On the morning of December 2, the National Assembly discussed the draft Resolution of the National Assembly on a number of breakthrough mechanisms and policies for the work of protecting, caring for and improving people's health.
National Assembly Delegate (NAD) Thach Phuoc Binh - Deputy Head of the Delegation of National Assembly deputies of Vinh Long Province - said that increasing the level of benefits and moving towards exemption of hospital fees in the 2026-2030 period is a humane policy but implementation shows many bottlenecks.
Accordingly, 30% of health stations do not have doctors and 35% of health stations provide drugs that lack or do not ensure quality.
If health insurance benefits are expanded when the lower level has not been strengthened, people will continue to pour into the upper level, increasing spending from the health insurance fund and overloading, going against the goal of reducing financial burden.
The delegate also said that the procurement and bidding system is still inadequate, lacking consistency in instructions, causing disruption in supply. Many hospitals have been charged more than the fund, and have outstanding health insurance debts of up to VND 7,000 billion in the period 2018-2021.
Increasing benefits in the context of unstable payment mechanisms can easily lead to abuse of services and prolong treatment, especially in autonomous units.
The delegate suggested adding prerequisites (pre-inspections) to Article 2 before expanding health insurance benefits. By 2026, it is necessary to complete the standardization of 70% of commune health stations on facilities, equipment, and essential drug lists and ensure that each health station has at least 1 doctor.
Regarding the salary and allowance regime for health workers (Article 3), the delegate commented that the regulation on salary classification of doctors from level 2, although improving initial income, does not address the root cause of the low-income problem. In reality, medical staff have quit their jobs en masse, and the income gap between the public and private sectors is getting larger. This solution is not enough to retain human resources.
The new 100% vocational preferential allowance is applied in some specialized majors. While many areas with equivalent danger levels such as emergency care, resuscitation for poison control, infection, epidemic control have not been tested, creating inequality and reducing motivation to work.
According to the delegate, the allowances for grassroots health care and preventive medicine are still low, not attractive enough to keep doctors in the commune. This leads to the risk of no more doctors working as a reserve in the next 10-15 years, with a shortage of 8,000 doctors (only reaching 42% of the demand).
The delegate proposed to complete Article 3 in the direction of: Developing a specific salary table for the health sector associated with risks, responsibilities, seniority, applying allowances according to job position instead of leveling according to degree. Expand 100% occupational allowances for resuscitation, anti-poisoning, ICU, infection, anti-epidemic, emergency, high-risk testing.
In particular, it is necessary to increase grassroots and reserve health allowances to 100% nationwide; disadvantaged areas will receive additional attraction allowances from 30% to 50%.
The delegate also suggested that it is necessary to ensure the source of allowances from the budget, avoiding dependence on the level of autonomy of the hospital.
Also talking about the salary and allowance policies for health care workers, delegate Tran Kim Yen (HCMC Delegation) said that in reality, the shortage of doctors in grassroots health care and preventive medicine is a huge challenge for the health sector nationwide.
Therefore, the delegate proposed to add emergency staff from outpatient hospitals to enjoy a 100% preferential allowance. At the same time, remove Point b, Clause 3, Article 3 so that those who regularly and directly work in health care at commune health stations and preventive medicine will all receive a preferential allowance of 100%, regardless of whether it is 100% or 70%.
