Health insurance coverage be expanded
04/11/2024 08:53 AM
Accordingg to USA’s commonwealth fund, an estimated 26 million Americans, or 8 percent of the U.S. population, lacked health insurance in 2023.1 While the United States still lags countries that have universal coverage, today’s uninsured rate represents a sea change from the years prior to the Affordable Care Act (ACA), when twice as many people — 49 million, or 16 percent of the population — lacked health coverage.2 This was also a time when people with preexisting conditions were out of luck when they sought to buy insurance on their own, when millions of young adults became uninsured when they graduated from high school or college, and when insurance companies in the individual market charged young women much higher premiums than young men and rarely covered maternity care.
In Vietnam, it is important to review and supplement object group participating health insurance.
The draft Law proposes amendments and additions to 40 provisions covering health insurance participants, contribution obligations, benefits, coverage, organisation of health insurance-based medical examination and treatment, fund management, and some technical provisions.
Commenting on the draft Law, deputy Vo Thi Minh Sinh of the Nghe An provincial delegation expressed concern about the health insurance contributions paid by employers and employees. This is one of the key changes in the draft Law. “Previously, the contribution rate was 4.5% of the minimum wage, but now it is 6%. This is considered reasonable and ensures the balance of the Health Insurance Fund without placing too much burden on employees and employers. The contribution ratio is also clearly defined: 2/3 for employers and 1/3 for employees,” Delegate Minh Sinh stated. She also expressed strong support for the contribution obligations and the bases for contribution.
While recognising the positive impacts of increasing the contribution rate from 4.5% to 6% – generating more revenue for the Health Insurance Fund, expanding coverage, improving healthcare services, and encouraging participation – deputy Vo Thi Minh Sinh also acknowledged the potential financial burden on workers and businesses. The increased contribution rate could further strain workers and businesses, especially low-income earners and small and medium-sized enterprises, especially in a challenging economic environment. Additionally, there are concerns about delayed or unpaid contributions by some businesses and workers.
To mitigate these negative impacts, deputy Vo Thi Minh Sinh proposed implementing support policies for low-income workers, particularly those in rural and mountainous areas, and those residing in remote, disadvantaged regions. Additionally, there should be incentives to encourage businesses to fully contribute to health insurance for their employees. Furthermore, she emphasized the need to strengthen management of the Health Insurance Fund, including intensified inspection and enforcement against those avoiding health insurance contributions. To ensure effective implementation of this policy, it is crucial to raise public awareness regarding its significance.
Regarding the subjects of health insurance participation (Article 12), deputy Huynh Thi Anh Suong of the Quang Ngai provincial delegation agreed with the approach of broadening participation to expand health insurance coverage. Accordingly, the draft Law has proposed adding several groups, including: Workers with fixed-term employment contracts lasting at least one month (currently it is three months); Foreign workers employed in Vietnam with fixed-term employment contracts lasting at least 12 months; Owners of businesses with business registrations according to social insurance law; and other groups mentioned in the draft Law.
According to the Government report on the management and use of the Health Insurance Fund in 2023, as of December 31, 2023, the number of health insurance participants reached 93,628 million people, achieving a coverage rate of approximately 93.35% of the population. Deputy Huynh Thi Anh Suong expressed concern about the remaining population, calling for a review to categorise them and add provisions regarding health insurance participation to increase coverage and achieve universal health insurance.
Regarding the rights and responsibilities of the health insurance bodies (as defined in Articles 40 and 41), the draft Law proposes amending and adding Clause 8 of Article 41 in Clause 29 as follows: "8. Inspect the implementation of health insurance examination and treatment contracts; conduct health insurance claim review."
National Assembly deputies observed that the draft Law has removed the provision stating that the health insurance bodies are responsible for "inspecting" the implementation of health insurance-based medical examination and treatment (in the current law). Deputy Tran Van Tuan of the Bac Giang provincial delegation believes this amendment is reasonable as the responsibility for inspecting medical examination and treatment services is not aligned with the health insurance bodies’ functions and duties. However, he proposed adding a provision requiring the health insurance body to "inspect the use of the Health Insurance Examination and Treatment Fund" and rephrasing Clause 8 as follows: "8. Inspect the implementation of health insurance-based medical examination and treatment contracts, the use of the Health Insurance Examination and Treatment Fund; conduct health insurance claim reviews."
Therefore, the Social Insurance offices should conduct inspections on the use of the Health Insurance Examination and Treatment Fund and health insurance-based medical examination and treatment contracts. This aims to enhance the control and efficient use of the fund, ensuring it benefits the right people for the intended purpose. It also helps prevent waste, abuse, and exploitation of the Health Insurance Fund, while increasing the responsibility of the fund management agency and ensuring compliance with the law.
Additionally, deputy Tran Van Tuan suggested adding a provision outlining the responsibility of healthcare facilities in Article 43 of the draft Law as follows: "Healthcare facilities are responsible for ensuring a full and timely supply of medications and medical supplies for health insurance cardholders within the scope of their coverage."
During the afternoon session, the National Assembly deputies also worked in groups and discussed the draft Data Law, generally agreeing on its necessity. They stated that this draft law is crucial for national digital transformation, facilitating state management, utilizing data for socio-economic development, and ensuring the protection of personal and non-personal data to guarantee security and information safety. However, some opinions suggested further reviewing the scope of regulation to avoid overlap and duplication with related laws, ensuring alignment with the development of the digital economy.
PV
Sickness
Work Injury and Occupational Disease
Survivor’s
Old-age
Maternity
Unemployment
Medical (Health Insurance)
Certificate of coverage
VSS - ISSA Guidelines on Social Security