Kinhtedothi - Discussing in groups about the Draft Law amending and supplementing a number of articles of the Law on Health Insurance (HI), delegates of the National Assembly Delegation of Hanoi proposed that there should be clear, unified, and synchronous regulations on HI payment, creating convenience for people to receive medical treatment under HI.
Attending the group discussion were Politburo member, Secretary of the City Party Committee, Head of the Hanoi National Assembly Delegation Bui Thi Minh Hoai and delegates of the Hanoi National Assembly Delegation.
Health insurance must pay for remote medical examination and treatment.
Discussing in the group about the Draft Law on amending and supplementing a number of articles of the Law on Health Insurance in the National Assembly session on the afternoon of October 24, Deputy Head of the People's Petition Committee Tran Thi Nhi Ha said that the rate of health insurance participation in our country is currently quite high, of which, in Hanoi it accounts for 94.5%. In recent years, almost everyone who goes to see a doctor has presented their health insurance card. Especially for the poor, cancer patients, dialysis patients... who really need health insurance cards as a lifebuoy for medical examination and treatment.
"This Law only amends a few articles, not the whole thing. I propose to evaluate the implementation of the Law and make a comprehensive amendment," said delegate Tran Thi Nhi Ha.
According to delegate Tran Thi Nhi Ha, the scope of benefits for participants according to the Draft Law is appropriate, but the Law on Medical Examination and Treatment has stipulated forms of remote medical examination and treatment, medical examination and treatment according to the principle of family medicine. "I propose that health insurance must also be paid for remote medical examination and treatment, medical examination and treatment according to the principle of family medicine. This is a new form of medical examination and treatment, suitable for practice" - delegate Tran Thi Nhi Ha expressed her opinion.
Regarding patient transportation, delegate Tran Thi Nhi Ha said that emergency transportation in case of accidents, myocardial infarction... must be given very early, and must be paid for by health insurance. Currently, the content of emergency patient transportation is only paid for by a few subjects. Thus, all emergency patients with health insurance must pay, and in emergency cases, it is determined by the doctor.
According to delegate Tran Thi Nhi Ha, the new draft law mentions the scope of health insurance in the field of medical examination and treatment without paying attention to the fields and services of screening and early detection as a preventive service. Screening to detect some diseases, especially cancer, is very important. These are diseases that, if detected early, will reduce treatment costs, reduce the state budget, reduce illness for the people, and health insurance needs to pay.
Regarding medical examination and treatment levels, according to the Law on Medical Examination and Treatment, there are 3 levels, but the Draft Law still heavily focuses on referrals. According to delegate Tran Thi Nhi Ha, from January 1, 2025, there will be 3 levels of medical examination and treatment, but this content in the Draft Law is relatively vague, not yet integrated with the Law on Medical Examination and Treatment. There must be a solution so that people know which facility they will go to for medical examination and treatment, creating order in medical examination and treatment as well as medical examination and treatment facilities knowing which level they are at to serve the people.
Delegates raised the issue of the shortage of drugs and consumables at medical facilities and how to handle the situation when people have health insurance cards but do not have drugs or consumables when going to see a doctor. The Ministry of Health has issued a Circular regulating the direct payment of drug and medical equipment costs for people with health insurance cards. It is hoped that the contents stipulated in the Circular will be stipulated in principle in the Law for synchronous implementation.
"There must be clear, transparent, unified and consistent regulations on this matter; creating convenience for people and ease of understanding for medical examination and treatment facilities" - delegate Tran Thi Nhi Ha emphasized.
Reviewing health insurance policy for the elderly
Discussing in the group, delegate Truong Xuan Cu expressed concerns about the policy for the elderly. The delegate said that reports from 2021 and 2022 showed that currently 5% of the elderly do not have health insurance, which is about 500,000 people, but by August 2024, this figure had increased to 2.6 million elderly people without health insurance.
“This figure makes management agencies and the elderly association very surprised because Vietnamese people have a long life expectancy but poor health in old age. Without health insurance, the burden on the lives of individuals and families will be extremely difficult. I propose that people aged 70 and over should be entitled to health insurance, and elderly people in near-poor households should be entitled to health insurance from 65 years old. According to statistics, 95% of Vietnamese elderly people aged 60 and over have illnesses. Those aged 60 to 80 have 3 underlying illnesses, those aged 80 and over have 6 underlying illnesses. Without health insurance, it will be very difficult,” proposed delegate Truong Xuan Cu.
At the same time, it was said that Vietnam currently has 17 million elderly people, of which 5.7 million have pension benefits, while the rest still have to work to earn a living. Citing further evidence of a paradox when in 2014, summarizing the health care work in the Northern mountainous region, data at the conference showed that the majority of mountainous provinces had surplus health insurance, because the health care services in the region were not yet developed, and people did not actively participate in health insurance; therefore, delegates recommended that the National Assembly reconsider the health insurance policy for the elderly.
Meanwhile, delegate Nguyen Anh Tri acknowledged that for more than 15 years, since the Law on Health Insurance was enacted, Health Insurance has done many things, including two major ones. That is the great effect in medical examination and treatment for the people, especially for patients with serious illnesses. A patient shared that after discovering the disease, calculating the cost of treatment, "the 5-storey house shook", but thanks to Health Insurance, the people in general, especially poor patients, were able to get treatment.
Besides, people feel secure when they have health insurance, although in the past, there were still many people who avoided buying health insurance. However, after 15 years, there have been many shortcomings that need to be amended. That is the risk of the Health Insurance Fund collapsing if it operates in the same way as the old Law.
According to the delegate, the issue of referral is currently a problem, although there have been many changes, while the rights and initiative of people with health insurance cards have not been clearly formed. Delegate Nguyen Anh Tri said that medical examination and treatment according to the insurance line should not be considered a measure to prevent overloading of the health system, but the health system must be reorganized so that people can go to the place of examination and treatment as quickly and completely as possible, with good doctors and good medicine; ensuring fairness and equality in health insurance benefits.
The draft Law amends 4 groups of policies: Adjusting the subjects participating in health insurance in line with related laws; adjusting the scope of health insurance in accordance with the contribution level, balancing the health insurance fund and health care requirements in each period; adjusting the relevant health insurance regulations in each level of medical examination and treatment; allocating and using the health insurance fund effectively. "I appreciate the Government's preparation to amend these 4 policies, especially the policy of adjusting the scope of health insurance in accordance with the contribution level. If this can be done, it will be great. The second is to adjust according to the level of technical expertise in medical examination and treatment" - delegate Nguyen Anh Tri shared.
Source: https://kinhtedothi.vn/tao-thuan-loi-cho-nguoi-dan-chua-benh-theo-bao-hiem-y-te.html
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