Sending a petition to the 10th session of the 15th National Assembly, An Giang voters said that the application of the base salary as a basis for calculating health insurance contributions is causing difficulties for many people, especially freelancers, and affecting the work of mobilizing people to participate in health insurance.
According to voters' reflections, the income of most freelancers is not determined according to the salary coefficient like cadres, civil servants, and public employees. Therefore, taking the base salary (currently 2.34 million VND/month) as the standard for calculating health insurance premiums is considered not suitable for real life, and needs to be studied and adjusted in a more flexible direction.
Responding to this proposal, Minister of Health Dao Hong Lan said that the Law on Health Insurance and Decree 146 (amended and supplemented by Decree 75) have clearly stipulated the groups of participants. Specifically, employees working at agencies and businesses pay health insurance based on the actual monthly salary recorded in the labor contract. Meanwhile, the group participating by household - those who do not receive monthly salary - will pay health insurance based on the base salary.
Leaders of the Ministry of Health affirmed that taking the base salary as a basis to ensure uniformity in policies, and at the same time create relative fairness between groups participating in health insurance. This approach also helps the State conveniently determine the level of support from the budget, because current support policies are based on the same reference system as the base salary.
Currently, the health insurance contribution level per household is determined to be equal to 4.5% of the base salary. With the base salary of 2.34 million VND applied from July 1, 2024, the first person in the household must pay 105,300 VND per month, equivalent to more than 1.2 million VND per year.
To reduce the financial burden on people, the current health insurance policy applies a deduction mechanism based on the number of members in the household. The first person pays 100% of the fee; the second, third and fourth people respectively only have to pay 70%, 60% and 50%. From the fifth person onwards, the contribution level continues to decrease to 40% compared to the standard level.
In addition, Decree 75 also allows localities to use budgets and other legal mobilized sources to support additional health insurance contributions for people, higher than the minimum level prescribed by the Central Government. Reality shows that many localities have proactively issued separate policies to expand the coverage of health insurance.
In Hanoi, the City People's Council has passed a resolution using local budget to support the entire remaining contribution level for people from near-poor households, thereby helping this group to be issued free health insurance cards. Similarly, Ho Chi Minh City also implements a policy to support 100% of the contribution level for people from near-poor households and people who have just escaped the near-poor standard to limit the risk of re-poverty due to medical examination and treatment costs.
Some localities with abundant budget revenue such as Quang Ninh also proactively buy health insurance cards for ethnic minorities and elderly people aged 70 to 79 who do not have pensions. In central provinces such as Nghe An and Ha Tinh, the Provincial People's Council also decided to increase the level of support for farmers, foresters, and fishermen with an average living standard higher than the minimum level according to regulations.
According to the assessment of the Ministry of Health, compared to many countries with similar economic conditions, the level of health insurance contributions in Vietnam is still low, while the benefits for medical examination and treatment that participants enjoy are quite comprehensive. The Ministry of Health hopes that voters and people will continue to share with the common policy, considering health insurance as a risk sharing mechanism and an important financial "shield" when unfortunately sick or ill.
