An acquaintance of mine lives only about 50km from Hanoi but always thinks that going to Hanoi is as difficult as hundreds of kilometers. He has a serious illness and needs to be examined regularly. Even though he has health insurance, he can only go to the district level. Many times he has proposed to go to big hospitals in Hanoi for treatment but all have failed because of the complicated procedures. Meanwhile, his family does not have enough money to go to private hospitals.
That obsession is not only for one person but for most people in the countryside when they get seriously ill. “Going to Hanoi for medical examination and treatment” is still something far away.
In fact, since the Law on Health Insurance was issued, although there have been positive and appropriate impacts of the health insurance policy based on the principle of risk sharing, ensuring social security and international integration, in reality, the law regulating the registration of primary medical examination and treatment facilities according to administrative boundaries has not created conditions for people to be able to go to all facilities at the same or lower level within the province for some diseases.
Special cases such as rare diseases and serious illnesses have not been examined and treated at higher levels, while lower-level facilities do not have enough professional capacity and must be referred to higher levels. Some chronic diseases have not been brought to the grassroots health care system for management and medication by higher levels, thereby limiting the rights of health insurance participants. In particular, the procedures for referral and issuance of referral papers are issues that cause inconvenience to patients, and there are even cases of negativity arising, asking - giving to keep patients, not allowing referral, causing public outrage.
However, it is not possible to immediately connect medical examination and treatment facilities to the Central level and remove the regulations on referral. Because this will cause overload and pressure on the Central level, affecting the quality of patient treatment. The delegation contributes to ensuring the stability, balance and sustainability of the medical examination and treatment system.
The solution to this problem is to amend and supplement a number of articles of the Law on Health Insurance. In particular, it is proposed to eliminate referral procedures for some cases of rare diseases, serious diseases...
This means that there will be specific regulations for some diseases that can skip referral procedures. This could be a reasonable solution to balance, not put pressure on the upper level and especially create conditions and reduce costs for some severe patients with serious illnesses.
It is expected that the draft Law on Health Insurance (amended) will be submitted to the National Assembly for comments and approval at the 8th session in October. This clearly demonstrates the spirit of administrative reform, medical examination and treatment procedures, reducing paperwork, increasing the application of information technology, decentralization, maximum delegation of power, creating convenience for the people.
