Additional regulations on autonomy

According to Nguyen Thuy Anh, Chairwoman of the NA's Committee of Social Affairs, the NS deputies are very interested in the financial autonomy mechanism of public health care facilities, primarily, financial autonomy, public-private partnership, and service prices. Many of them said that the requirement is to solve the basic inadequacies and existing problems in medical treatment so that when the law is enacted, it must be down to earth, suitable, and feasible.

Specifically, finance is the revenue source of medical units to maintain regular operations of the unit, with savings to invest in development, especially to increase income for medical staff. Thereby, it shows that the price of medical services should approach the market price. Besides, there are also suggestions that it is needed to include the content on precise and sufficient calculations (depreciation, management costs, etc.); on payment of hospital fees on a case-by-case basis, or for each patient, including health services and health insurance, into the bill.

Regarding the price of medical treatment services (Article 108), Anh said that there was an opinion by a NA member that medical treatment is a special service. As a result, the authority to decide on medical treatment prices needs to follow the principle of precise and sufficient calculation. Accordingly, the State shall uniformly manage prices and promulgate medical treatment prices for public health facilities, stipulating the medical treatment price bracket for facilities that exercise autonomy and socialization. As for the price of medical treatment in a private facility, it must comply with the provisions of the Law on Prices, yet it is necessary to build a mechanism to control prices to protect the interests of patients.

However, through absorption and adjustment, the NA Standing Committee found that the revised law on prices is being submitted to the NA for feedback at this meeting and the principles and methods of pricing as well as decision-making authority on prices should be specified in specialized laws on prices to ensure inclusiveness and comprehensiveness. Therefore, only regulations on medical expenses and the management and control of medical expenses shall be made; at the same time, the factors used as a basis for calculating the price of medical services in Article 108 shall be stated. In addition, the state budget shall be supplemented with the regulation that the state budget should cover expenses not yet included in the medical service price for state-owned medical facilities (Clause 4, Article 106 of the draft law) and stipulate the roadmap for this compensation to be applied from January 1, 2027 (Clause 7, Article 118).

Chairwoman of the NA's Committee of Social Affairs - Nguyen Thuy Anh

Commenting on socialization in medical treatment (Article 107), deputy Nguyen Tri Thuc (Ho Chi Minh) and Trinh Xuan An (Dong Nai) said that, Point b, Clause 3, Article 107 shall stipulate "Investment in a public-private partnership to establish medical facilities, and build infrastructure", and proposed to add the phrase "procurement of medical equipment", because of the fact that recently, public-private investment cooperation establishments do not provide medical equipment to operate.

According to deputy Pham Khanh Phong Lan (HCMC), the provisions of the law have not completely solved the problem of socialization and hospital autonomy. The goal of socialization is to promote the capacity of medical staff, yet now we are struggling to reduce the payment price under health insurance to the lowest level. Therefore, it is necessary to have a formal review and evaluation of hospital autonomy to draw lessons, as a premise for clear and realistic regulations.

The State stipulates the price bracket for medical care services

Additionally, deputy Le Van Cuong (Thanh Hoa) suggested paying attention to payment in emergency cases (Article 59) to help reduce treatment costs. At the same time, he proposed to add content on disease management and hospital management to the subjects in Article 4, since currently there are about 50,000 trained health workers, but the hospital management force consists of only about 200 people.

Deputy Tran Khanh Thu (Thai Binh)

Therefore, deputy Tran Thi Thanh Huong said that the authority to decide the price of medical services needs to follow the principle that the State uniformly manages the price; the State shall promulgate the price of medical services for public health facilities, establish and stipulate a price bracket for medical care services for health facilities implementing the autonomy and socialization mechanism. As for the price of medical services in private facilities, it is necessary to comply with the provisions of the Law on Prices and to build a mechanism to control prices to protect the interests of patients in the best way./.