Health insurance patients have to buy medicine outside: Don't put the blame on the patient

People wait to check in at a medical facility in Ho Chi Minh City - Photo: PHUONG QUYEN

A parent was upset about the fact that students were required to participate in health insurance, but when it came to medical treatment, "there was a shortage everywhere".

Or cancer patients have to buy their own IV lines even though their health insurance still covers them. The costs of medicine and supplies that should be covered by health insurance, people have to pay out of their own pockets. So, participating

Is health insurance really meaningful?

The Ministry of Health's leaders said that there was enough legal basis for bidding and purchasing. However, the situation of "local" shortages still occurred, hospitals have not been able to purchase or are organizing bidding.

There are even hospital leaders who say "there are alternative medicines, but patients want better medicine so they have to go out and buy it themselves" and the responsibility is pushed back onto the patients.

Faced with the prolonged shortage of drugs and medical supplies, the Ministry of Health has recently made many proposals and developed policies to ensure the rights of patients.

In particular, the circular guiding the regulation of direct payment for people with health insurance cards is one of the proposed solutions.

This circular took a long time to develop and will take effect from January 1, 2025. In particular, to be paid for the cost of self-purchased medicine and medical supplies directly, 5 conditions must be met.

Director of the Health Insurance Department (Ministry of Health) Tran Thi Trang said this is only a temporary solution when hospitals do not have medicine and medical supplies for objective reasons, not a fundamental solution to solve the shortage of medicine and supplies.

The circular also clearly states the conditions for direct payment to patients, avoiding the abuse of requiring patients to go out to buy medicine. And medical facilities must be responsible for ensuring treatment drugs, and if there is a real shortage due to objective reasons, they must also ensure the patient's right to pay.

Accordingly, to be paid directly when having to buy medicine from outside, the patient must be requested by the hospital to pay to the social insurance agency, proving that the lack of medicine and supplies must be due to "objective" reasons according to regulations.

However, in reality, few hospitals dare to publicly announce "we are lacking medicine and medical supplies", because the Ministry of Health and the Government have directed that "medical facilities must take responsibility if there is a shortage of medicine and supplies".

And if the hospital cannot explain that "there is a lack of medicine due to objective reasons, and they have tried everything to purchase it but failed", then the patient will not be eligible for payment.

Not to mention that the patient has to submit the application to the social insurance agency and wait for 40 days for the application to be processed. And it is not certain that the application for payment will be complete the first time, the patient may have to go back and forth many times.

Recently, many voters also sent questions to the Ministry of Health when the health insurance premium has just increased according to the basic salary but patients have not seen any change in the quality of medical examination and treatment.

They still have to pay out of pocket to buy medicine and medical supplies without even knowing whether the medicine and supplies are really of guaranteed quality, and whether there are invoices and documents to be paid for?

The responsibility of providing adequate medicine and medical supplies lies with the hospitals, please do not put the responsibility on the patients.

Source: https://tuoitre.vn/benh-nhan-bao-hiem-y-te-phai-mua-thuoc-ngoai-dung-do-trach-nhiem-len-nguoi-benh-20241021080120551.htm