Addressing the meeting, Deputy Minister of Health Pham Le Tuan said the Ministry of Health coordinated with the Ministry of Finance to issue Circular 37/2015/TTLT-BYT-BTC, dated October 29, 2015, regulating prices of insurance-covered medical services and Circular 02, dated March 15, 2017, regulating prices of services not covered by health insurance. The current price schedule cover two of the four factors in healthcare costs, which are direct costs and salary of medical workers, but do not include management costs and asset depreciation.

The Government ordered the health sector to increase covered medical services prices step by step and in a prudent manner, and not simultaneously carry out the work in all provinces and cities. As a result, the prices have been adjusted while the country has still successfully controlled inflation, ensured macro-economic stability and promoted efforts towards universal health insurance coverage. So far, new prices of medical services nationwide that include direct costs and salary of medical workers have been applied, thus ensuring the equality in paying medical costs between persons with health insurance cards and those without them.

According to Deputy Minister Tuan, as various circumstances have appeared after Circular 37 was issued, the Health Ministry discussed with the Vietnam Social Security (VSS) and decided to promulgate three guidance documents, namely Official dispatches 824/BYT-KH-TC dated February 16, 2016; 1044/BYT-KH-TC dated February 29, 2016; and 7117/BYT-KH-TC dated September 27, 2016.

Basing on proposals submitted by hospitals and localities, the Ministry of Health, the Ministry of Finance and the VSS have held many meetings to discuss amendments and supplements to Circular 37. The amendments were approved by Deputy Prime Minister Vuong Dinh Hue and are set to be carried out in two phases.

In the first phase, scheduled for completion before May 15, 2018, relevant sides instruct the insurance reimbursement for some services (checks-up, days of using patient beds, X-ray, CT scanning, MRI scanning, normal ultrasound scanning, and otorhinolaryngological endoscopy) at medical establishments which have the number of services higher than their given quotas. They will also review the number and prices of services with inappropriate prices, firstly check-up prices, days of using patient beds and 39 services like X-ray, CT, MRI, ultrasound scanning, otorhinolaryngological endoscopy, traditional medicine, and testing.

In the second phase, the Ministry of Health in collaboration with the Ministry of Finance and the VSS to learn from some countries’ experience to re-organise existing services and set up quotas and prices of 2,000 – 3,000 services.

Tuan said after the meeting, the Ministry of Health will continue fine-tuning to issue the new circular this May as ordered by the Government. The debatable contents will continue to be discussed to be added later. In the short term, the circular will only supplement the surveyed services whose prices need to be adjusted. However, some of the remaining services and prices have not been reviewed, as requested by the VSS and relevant sides, will be considered and have their prices adjusted later.

Therefore, the draft circular will summarise the content of previous guidance documents (824/BYT-KH-TC dated February 16, 2016, 1044/BYT-KH-TC dated February 29, 2016, and 7117/BYT-KH-TC dated September 27, 2016). It will adjust check-up prices, days of using patient beds and 39 technical services while instructing the insurance payments for some cases with costs surpassing the covered maximum costs.

Healthcare prices are currently calculated basing on the basic wage of 1.15 million VND. According to the draft circular, check-up prices will be reduced in hospitals of all levels compared to Circular 37, which took effect on July 1, 2016. They will be cut down from 39,000 VND to 35,000 VND per visit at special-level and level-1 hospitals, from 35,000 VND to 29,000 VND at level-2 hospitals, from 31,000 VND to 23,000 VND at level-3 hospitals, and from 29,000 VND to 20,000 VND at level-4 hospitals. However, the average number of patient visits per check-up room each day with these draft prices will be raised from 45 to 55 at level-2 hospitals, from 35-37 to 55 at level-3 and 4 hospitals, and 30 at communal clinics.

In the draft circular revising Circular 37, the Ministry of Health plans to raise prices of medical services at special and level-1 hospitals and slightly reduce prices at hospitals of levels 2, 3 and 4. At special-level hospitals, the price of a patient bed will be adjusted from 677,100 VND to 751,000 VND per day in the intensive care unit or the organ and stem cell transplant units, and from 362,800 VND to 425,100 VND per day in the critical care and clinical toxicology units. At level-1 hospitals, the prices will be increased from 632,200 VND to 710,000 VND per day in the intensive care unit or the organ and stem cell transplant units, and from 335,900 VND to 404,000 VND per day in the critical care and clinical toxicology units. Prices of patient beds at communal clinics are also set to hike from 54,000 VND to 86,000 VND.

Earlier, basing on its own survey, the VSS had proposed prices of patient beds at hospitals of all levels be equivalent to 70 percent of those stipulated in Circular 37.

The Ministry of Health plans to boost prices of technical services like X-ray, CT, MRI, ultrasound scanning and otorhinolaryngological endoscopy to be equivalent to 120 percent of the prices set in Circular 37.

At the meeting, participants discussed the contents that need to be amended, including the direct costs included in check-up prices, the specification of the times of check-ups and payment of check-up costs in certain cases, the adjustment of check-up prices according to hospital levels, and the method for calculating the length of hospital stay.

International Cooperation Department