The necessity of amending the Law on Health Insurance
At the workshop, Deputy Minister of Health Tran Van Thuan stated that the implementation of the health insurance policy has achieved many positive results, including coverage, benefits for participants, and medical service quality. However, during the implementation process, it was found that the current Law on Health Insurance still has some existing flaws and limitations due to the internal regulations of the law and new factors that have not had sufficient legal basis to resolve; even some guiding documents are still lacking specifics and inconsistent with other legal documents.
Therefore, since the end of 2018, the Ministry of Health, together with the Ministry of Finance, the VSS and related ministries and agencies, has researched and developed amendments to the Law on Health Insurance. Accordingly, this amendment is expected to adjust 5 major policy groups, including: expanding the participation group; expanding the scope of benefits for health insurance participants; diversifying types of medical service providers, strengthening primary healthcare at the grassroots level; ensuring transparency, publicity, efficiency, and accountability of service providers and the VSS in the appraisal activities; improving the management and use efficiency of the health insurance fund.

Deputy Minister of Health Tran Van Thuan delivered a statement at the workshop

Affirming the necessity of amending the Law on Health Insurance, VSS Deputy Director General Nguyen Duc Hoa emphasized: "The reality shows that the Law on Health Insurance has played an important role in creating policy mechanisms to achieve a coverage rate of over 91%. Therefore, the draft Law on Health Insurance (amended) must be based on urgent issues in reality to be better implemented. At the same time, it is also necessary to clarify whether this amendment will revise the entire law or just make additions and revisions."

In particular, according to Hoa, the concepts defined in the Law on Health Insurance also need to be clarified. Firstly, the concept of health insurance appraisal work - according to the functions, tasks, and reality in Vietnam, need to be clearly defined in the law on the responsibilities of the VSS in implementing this "appraisal" task, that is to control the health insurance medical expenses based on checking, controlling, and cross-checking payment requests of medical service providers with legal regulations to determine payment expenses and settlement according to the health insurance regime.

Clear identification of priority issues.

Emphasizing the need to clarify the objectives of amending the Law on Health Insurance, Ms. Nguyen Thi Kim Phuong - an expert in the field of health finance and health insurance (World Health Organization - WHO Vietnam Office) suggested that the draft law should clarify certain concepts and unify their names to avoid misunderstandings and difficulties in the implementation process.

VSS Deputy Director General Nguyen Duc Hoa delivered a speech

Stating that "if the Law on Health Insurance is not completely amended, there will be many obstacles.", Ms. Tong Thi Song Huong, Secretary General of the Vietnam Medical Association, also suggested that the draft Law on Health Insurance needs to clarify concepts such as initial health insurance medical examination, initial health insurance coverage, health insurance for families, emergency medical treatment, and what is meant by "exceeding professional capacity."

Regarding the expansion of health insurance benefits, Ms. Phuong believes that when developing a benefit package with a list of health services to be reimbursed, payment levels should be accompanied by payment conditions and limits.

Delegates contributed ideas at the workshop

Sharing at the workshop, Mr. Nguyen Hoang Mai, Vice Chairman of the Social Affairs Committee of the National Assembly, proposed that the drafting committee should study and clearly define the sources of funding for preventive healthcare and health insurance payments for preventive diseases to avoid overlap. He also suggested expanding health insurance payment services to a reasonable level and defining an appropriate roadmap. According to Mr. Mai, this issue relates to three paths that the healthcare sector must follow: the path of accurate pricing of healthcare services; the path of increasing health insurance premiums; and the path of increasing health insurance benefits for participants./.