Ensuring benefits of health insurance participants

Health minister Nguyen Thanh Long said the Government, Ministry of Health and relevant ministries and sectors have almost completed the development of documents guiding the implementation of the Law on Health Insurance. Legal normative documents and guidelines have been fully, timely and regularly updated, revised and amended to suit reality, ensuring the benefits of health insurance enrollees, effectively managing and using the health insurance fund.  By the end of 2020, up to 87.96 million people, or 90.85 per cent of the total population, had joined the health insurance scheme, in which the Government subsidises premiums for more than 51 million people, or 58 percent.

Health minister Nguyen Thanh Long

A report by the National Assembly Committee for Social Affairs indicates that with 90.85 per cent of the total population joining the health insurance scheme by 2020, the figure was 10.85 per cent higher than the set target. However, the majority of insured people are covered by the State subsidised health insurance premiums. Furthermore, the number of enrollees in the household health insurance scheme only reached 76.5 per cent of the total. The report also shows that the expansion of health insurance enrollees has been affected by the COVID-19 pandemic since 2020.

In 2020, there were 167 million people using medical examination and treatment services, a decrease of 10 per cent compared to 2019, but total payment for health insurance-based medical examination and treatment dropped just 2 per cent.

“The decrease in healthcare expenditures covered by health insurance does not correspond to the reduction of people using medical services due to the prolonged inpatient treatment time which was a result of lockdowns enforced in the locality or medical facility. Patients couldn’t be transferred between levels or patients had to stay put even though they already recovered. Of note, due to COVID-19, people are hospitalised only when their illness becomes serious, making the treatment more complicated and costly,” said Long.

Regarding the management and use of the health insurance fund in 2020, Chairman of the Committee for Social Affairs Nguyen Thuy Anh said: “COVID-19 affected social-economic activities, many enterprises ceased operation, workers became jobless. Localities couldn’t afford health insurance premiums for certain people from the local budget as usual. All these hindered the collection of health insurance premiums.”

“The balance of the health insurance fund is still guaranteed because the Government, health ministry and concerned ministries and sectors have synchronously implemented many solutions to control spending from the fund. Nevertheless, certain challenges need to be addressed. The number of participants increased but most of them enjoy the State premium subsidisation payments, thus, total collection remains  low; the contribution  rate remains unchanged while the benefits of the health insurance scheme are expanded; some employers still avoid or delay the contribution of insurance premiums; while many people only buy health insurance when they get sick,” said Anh.

Illustrative image (internet)

Contribution rate needs to be adjusted

During the group discussion, health minister Long said health insurance has helped people and the disadvantaged get access to medical services. The health insurance fund has covered 100 per cent of services for insured people, which shows a preeminent policy of the State towards people’s healthcare. He added that the scope of benefits is expanded and insured people can get access to most quality services but the contribution rate remains low compared to many other countries.

“The healthcare sector considers health insurance one of social security issues of overriding importance to people, especially labourers, the impoverished and the vulnerable. At present, the health ministry is about to present to the Government and NA a revised Law on Health Insurance. Along with that, ensuring the sustainability and expanding the health insurance system are extremely significant. We apply the principle of contributions-benefits for risk-sharing, thus, increased health insurance enrollment will help better share risks with the disadvantaged. In the future, the revised Law on Health Insurance ensures that all people get access to health insurance-based medical services,” Long said. 

Deputy Dinh Ngoc Quy of Gia Lai Province said health insurance was a lifeline for people when they fall sick, especially in the context of rising healthcare costs. He said it was necessary to have a Resolution on increased investment for grassroots medical facilities, and to adjust the contribution rate.

Further assistance to certain groups of enrollees

Deputy Cao Thi Xuan of Thanh Hoa Province said, as a result of policy adjustments, more than 1,832 communes with over 2.1 million people in ethnic groups no longer receive the State subsidy for insurance premiums so it was really hard for them to continue their contributions. “To ensure the rights and benefits of people in ethnic communities in accessing health insurance-based medical examination and treatment services, in 2021, the Government continues paying premiums for these groups of enrollees,” said Xuan.

Deputy K’Nhieu of Long Dong Province also called for the Government to continue helping ethnic groups in communes that are no longer classified as in difficult or extremely difficult circumstances in line with the Prime Minister’s Decision No 861/QĐ-TTg on paying insurance premiums. Concurrently, relevant authorities should study measures to ensure that people in remote areas and in ethnic communities are covered by health insurance.

Deputy Trinh Thi Tu Anh of Lam Dong Province said the health insurance policy should pay more attention to older people, assist 100 per cent of health insurance premiums for older people from poor households, raise the assistance level from 75 to 100 per cent for the older people from near-poor households, and reduce the eligible age for social welfare benefits for older people from 80 to 75. She added that the Government should raise the rate of health insurance premium subsidies to 50 per cent for agricultural, forestry and fishery households with decent living standards to 50 per cent; and the rate of subsidies for pupils and students from 30 to 50 per cent./.