Deputy Prime Minister Vu Duc Dam chairs the dialogue (Source: VSS)

Encouraging private health development

To date, the VSS has signed contracts on medical check-ups and treatment using health insurance with more than 600 private health clinics. The agency paid over 6.6 trillion VND (290 million USD) for 17 million health insurance card holders in 2016. The respective figures for 2017 were over 8.6 trillion VND (377.5 million USD).

Speaking at the event, Deputy Prime Minister Vu Duc Dam said that the Party and State’s policy is to encourage the private health sector to develop and follow the target of protecting and caring for people’s health.

In spite of numerous strategic policies, the proportions of patient beds and health insurance payment for the private health sector remain low, Dam said. He called for a straightforward and constructive dialogue in order to tackle shortcomings and weaknesses.

Participants at the dialogue discussed the negotiation and signing of health insurance payment contracts with social insurance offices; the payment of health insurance on holidays, Saturdays and Sundays; certificate of professional practice; policies to encourage investment in the private health sector; and support for check-up and treatment payment for poor people.

In response to the Vietnam Private Hospital Association’s idea saying that the health insurance check-up and treatment contract drafted by the VSS does not match the Health Ministry’s Circular No.41/2011/TT-BYT on granting the certificate of professional practice to health workers and the certificate of operation to health clinics, VSS Deputy General Director Pham Luong Son affirmed that the VSS abides by the contract form stipulated in Circular No.41.

According to the circular, the parties involved must negotiate with each other to supplement contract clauses that conform to each locality’s situation and each health clinic’s characteristic, Son said. He confirmed that the VSS always encourages private health clinics to allow medical check-ups and treatment using health insurance to offer more choices for people. Deputy Prime Minister Dam suggested revising the contract content in which the parties commit to following contract clauses and law regulations on check-ups and treatment using health insurance.

Each party has the right to temporarily stop the contract and inform authorised agencies to address violations (if any) in line with law regulations on check-ups and treatment using health insurance, instead of the clause stipulating that only the social insurance agency has the right to end the contract unilaterally, Dam stressed. VSS Deputy General Director Pham Luong Son pledged to soon issue a document guiding and requesting local social insurance agencies to follow the new regulation.

An overview of the dialogue (Source: VSS)

No discrimination between private and public hospitals

Regarding regulations on applying professional and technical levels for private medical clinics to sign health insurance contracts for medical examination and treatment, the Ministry of Health has yet mentioned private hospitals which were classified and ranked earlier. Deputy Health Minister Pham Le Tuan said there will be a document clarifying the transition time for these hospitals while they are waiting for technical classification according to the ministry’s new decision.

As regards recommendations of the Vietnam Private Hospital Association about certificates of medical examination and treatment practice, Deputy Prime Minister Vu Duc Dam and Chairwoman of Vietnam General Medical Association Nguyen Thi Xuyen said doctors in all countries are licensed with certificates of professional practice and there are legal regulations in the field. The certification of professional practice is needed as it relates to the patients’ rights. If the procedure to obtain this certificate is complicated, it should be adjusted.

About the report of the association of private hospitals that there is discrimination between private and public hospitals when paying health insurance for medical check-ups and treatment, Pham Luong Son said this is not the policy of the Vietnam Social Security. Any agencies under the Vietnam Social Security refuse to pay these techniques will be handled according to regulations, he affirmed.

As regards the report of private medical clinics on not being paid medical examination and treatment using health insurance on holidays, Saturdays and Sundays, Son said this payment is conducted in line with regulations stipulated in Circular 16/2015/TTLT-BYT-BTC. Deputy Health Minister Pham Le Tuan said the ministry has promulgated Circular 16/2015/TTLT-BYT-BTC relating to this matter and asking health facilities to arrange sufficient human resources. 

Deputy Prime Minister Vu Duc Dam asked the Ministry of Health and the Ministry of Finance to revise Circular 16/2015/TTLT-BYT-BTC on health check-ups and treatment on holidays and weekends towards facilitating both health facilities and patients to help hospitals proactively arrange medical staffs. He suggested medical facilities inform health insurance agencies about extra time for medical examination and treatment without waiting for approval because all health facilities have to participate in the health insurance assessment information system of the Vietnam Social Security to ensure effective cost monitoring.

Enhancing application of information technology in medical examination and treatment, and health insurance payment

Head of the department for implementing health insurance policy under the Vietnam Social Security Le Van Phuc said the reason for slow payment of health insurance in medical examination and treatment is that it takes a long time for health insurance assessment party and private health facilities to reach consensus on the assessment outcomes.

Pham Luong Son said the Vietnam Social Security has an information technology system that always updates data on health insurance payment. Localities with slow payment will be strictly punished.

Chairman of the Private Hospital Association Nguyen Van De admitted that as some medical establishments were slow in submitting reports, VSS agencies did not have basis for payment. The Private Hospital Association has issued a document requesting its members to seriously comply with regulations.

Deputy PM Vu Duc Dam said the update of data to serve payment of health insurance via the VSS’s health insurance eligibility verification portal must be practiced by all provincial social security agencies and private medical establishments. In the long term, private health care services will develop strongly and play an increasingly important role, so relevant sides must strictly comply with regulations right from the beginning so as to boost their private sector’s development in the future. The association has to clarify typical wrongdoings in order to immediately rectify its members.

The Deputy PM also asked the Private Hospital Association to take part in training courses and help its members to thoroughly grasp and seriously comply with regulations on transferring data to the health insurance eligibility verification system of the VSS, thus carrying out their payment procedures in a timely manner and actively updating themselves on the status of their balance sheet.

Chairwoman of the Vietnam Medical Association Prof. Dr Nguyen Thi Xuyen said her association has sent four survey teams to four provinces to inspect medicine procurement of health care establishments. Results show that private health care establishments in these localities purchased medicine and medical supplies at prices not higher than the result of centralised bidding for medicine procurement at provincial health departments. However, the problem is that the centralised bidding in provinces was not conducted in accordance with regulations.

Nguyen Ta Tinh, Director of the VSS’s Department for Pharmaceuticals and Medical Supplies, pointed out some wrongdoings in the bidding for medicine procurement and price differences of medical supplies. For example, the common bid price for the same type of Indian stent used for coronary artery disease patients was 37 million VND (over 1,600 USD), but it was 57 million VND (nearly 2,500 USD) in Thanh Hoa province.

“In this case, the VSS suggests payment at an appropriate level, and the price difference should wait for competent agencies to be handled,” he said. Nguyen Ta Tinh, Director of the VSS’s Department for Pharmaceuticals and Medical Supplies, speaks at the dialogue.

Enhancing dialogue, dealing with information in timely manner

Listening to opinions, Deputy PM Vu Duc Dam emphasised that it is of critical importance to ensure the balance and sustainability of the health insurance fund when medical expenses are growing and health insurance premiums remain low but unable to be increased in the coming time. If all provinces overspend the health insurance fund, it will be hard for the fund’s balance to be kept. VSS agencies need to seek measures to address the problem of ineligible medical practices and supplies in the list of those covered by health insurance in not only private health care establishments but also public hospitals. They also have to strictly deal with irregularities in the centralised bidding for medicine procurement in localities.

He said the ration of patients examined and ultrasound scans conducted has its own reason. If a doctor examines too many patients and carries out too many ultrasound scans in a certain period of time, quality should be brought into question. Meanwhile, the granting of medical practice certificates was stipulated in law and all countries do the same, so Vietnam must comply with that instead of allowing persons without practice certificates to give check-ups or treatment to people.

The Deputy PM asked the Ministry of Health and the VSS to review regulations, adding that they can make adjustments to help health care establishments play an active role in their operations while still ensuring examination and treatment quality. The granting of medical practice certificates must adhere to regulations, but agencies with cumbersome procedures should also be rectified.

Acknowledging the straightforward and detailed opinions at the dialogue, Deputy PM Dam asked the Ministry of Health, the VSS and private medical establishments to step up dialogue and information update to immediately resolve any problems arising. The Party and State supports the development of private health care, especially the segment that applies high techniques.

International Cooperation Department