NA Chairman Tran Thanh Man delivers remarks at the working session. Photo Lam Hien

Thorough and comprehensive impact assessment

Presenting the proposal for the amendment and supplementation of certain provisions of the Health Insurance Law, Minister of Health Dao Hong Lan stated that the draft law amends and supplements 40 provisions regarding: participants in health insurance, contribution responsibilities, benefits, scope of coverage, health insurance examination and treatment, fund management, and some technical regulations. The subjects of application are domestic organizations and individuals as well as foreign organizations and individuals in Vietnam related to health insurance.

The draft Law fully reflects the four policy groups approved by the Government, including: adjusting the subjects participating in health insurance in accordance with relevant legal regulations; adjusting the scope of health insurance benefits in line with contribution rates, balancing the health insurance fund, and health care requirements at each stage; adjusting health insurance regulations according to the technical expertise level of examination and treatment, and promoting the role of grassroots health care in primary health care and health insurance examination and treatment; effectively allocating and using the health insurance fund.

Presenting the preliminary verification report of the draft Law, Chairwoman of the NA Committee of Social Affairs Nguyen Thuy Anh stated that the Standing Committee of the NA Social Committee basically agrees with the scope of amendments and supplements as proposed; the content of the draft Law is fundamentally consistent with the purpose and requirements of law construction; the amended provisions closely adhere to the four policies approved in the proposal for law construction.

However, the draft Law still has some adjustments, such as: some contents have been omitted, such as policies on supplementary health insurance; some policies have been expanded, such as expanding the subjects participating in mandatory health insurance; and regulations on payment of health insurance examination and treatment costs.

The Standing Committee basically agrees with the draft Law's addition of subjects participating in health insurance in accordance with relevant legal regulations such as the Law on Social Insurance, the Civil Defense Law...

However, she emphasized that the Standing Committee requests a thorough and comprehensive impact assessment of the expansion of groups of subjects covered by the State budget, supported by the state budget, and those covered by employers and employees.

Ensuring feasibility, universality, and fairness

Commenting on the draft Law, NA Chairman Tran Thanh Man emphasized that health insurance is a financial mechanism for healthcare, as well as a social security policy, aiming for fairness, efficiency, and development in public health care.

The major challenge now is to better ensure the benefits of health insurance participants, reduce personal spending on medical services, and improve the efficiency of primary healthcare activities. The current health insurance coverage rate is 93% of the population; however, the personal spending rate of medical service users remains quite high, nearly 45%, while the target is below 30%.

Highlighting this reality, the NA Chairman requested that the amendments and supplements to the Health Insurance Law must closely follow the Party’s Resolutions and relevant legal regulations; focus on amending and supplementing truly necessary, urgent, and clear contents with high consensus, ensuring synchroniastion and consistency with the provisions of the 2023 Law on Medical Examination and Treatment, addressing the inadequacies and obstacles summarized from practice, and thoroughly researched to ensure feasibility.

A view of the working session. Photo Lam Hien

Regarding the expansion of participants in health insurance, NA Chairman Man  affirmed that it is appropriate. However, it is necessary to carefully review to ensure fairness, not to miss any subjects, and not to let anyone lose or reduce their benefits in participating in health insurance compared to the present. This is an issue that needs careful calculation and consideration, especially paying attention to people with meritorious services, ethnic minorities, people living in difficult areas, and the elderly.

Recalling the severe losses caused by Typhoon Yagi, he emphasised that “Many people are in great difficulty, without homes, having to stay in temporary shelters in public facilities. Therefore, taking care of medical examination and treatment for the people is a regular task, especially in difficult areas.”

He stated that ensuring the benefits of health insurance participants and expanding the benefits of health insurance participants is a humane regulation. However, it needs to be considered and weighed to ensure feasibility, universality, fairness, and the ability to balance the Health Insurance Fund in line with socio-economic conditions.

 VSS Director General Nguyen The Manh clarifies points raised by some delegates

Clarifying some issues raised by the delegates, Director General of Vietnam Social Security (VSS) Nguyen The Manh stated that in recent years, VSS has closely coordinated with relevant agencies to amend the Health Insurance Law and agreed to propose amendments to four very urgent and necessary policies to address obstacles in the implementation of health insurance policies.

“When amending, it ensures fairness and transparency; ensures the rights of patients participating in health insurance; ensures the most convenient and simplest administrative procedures for health insurance participants,” said the VSS Director General.

According to Director General Manh, the coverage of health insurance has been increasing over the years and is approaching universal health insurance; on average, there are about 180 million health insurance medical examination and treatment visits each year, equivalent to about 50 million people receiving medical examination and treatment annually. Thus, ensuring full payment and administrative procedure reform for these 180 million visits is an effort of both the VSS and the health sector, especially in ensuring both benefits and balancing the health insurance fund.

“The issues in payment for medical examination and treatment costs have been closely coordinated by the Ministry of Health and the VSS. In 2024, nearly 10 trillion VND of issues from 2016 to now have been resolved,” he said.

Additionally, the VSS Director General stated that currently, health insurance medical examination and treatment data has been fully stored and uploaded to the system, helping to manage and prevent health insurance fraud.

Furthermore, he added, once the Law is passed by the NA, it will help increase the number of participants by about 1.8 million people, among the 7% who have not yet participated in health insurance.

Concluding the discussion, Vice NA Chairwoman Nguyen Thi Thanh requested the Government to continue researching and completing the project dossier to submit to the NA at the eighth session as per regulations.

In this context, she said, it is necessary to evaluate the impact on the balance of the Health Insurance Fund when expanding the coverage to include more participants, broadening the scope of benefits for those receiving medical examination and treatment under health insurance, and the benefit rates for certain groups of health insurance participants to ensure the feasibility and persuasiveness of the chosen plan./.