Improving the efficiency of specialized inspection by Vietnam Social Security (Illustrative image)

Visible advancement

If before 2016, at the time when the Vietnam's social insurance industry was not assigned to perform the function of paying personal income, the debt of social and health insurance accounts for a relatively high proportion compared to the total receivable according to the plan assigned by the Government, specifically: accounted for 4.86% (2014); 3.74% (in 2015), since 2016, the debt has gradually decreased, corresponding to 2.7% (2016), 2.2% (2017), 1.7% (2018) and 1.6% (in 2019). Particularly in 2020, the debt ratio accounted for 3.35% of total receivables, mainly due to the Covid-19 pandemic putting a negative impact on production and business activities, causing businesses to face difficulties, leading to increased social insurance debt.

During the period 2016-2020, through inspection and examination, the Vietnam's social security industry discovered and requested agencies, organizations and units to pay 664.1 billion VND of payment for social, health and unemployment insurance premiums with 240,245 people participating and enjoying social security benefits; has withdrawn the social insurance fund of 50.4 billion dong for enjoying the social insurance benefits in contravention of regulations; recovered the health insurance fund of 828.4 billion dong in contravention of regulations; has not yet accepted payment for medical treatment under health insurance of 169.9 billion VND.

In particular, in order to increase the efficiency of inspection and examination, Vietnam Social Security (VSS) has actively promoted the implementation of database and information technology application, in order to reduce the average working time compared to traditional inspection and testing methods. Specifically, for employers alone, 22.8% of the working time of the inspection team and 49.6% of the working time of the inspected subjects were reduced.

It can be said that the visible changes in the collection and reduction of outstanding debts, especially in minimizing the abuse and profiteering of the social and health insurance fund over the past time, show that the regulation of assigning the function of personal information to pay social, health and unemployment insurance premiums for the social security agency are completely appropriate, brings high efficiency and contributes to protecting the legitimate rights and interests of employees; it is also necessary to deter, prevent violations of payment of social, health and unemployment insurance premiums.

Illustrative image (internet)

Laws need amendments to strengthen the prevention of abuse and profiteering of social and health insurance funds

Over the past time, the implementation of policies on social, health and unemployment insurance has achieved various important achievements. However, the abuse and exploitation of social and health insurance funds remain complicated with an increasing trend. Violations caused by subjective consciousness are increasingly sophisticated and diverse.

In the field of social insurance, there has been a situation of buying and selling social insurance books through social networks in the form of authorization; purchasing, selling, and false issuance of Certificates of leave to enjoy social insurance benefits; recruiting pregnant women, registering to pay social insurance premiums without actually working at the unit to benefit from social insurance through settlement of maternity benefits of giving birth.

In the field of health insurance, numerous cases have been recorded of using health insurance cards in contravention of regulations, colluding with medical staff to falsify records to benefit the health insurance fund; making medical records without patients; prescribing an increase in quantity, drugs, medical supplies, technical services, hospital bed costs without any patient using them; not guaranteeing the interests of patients with health insurance cards, collecting money from patients for the costs of drugs and medical supplies already included in the price structure of beds, medical treatment, and technical services.

However, as the function of specialized inspection has not been assigned to pay and enjoy social and health insurance benefits, social security agencies can only refuse to pay or request a refund to the social and health insurance fund and request competent authorities for handling when they detect violations or signs of profiteering from the social and health insurance fund; there is no sanction for handling and recovering wrongly spent amounts, so it is not strong enough to deter and prevent violations in time. Meanwhile, as inspectors of state management agencies in charge of social and health insurance have to focus on inspection and examination tasks according to specialized functions, the inspection of the implementation of social and health insurance policies over the past time was reported to be of a moderate amount, leading to ineffective prevention of violations as expected.

In this field, the VSS owns numerous advantages thanks to qualified human resources, facilities, centralized data system, synchronous software system from participation, detailed regime settlement to each individual, therefore, the collection of information, documents and evidence in the inspection is timely anywhere, anytime. Not to mention, if the function of specialized inspection in payment and enjoyment of social and health insurance benefits is assigned to the VSS, it will help increase the efficiency of specialized inspection and strengthen the capacity to manage and control expenditures and outputs of funds, contributing to prevent and minimize acts of abuse and profiteering, towards ensuring the balance of social and health insurance funds.

From the perspective of state management, in addition to the implementation of specialized inspection on payment of social, health and unemployment insurance, in case the VSS is assigned to the function of inspecting the payment and enjoying the social and health insurance benefits, it will contribute to effectively controlling collection and spending within the scope of assigned tasks, ensuring accurate, sufficient and timely benefits of participants and beneficiaries of welfare policies and meeting requirements and tasks in the new situation./.