Many revenues and expenditures are not in accordance with regulations.
The State Audit has just completed an audit of the management and use of public finance and public assets in 2023; the topic "implementation of the arrangement and reorganization of public service units according to Resolution No. 19-NQ/TW dated October 25, 2017 for the period 2021-2023"; the management and use of state financial funds outside the central budget for the period 2020-2023 at the Ministry of Health.
According to the inspection results, many patient collections are not in accordance with regulations: Some units have not recorded revenue from medical examination and treatment services for completed services; reflecting the nature of revenue sources incorrectly; Some medical services have established prices with a number of drug lists and costs that have been included in the price structure of medical examination and treatment services paid by social insurance, but medical examination and treatment facilities still collect additional money from patients; applying prices for medical examination and treatment services is not accurate...
Some hospitals generate revenue from performing technical services that are not specified in Circular No. 13/2023/TT-BYT dated June 29, 2023, such as surgical services on demand during or outside of business hours; liver transplant surgery; Collecting from patients some technical services that have been included in the daily price, bed price in the surgical service price...
The suffering of the medical practitioner
Pharmacist Nguyen Xuan Son - Head of Pharmacy Department (Thanh Hoa Dermatology Hospital) - said that it is not common for medical examination and treatment facilities to collect additional money from patients even though medical services have been included in the price structure of medical examination and treatment services covered by social insurance. However, at specialized hospitals such as Thanh Hoa Dermatology Hospital, patients still have to pay when the medicine is not suitable and the insurance does not pay. For example, when a doctor prescribes liver function support medicine, the insurance does not pay for the wrong reason, only paying when the patient has a skin disease with chronic liver disease, acute liver disease... Therefore, doctors must advise patients to buy medicine themselves.
Associate Professor, Dr. Nguyen Lan Hieu - Director of Hanoi Medical University Hospital - although did not give an assessment of the above situation, he also said that in recent years, hospitals have been struggling in their operations, so there are still many shortcomings. Surely after the audit, they will be seriously rectified.
Ms. Tran Thi Trang - Director of the Health Insurance Department (Ministry of Health) - said that in the draft revised Law on Health Insurance, the Ministry of Health proposed many options to reduce the rate of out-of-pocket spending of people such as proposing a supplementary health insurance package, adding funding for medical examination and treatment from the health insurance fund, prioritizing the expansion of health insurance payment for screening of some diseases...
The scope of benefits for health insurance card holders is currently quite comprehensive with more than 18,000 medical technical services including high-tech and expensive services such as cardiovascular intervention, cardiovascular surgery, endoscopic surgery, MRI, CT, PET-CT... The list of health insurance drugs includes more than 1,000 active ingredients, modern biological products and hundreds of oriental medicines, medicines from medicinal herbs including expensive cardiovascular and cancer treatment drugs.
However, personal preventive services such as: medical examination, risk detection, diagnosis, early treatment, prevention of disease progression, chronic diseases, rehabilitation, home care, treatment of occupational diseases and work-related accidents are not covered by the health insurance fund. Some necessary services and products used in diagnosis and treatment for patients are not currently paid, affecting the rights of patients and not meeting professional requirements.
"The above shortcomings are one of the reasons why people's out-of-pocket spending on health care is high, accounting for 43%," Ms. Trang added.
Therefore, in the draft revised Law on Health Insurance, the Ministry of Health proposed many options to reduce the rate of out-of-pocket spending of people such as proposing a supplementary health insurance package, adding funding for medical examination and treatment from the health insurance fund, prioritizing the expansion of health insurance payment for screening of some diseases...
The Ministry of Health believes that expanding early diagnosis and treatment of some diseases will help increase people's financial security. In particular, people will be paid by the health insurance fund, contributing to the goal of reducing the current out-of-pocket spending rate of 43% to about 23% by 2025.
