The increasing numbers each year are proof of the increasingly sustainable and effective implementation of health insurance policies. At the same time, this reality also puts new pressures on policy implementing agencies when the desire to expand maximum benefits for health insurance participants must always be placed alongside the problem of balancing revenue and expenditure and optimizing financial resources.
Celebrating the 15th anniversary of Vietnam Health Insurance Day (July 1, 2009 - July 1, 2024), the communication theme for 2024 is "Effective use of the Health Insurance Fund, ensuring patient rights and improving the quality of medical examination and treatment under health insurance at grassroots health facilities", aiming to continue to widely spread the meaning and humanistic values of health insurance policies, while continuing to further enhance the responsibility and capacity of organizing the implementation of health insurance policies, controlling the costs of medical examination and treatment under health insurance...
It can be seen that the successful and effective implementation of health insurance policy in recent years must include many factors, such as: Coverage; ensuring fair access for all people; using resources reasonably; protecting patients' finances and contributing to improving the quality of health services... Data from Vietnam Social Security shows that these factors have been relatively fully ensured in recent times, which is a premise for health insurance policy to achieve many positive results, both in terms of coverage and benefits for health insurance participants.
Reality poses many challenges in the implementation of this important social security policy. The benefits of health insurance participants are continuously adjusted in the direction of expansion; at the same time, the price of health insurance examination and treatment services also has many factors increasing such as adjusting the structure to add salary costs and special allowances for medical staff; the method of paying health insurance examination and treatment costs according to service prices has revealed many shortcomings; the cost of health insurance examination and treatment is constantly increasing. It is estimated that in 2023, the whole country will have about 174.8 million health insurance examinations and treatments with a payment amount of about 124,300 billion VND...
In addition, Vietnam is facing a rapidly aging population, changing disease patterns with increasing demand for medical examination and treatment. It is expected that with the current rate of cost increase, the situation of health insurance examination and treatment expenditure being higher than annual revenue will continue, and the reserve fund will quickly run out...
In order to ensure financial resources for the Health Insurance Fund, in recent times, this task has always been given special attention by the Social Insurance Agency for effective implementation. Along with many solutions, since July 2016, Vietnam Social Insurance has built and officially operated the Health Insurance Assessment Information System.
However, according to the representative of the Vietnam Social Security, the appraisal work cannot be the only factor determining the appropriate use of the fund. The effective management of the Health Insurance Fund will be assessed based on ensuring all three objectives: the rights of health insurance participants; the ability of the Health Insurance Fund to pay, and the most important issue is the quality of medical services commensurate with the price of medical services.
Therefore, first of all, there must be appropriate policies, then there must be solutions suitable to reality, solving the root of the problem: From determining financial resources, appropriate benefits within the payment capacity of the Health Insurance Fund, the ability to pay health insurance of employers, employees, people and the state budget; enhancing the responsibility of health insurance examination and treatment facilities in using the Health Insurance Fund effectively, and practicing thrift to prevent waste in prescribing drugs, medical supplies, technical services for patients...
Source: https://nhandan.vn/su-dung-hieu-qua-quy-bao-hiem-y-te-post816936.html
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