Deputy Prime Minister Tran Hong Ha emphasized the need to pay more attention to grassroots healthcare in allocating the budget for health insurance coverage. It is essential to effectively carry out tasks related to primary healthcare, management of certain chronic diseases, preventive healthcare, and to prevent unnecessary burden on higher-level healthcare facilities by the public 

The Deputy Prime Minister requested that ministries and agencies engage in frank discussions, clarify the points of disagreement, and set the goal of finalizing and issuing the revised decree amending and supplementing certain provisions of Decree No. 146/2018/ND-CP. He also emphasized the need for the revised decree to take effect immediately in order to ensure the rights and benefits of patients.

Deputy Minister of Health Tran Van Thuan presented the specific proposals for amending and supplementing certain provisions of Decree No. 146/2018/ND-CP 

During the meeting, Deputy Minister of Health Tran Van Thuan presented the specific proposals for amending and supplementing certain provisions of Decree No. 146/2018/ND-CP, the focus was on several key areas: Payment principles and settlement of medical examination and treatment costs covered by health insurance, the groups eligible for subsidized health insurance premiums, and the co-payment ratio for certain beneficiary groups.

In this regard, representatives from ministries and associations agreed to replace the regulation on health insurance fund payment that should not exceed the total payment for medical examination and treatment costs at healthcare facilities with a budget allocation plan, includes flexible adjustment mechanisms based on the actual healthcare services provided by the facilities.

Nguyễn Đức Hoà, Deputy General Director of VSS, provided feedback on the payment and settlement mechanisms for medical examination and treatment costs under health insurance 

The leaders of VSS and representatives from the Ministry of Finance proposed improving regulations on the establishment, approval, allocation, and adjustment of the budget for health insurance coverage for healthcare facilities. It is suggested that the budget is allocated based on the principle of the annual state budget allocation, ensuring that the total annual payment does not exceed the prescribed limit but allowing for flexible adjustments to address the issue of surplus or insufficient funds in some facilities, but the Health Insurance Fund remain surplus.

Agreeing with this viewpoint, Deputy Chairman of the People's Committee of Ho Chi Minh City, Duong Anh Duc, emphasized the need for the decree to specify the application of flexible and adaptable payment and settlement mechanisms for medical examination and treatment costs under health insurance, without compromising patients' rights and benefits. He also stressed the importance of controlling and preventing abuses and profiteering in the use of medications and medical equipment that are not appropriate for the prescribed treatment protocols.

Deputy Prime Minister Tran Hong Ha emphasized that the draft decree must adhere to the principle of health insurance, which is risk-sharing and focusing healthcare resources on the unfortunate and vulnerable individuals 

In his closing speech, Deputy Prime Minister Tran Hong Ha requested the Ministry of Health to consider and improve the regulations on the payment and settlement of medical examination and treatment costs under health insurance, including the procedural sequence, authority in constructing, approving, allocating, and adjusting the budget for health insurance coverage at healthcare facilities. He also emphasized the need to increase the total healthcare expenditure for the following year compared to the previous year, ensuring the implementation of healthcare policy objectives according to the law.

"The draft decree must adhere to the principle of health insurance, which is risk-sharing and focusing healthcare resources on the unfortunate and vulnerable individuals. In  cases  the total health insurance expenditure exceeds the total revenue, the alternative budget plan provided by the state budget should be considered," Deputy Prime Minister Tran Hong Ha noted and emphasized “the importance of prioritizing grassroots healthcare in budget allocation for health insurance coverage to effectively carry out tasks related to primary healthcare, management of certain chronic diseases, and preventive healthcare, to prevent unnecessary burdens on higher-level healthcare facilities.

The Ministry of Health is responsible for guiding healthcare facilities to prepare annual budgets based on workload and assigned tasks, rather than rigidly following the previous year's total expenditure.

Additionally, the Deputy Prime Minister instructed the Ministry of Health to issue comprehensive treatment protocols to optimize treatment effectiveness and establish monitoring mechanisms to limit arbitrary practices and the misuse of drugs and medical equipment under health insurance.

"The total health insurance meical examination and treatment expenditure exceeds the total revenue, alternative budget plans by using supplement from the state budget should be considered," noted the Deputy Prime Minister.

The Ministry of Health, VSS, and relevant ministries and agencies are tasked with examining, researching, and proposing amendments and supplements to the Health Insurance Law and Social Insurance Law. The objective is to diversify health insurance packages to meet the varying payment capacities of individuals, establish a mechanism for reimbursing differential costs for insured patients who require treatment protocols or higher-level healthcare services, and develop, update, and share healthcare data between the Health Insurance Fund and healthcare facilities to control the quality of patient care while avoiding the misuse of expensive treatment techniques.