Proposal for health insurance to cover screening costs for some common diseases

NDO - According to National Assembly delegates, diseases such as cancer, hypertension, and diabetes account for a large proportion of treatment costs. Screening for these diseases is not covered by health insurance, causing a waste of the health system's disease prevention potential.

On the afternoon of October 31, under the direction of Vice Chairwoman of the National Assembly Nguyen Thi Thanh, the National Assembly discussed in plenary session in the hall the draft Law amending and supplementing a number of articles of the Law on Health Insurance.

The majority of National Assembly deputies agreed with the promulgation of the Law to continue institutionalizing the Party and State's guidelines, policies and strategies on developing universal health insurance in accordance with the socio-economic conditions of our country.

Vice Chairwoman of the National Assembly Nguyen Thi Thanh chaired the discussion session. (Photo: THUY NGUYEN)

At the same time, ensure social security, rights and interests of health insurance participants, medical examination and treatment facilities, gradually reduce the rate of direct out-of-pocket expenditure of health insurance participants; effectively manage and use the health insurance fund; overcome urgent problems and difficulties after 15 years of implementing the Law on Health Insurance.

Ensuring consistency in regulations on prices for medical examination and treatment services under health insurance

Commenting on the draft Law, delegate Tran Thi Nhi Ha (Hanoi delegation) said that regarding the scope of benefits for health insurance participants, the Health Insurance Fund currently does not pay for preventive and screening services.

Meanwhile, diseases such as cancer, hypertension, and diabetes account for a large proportion of treatment costs. "Screening for these diseases is not covered by health insurance, wasting the health system's disease prevention potential," the delegate analyzed.

The delegate proposed to add point 1, clause 1, Article 21 on the scope of health insurance payment for the list of periodic screening prevention services. The Minister of Health shall specify the list of diseases, frequency, and price range of these services.

Regarding payment of medical examination and treatment costs under health insurance, the Law on Medical Examination and Treatment has specifically stipulated the price of medical examination and treatment, including total cost, accumulated or expected profit and other financial obligations.

Delegate Tran Thi Nhi Ha (Hanoi delegation) gives comments on the draft Law. (Photo: THUY NGUYEN)

Delegates proposed two options. Option 1 is to amend the draft Law in the direction of harmonizing regulations on prices of medical examination and treatment services according to the Law on Medical Examination and Treatment. However, the price of health insurance will increase, leading to the risk of insecurity for the fund, so the draft must include policies to balance the Fund such as supplementing the fund source and increasing the efficiency of fund use.

Option 2 : Implement health insurance payments according to quotas and diagnostic groups. On that basis, the Ministry of Health issues unified prices for health insurance examination and treatment services nationwide.

It is necessary to supplement regulations on connecting clinical results between medical facilities.

Participating in the discussion, delegate Tran Thi Hoa Ry (Bac Lieu delegation) expressed her agreement with the regulation on connecting technical expertise levels when examining patients to ensure the constitutional right of people to choose the most suitable and best medical examination place for themselves when they are sick.

However, delegates suggested that it is necessary to add regulations on the connection of paraclinical results between medical examination and treatment facilities at the technical professional level and clearly stipulate the time for implementing nationwide connection to recognize paraclinical results of medical examination and treatment facilities.

Delegate Tran Thi Hoa Ry (Bac Lieu delegation). (Photo: THUY NGUYEN)

According to the delegate, if the health sector can connect test results, it will save thousands of billions of VND for the health insurance fund. More importantly, it will reduce the burden on paying for health services for the entire society, including millions of people who are poor, near-poor patients and ethnic minorities in difficult circumstances.

Delegates hope that the National Assembly and competent authorities will have timely decisions clearly showing the roadmap for implementing the connection of paraclinical results in the draft Law so that all people have the opportunity to enjoy the results of health policy.

Agreeing with the above viewpoint, delegate Nguyen Thi Viet Nga (Hai Duong delegation) said that the draft Law has simplified the procedures for transferring patients between medical examination and treatment facilities, and expanded the rights of people receiving medical examination and treatment under health insurance. This is extremely consistent with the thoughts and wishes of voters.

Delegate Nguyen Thi Viet Nga (Hai Duong delegation). (Photo: THUY NGUYEN)

However, along with the regulation to simplify the referral procedure, delegates suggested that it is necessary to consider the regulation on connecting the results of clinical examinations of previous medical examination and treatment facilities to reduce waiting time, examination and treatment of patients; reduce costs for patients; prevent waste, and save costs for the health insurance fund.

This is also an important stepping stone towards synchronizing and connecting patient records and data at medical facilities nationwide and enhancing the responsibility of medical examination and treatment facilities in complying with current regulations on hospital quality management - delegate Viet Nga emphasized.

Source: https://nhandan.vn/de-xuat-bao-hiem-y-te-chi-tra-phi-sang-loc-mot-so-benh-pho-bien-post842387.html