At the fourth session, the NA Standing Committee gave opinions on the reports on the management and use of the health insurance fund in 2020; the two-year implementation of the Resolution No 68/2013/QH13 on accelerating the implementation of health insurance policies and laws, towards universal health insurance (2019-2020).

Solid foundation towards universal health insurance

Chairwoman of the NA’s Committee for Social Affairs Nguyen Thuy Anh said Resolution No 68 stipulates that: “By 2015, at least 75 per cent of the total population join the health insurance system and by 2020 the figure is 80 per cent”, but such a target was already fulfilled in 2016, four years ahead of schedule. Of note, in 2020, the number of health insurance participants reached 87.97 million, equal to 90.85 per cent of the total population, 10.85 per cent higher than the set target.

However, NA Chairman Vuong Dinh Hue said the number of participants in household health insurance accounted for only 76.5 per cent of the total participants. Since 2020, the expansion of participants in certain localities has been affected. Some enterprises ceased operating or were dissolved, employees were unemployed, leading to the late payment or non-payment of premiums, etc. "Our target in the future is more challenging, thus, without breakthrough solutions it will be a real challenge," said Hue.

The NA Standing Committee acknowledged efforts of the Government, Ministry of Health, Vietnam Social Security (VSS) and relevant ministries and sectors for effective coordination in the implementation of health insurance policies in the 2019-2020 period, especially in carrying out solutions to realise targets and duties set in Resolution No 68 as well as in the management and use of the health insurance fund.

Study on new Resolution on health insurance development

Though the number of health insurance participants exceeded the target set by Resolution No 68, NA Vice Chairman Tran Thanh Man said certain shortcomings needed to be addressed and more efforts were needed to attract the other 10 per cent of the population, especially in the context of the COVID-19 pandemic.

According to Health Minister Nguyen Thanh Long, the majority of the current health insurance participants received State support. Enterprises, employers and employees that pay the health insurance premiums as required by law are in the formal sector, whereas not many labourers in the informal sector join health insurance. Some people only buy health insurance once they contract a disease. He noted that in 2020, due to the impacts of COVID-19, some businesses suspended or terminated employment contracts, making employees unable to join the health insurance system. Furthermore, some businesses ceased operation, making employees jobless, which increased non-payment of premiums to the health insurance fund compared to 2019.

VSS General Director Nguyen The Manh 

In response to questions raised by deputies, VSS Director General Nguyen The Manh said the health insurance-based medical examination and treatment fund has continuously expanded both in collection and expenditure. He said in 2020 alone, collection was higher than expenditure because social security agencies strengthened the management of and expanded the health insurance network, particularly household health insurance scheme (19.6 million participants in household health insurance scheme with total contributions up to nearly VND10 trillion).

“VSS worked closely with the health ministry and healthcare facilities to ensure optimisation of the medical examination and treatment fund in the context of limited and difficult collection. VSS has also linked data with nearly 13,000 healthcare facilities to facilitate the payment for medical examination and treatment fees,” said Manh.

NA Vice Chairman Tran Thanh Man said it was necessary to review the implementation of Resolution 68 to examine the comprehensive outcomes as well as shortcomings after eight years, which should focus on unachieved goals.

Under the new circumstance, the Government recommends the NA introduce a Resolution on the scientific, comprehensive, sustainable, effective and feasible development of health insurance in the future; soon proposes to the NA a draft Law on Health Insurance (amended), a draft Law on Medical Examination and Treatment (amended), to institutionalise the set targets to better care for people in line with the 12th Party Central Committee’s Resolution No 20/NQ-TW dated October 25, 2017 on the protection, care and improvement of people’s health in the new situation.

He added that due attention should be paid to the labourers’ participation in the health insurance scheme in COVID-19-hit localities and to improve the quality of grassroots medical and preventive healthcare facilities; and to the application of information technology to help better connect with the national database system.

The Government directs the health ministry and VSS to work closely together to thoroughly resolve any existing shortcomings in the payment of medical examination and treatment costs under health insurance, to have breakthrough solutions to maintain and increase the number of health insurance participants as well as to balance the health insurance fund whilst ensuring benefits of participants. The Government also instructs relevant ministries and sectors to strengthen inspection and examination of compliance with health insurance policies and law, strictly penalise any violations such as evasion of health insurance contributions or abuse of the health insurance fund.

NA Chairman Vuong Dinh Hue said social insurance and health insurance is a significant policy in the social security system, thus the implementation of policies and laws, and the management and use of health insurance fund are of great concern to people and voters. These issues will also be discussed at the second sitting of the 15th National Assembly./.