurance medical examination and treatment. It is not possible to consider patients paying for medicine themselves and waiting for payment as a complete solution.
People participate in health insurance to reduce the burden of costs when sick, not to learn how to adapt to drug shortages. A good social security policy cannot force beneficiaries to compensate for the gaps in supply, bidding or procurement.
The causes of the health insurance drug shortage have been pointed out: Problems in bidding, centralized procurement, slow list approval, changes in technical guidelines, and lack of supply from manufacturers.
New regulations from July 1, 2025 allowing hospitals to be more autonomous and flexible in drug procurement, along with decrees and circulars to simplify procedures, increase transparency, are clearly positive steps. But policies are only truly meaningful when they reach the hospital's pharmacy counter, reach patients, instead of just lying on paper.
Lack of health insurance drugs, after all, is not just about healthcare supply. It is also a test for the effectiveness of social security policies and the operating capacity of the system. People pay health insurance so that when they are sick, they have a support. That support cannot be sometimes available, sometimes not; and even more cannot be "fluctuating" with each month, each supply period.
