Building Supplementary Health Insurance Package to Enhance Resource Utilization Efficiency for Healthcare Services, Reducing Out-of-Pocket Expenses for Patients
24/10/2023 06:45 PM
The Supplementary Health Insurance Package is expected to contribute to covering healthcare expenses beyond the scope of mandatory health insurance, increasing the participation rate in universal health insurance coverage, and ensuring appropriate health care services and the financial capacity of the health insurance fund. This aims to create fairness and convenience in the provision and utilization of health services under health insurance.
Financial protection for participants
On October 10th, in Hanoi, the Ministry of Health, in collaboration with the Vietnam Medical Association, organized a Policy Symposium on the Supplementary Health Insurance in the amended Health Insurance Law project. In her opening remarks, Tran Thi Trang - Acting Director of the Health Insurance Department (Ministry of Health), stated that Resolution No. 20-NQ/TW dated October 25th, 2017, emphasized several important points in implementing health insurance policies. Firstly, health insurance is a pillar in the healthcare and social security policies, playing a vital role in universal healthcare coverage. Secondly, the Resolution requires strong financial innovation in healthcare.
Overview of the Policy Symposium on Supplementary Health Insurance in the revised Law on Health Insurance project
Thirdly, Resolution No. 20-NQ/TW places great importance on strengthening and developing primary healthcare services and ensuring access to healthcare services at the grassroots level. It also aims to expand and diversify healthcare through health insurance and primary healthcare facilities, increasing the proportion of healthcare utilization at the grassroots level. Fourthly, the health insurance reforms are closely linked to the reform of healthcare service pricing, aiming for accurate and sufficient cost accounting.
The Package aims to establish additional healthcare benefits beyond the coverage provided by mandatory health insurance, enhancing patient rights and reducing out-of-pocket expenses. This supplementary health insurance package is expected to be voluntary health insurance that individuals can choose to participate in, based on their existing enrollment in mandatory health insurance. The supplementary health insurance package will cover additional payment components, increased benefits according to patient needs, and additional services beyond what is currently provided by health insurance.
Tran Thi Trang - Acting Director of the Health Insurance Department (Ministry of Health), made a statement at the Symposium
Towards universal health insurance coverage
During the Symposium, participants listened to and discussed several topics, including the draft provisions on supplementary health insurance and proposals for supplementary health insurance benefits in the amended Health Insurance Law project, the management of health insurance services under the Insurance Business Law, and the current status of health insurance business management in Vietnam. The impact and requirements for ensuring fairness in accessing supplementary health insurance were also addressed, along with international experiences in implementing supplementary health insurance policies.
Duong Tuan Duc, Director of the Center for Medical Claim Review (Vietnam Social Security)
Duong Tuan Duc, Director of the Center for Medical Claim Review (Vietnam Social Security), shared insights on the provisions of supplementary health insurance in the draft amendments on the Health Insurance Law. He emphasized that Resolution No. 20-NQ/TW highlights the goal of diversifying health insurance packages. In the draft amendments on the Health Insurance Law, there is a need to clarify the two aspects of mandatory supplementary health insurance and voluntary supplementary health insurance. If it is voluntary supplementary health insurance (where individuals voluntarily participate based on their needs), we must follow the regulations of the Insurance Business Law. For mandatory supplementary health insurance, it should be incorporated into the Health Insurance Law.
Duc emphasized that the development of voluntary supplementary health insurance packages, as stated in the draft Health Insurance Law (amended), could potentially lead to the expansion of voluntary supplementary health insurance into commercial health insurance. Regarding the issue of information sharing and linkage between the social security agency and insurance companies, Duc mentioned two types of shared information: medical information and information on assessment and payment activities. In particular, sharing medical information involves the sharing of patient information, therefore, the protection of individuals' information privacy needs to be ensured.
Nguyen Thi Hong Chi, a representative from the Insurance Supervisory Authority (Ministry of Finance)
Chi stated that the provisions on supplementary health insurance in the draft Health Insurance Law (amended) need to be thoroughly studied and evaluated. It is important to ensure no overlap or contradiction with the Insurance Business Law.
Nguyen Khanh Phuong, Vice Director of the Health Strategy and Policy Institute (Ministry of Health)
Phuong mentioned that in order to achieve universal health insurance coverage, it is necessary to mobilize sufficient financial resources to meet the healthcare needs of the population. At the same time, it is important to reduce direct out-of-pocket expenses for healthcare and minimize financial barriers in accessing healthcare services for the population. This includes increasing the efficient utilization of resources for healthcare services.
She emphasized the participation in supplementary health insurance based on existing enrollment in social health insurance. Supplementary health insurance will help cover healthcare expenses beyond the scope of mandatory health insurance. It aims to increase the participation rate in universal health insurance coverage, ensure appropriate healthcare benefits according to the needs of individuals, and the financial capacity of the health insurance fund. This will create fairness and convenience in the provision and utilization of health services under health insurance, as well as improve the effectiveness of primary healthcare facilities. It also aims to enhance the efficiency of health insurance fund management, operation, and utilization./.
Work Injury and Occupational Disease
Medical (Health Insurance)
Certificate of coverage
VSS - ISSA Guidelines on Social Security