Proposal to increase direct spending on medical examination and treatment to 91%
Presenting the Report at the Session, Minister of Health Dao Hong Lan said that after 15 years of implementation, the Law on Health Insurance has truly come into life with 93.3 million people, equivalent to 93.35% of the population participating in health insurance; affirming the correctness and appropriateness of the health insurance policy according to the principle of risk sharing, ensuring financial resources for the people's medical examination and treatment needs, ensuring social security and international integration. In addition, in the implementation process, there have been problems, inadequacies and limitations that need to be adjusted.
The draft Law amends and supplements 40 articles on health insurance participants, payment responsibilities, benefits, scope of benefits, health insurance medical examination and treatment organization, fund management and some technical regulations; is structured with 2 articles on the content of amendments, supplements, abolition and the effective date of the Law.
The draft Law focuses on amending and supplementing regulations that need to be unified and synchronized with related laws, overcoming shortcomings of current laws that are urgent, have full information and data, and reach consensus. These include regulations on switching from 4 levels of medical examination and treatment to 3 levels of technical expertise to take effect from January 1, 2025, in sync with the Law on Medical Examination and Treatment.
According to Minister of Health Dao Hong Lan, the Draft Law has amended and supplemented the subjects participating and the responsibility to pay health insurance to overcome shortcomings and synchronize with the Law on Social Insurance; updated the subjects that have been stably implemented in laws and decrees; added a number of subjects that need State support to increase universal health insurance coverage; amended the responsibilities, methods, payment deadlines, the responsibility to make a list of health insurance payment, the validity period of the card; added the acts of late payment and evasion of health insurance payment.
The draft Law also amends regulations on medical examination and treatment in the right and wrong lines (cross-line) updated according to the technical expertise level of the 2023 Law on Medical Examination and Treatment. The procedure for transferring to a higher level of expertise for some rare diseases, serious diseases... is eliminated to reduce procedures, create convenience, reduce out-of-pocket expenses for people, and save costs for the fund...
At the same time, the Draft Law has amended and supplemented regulations on patient transportation; some scope of benefits for treatment of strabismus and refractive errors of the eyes for people under 18 years old. Regulations on cases of chronic diseases transferred to lower levels are allowed to use drugs as higher levels and adjustment of the rate of health insurance benefits in some cases to promote the role of grassroots health care.
The draft Law has adjusted to reduce the health insurance fund management cost ratio by 1% from 5% to 4% to increase direct spending on medical examination and treatment from 90% to 91% from the beginning of the year, saving procedures and time for allocating and adjusting funds.
Supplementing the form of warning and urging health insurance payment before applying administrative measures
Reporting on the review of the Draft Law amending and supplementing a number of articles of the Law on Health Insurance, Chairwoman of the National Assembly's Social Committee Nguyen Thuy Anh said that the Social Committee basically agrees with the addition of health insurance participants, responsibility for payment and health insurance payment methods stipulated in the Draft Law. At the same time, she requested the Government, the agency in charge of drafting the Draft Law, to continue reviewing to ensure that the subjects participating in health insurance as prescribed in other legal documents are fully reflected in Article 12 of this amendment. Continue to review and compare carefully so as not to reduce or lose health insurance support benefits compared to current regulations, and not to create inequality among health insurance participants.
Regarding the subjects participating in health insurance who are pupils and students, the Social Affairs Committee of the National Assembly found that it is not necessary to amend or supplement this regulation because it is being implemented stably. At the same time, it proposed that the Government study the option of increasing the support level for this group instead of the regulation allowing the choice of payment method to reduce family expenses.
Regarding the amendment of the regulation on "transfer of medical examination and treatment" in the direction of expanding one step further, better ensuring the rights of health insurance participants, according to Director Nguyen Thuy Anh, this regulation is appropriate, however, it is necessary to further assess the impact on the ability to balance the health insurance fund as well as the organization and operation of the medical examination and treatment system, including grassroots health care, to propose measures to ensure implementation.
The Social Committee basically agrees with the amendment and supplement of the regulations on transferring patients between health examination and treatment facilities covered by health insurance in Article 27 to overcome current shortcomings and ensure the right of people to timely use quality medical services, appropriate to their health condition. However, it is necessary to pay attention to the drafting technique to avoid the understanding that primary health examination and treatment facilities are only allowed to use lower-level drugs and medical equipment than primary and specialized health examination and treatment facilities.
Regarding late payment and evasion of health insurance, the Social Committee believes that it is necessary to supplement regulations clarifying the concepts of "late payment of health insurance" and "evasion of health insurance" in Article 2 and specifying sanctions for late payment and evasion of health insurance, but it is necessary to have a thorough impact assessment and widely consult the affected subjects. The application of the provisions of the Social Insurance Law needs to be carefully calculated and adjusted to suit the health insurance sector.
In addition, it is recommended to study and supplement the form of warning, urging, informing, and reminding businesses that are late in paying health insurance for employees before applying administrative and criminal measures in Clause 3, Article 49 of the Draft Law.
Source: https://kinhtedothi.vn/de-xuat-bo-thu-tuc-chuyen-tuyen-voi-nguoi-mac-benh-hiem-ngheo-benh-hiem.html
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