Facilitate people's access to health services

Mr. Dinh Thanh Tung, Deputy Executive Director of Provincial Social Insurance.

Reporter: Could you please tell us what are the important new points of the 2024 Health Insurance Law?

Mr. Dinh Thanh Tung: The 2024 Health Insurance Law consists of 11 chapters and 141 articles; an increase of 2 chapters and 16 articles compared to the current Law, with many new points, such as adding a number of subjects participating in compulsory health insurance paid or supported by the state budget, including people from 70 to under 75 years old belonging to near-poor households and people from 75 years old and above receiving monthly survivor benefits; medical staff, village midwives; people participating in security and order protection forces at the grassroots level; people belonging to households working in agriculture, forestry, fishery and salt production with an average living standard.

Adjusting the contribution level and responsibility for health insurance contributions for enterprises, cooperatives, cooperative unions, and business households operating in the fields of agriculture, forestry, and fishery that pay wages based on products or contracts, can choose to pay monthly, every 3 months, or every 6 months. Regarding the contribution level, it is determined based on a percentage of the basic salary or monthly income, with support from the state budget for vulnerable groups.

In addition, health insurance participants are allowed to change their initial health insurance medical examination and treatment facility every quarter (if needed), the change deadline is within the first 15 days of each quarter. In particular, regarding referrals, the amended Law expands the right to inpatient treatment at basic health insurance medical examination and treatment facilities nationwide without requiring a referral.

The 2024 Law on Health Insurance also stipulates that health insurance participants are entitled to 100% of the costs of medical examination and treatment at initial medical examination and treatment facilities nationwide according to the prescribed percentage of the benefit level; inpatient examination and treatment at basic health insurance medical examination and treatment facilities nationwide and at any basic or specialized health insurance medical examination and treatment facility that was identified as a district level before January 1, 2025. In addition, ethnic minorities and people from poor households living in areas with difficult socio-economic conditions or areas with particularly difficult socio-economic conditions will also be paid 100% of the costs of inpatient examination and treatment at specialized medical examination and treatment facilities by the health insurance fund. People with rare diseases, serious diseases, diseases requiring surgery or using high technology will be paid 100% of the costs of medical examination and treatment by the health insurance fund according to the prescribed percentage of the benefit level, allowing access to specialized medical examination and treatment facilities.

Social Insurance officers of Bac Yen district guide people to check health insurance beneficiary information on the VssID application.

The Law also adjusts the rate of expenditure for health insurance examination and treatment to increase to 92% (previously 90%). Issue regulations attached to the Circular guiding the payment mechanism for drugs and medical equipment transferred between medical examination and treatment facilities and the cost of paraclinical services transferred to other facilities in case of shortage of drugs and medical equipment.

In addition, the 2024 Law on Health Insurance stipulates that agencies, organizations, and employers who are responsible for paying health insurance but do not pay or do not pay in full will be subject to penalties depending on the nature of the violation, such as: being required to pay the full amount of late payment or evasion; paying 0.03%/day calculated on the amount of late payment or evasion of health insurance and the number of days of late payment or evasion of payment to the health insurance fund; and administrative sanctions according to the provisions of law.

Reporter: How does the 2024 Health Insurance Law affect the implementation of health insurance policy in Son La province?

Mr. Dinh Thanh Tung: By the end of March, the number of people participating in health insurance in the province was 1,237,761, with a coverage rate of 93.0% of the population. The amended and supplemented Law on Health Insurance in 2024 has brought about important and practical changes, reflecting the State's efforts in perfecting the health insurance system, towards the goal of universal coverage. The new regulations not only expand the scope of protection and enhance the rights of participants, but also create flexibility and convenience in accessing and using health services.

In addition, the scope of compulsory health insurance participation has been expanded, adding more groups of subjects such as village health workers, village midwives, security and order protection forces at the grassroots level... This helps increase the coverage of health insurance in the province, contributing to ensuring health care benefits for more groups of people, especially those working in high-risk health environments.

People come to register for health insurance examination and treatment at Muong La District General Hospital.

Another important change is to increase the proportion of health insurance fund expenditure for medical examination and treatment activities to 92% (previously 90%). This helps medical facilities have more resources to improve service quality, invest in equipment and facilities, help people access modern medical services and better meet the medical examination and treatment needs of people in the province.

Reporter: To implement the amended Law on Health Insurance in a unified and synchronous manner throughout the province, how will the provincial Social Insurance implement solutions?

Mr. Dinh Thanh Tung: The provincial Social Insurance advises the provincial People's Committee to issue a plan to implement the Law on Health Insurance in 2024. Review legal documents related to the Law on Health Insurance, recommend competent authorities to promptly amend, supplement, replace, abolish or issue legal documents to ensure compliance with regulations.

Provincial Social Insurance officers promote health insurance policies to students of Son La College.

Coordinate with the Department of Health to ensure initial health insurance registration activities in accordance with the provisions of the Law. Direct the Social Insurance of districts and towns to promote communication about new points of the revised Health Insurance Law in 2024, bringing the latest health insurance policy information to the people quickly and promptly. Thereby, helping people easily access health care services; building a modern, transparent and fair health system.

Focus on innovating the content and methods of communication through conferences to disseminate legal policies, through conferences of reporters at the provincial, district and commune levels, through social networking platforms such as Zalo, Facebook, etc. to spread the state's superior policies on health insurance to many people in the area. At the same time, strengthen inspection and examination of the implementation of health insurance policies and laws at health insurance examination and treatment facilities to avoid profiteering from health insurance funds.

Reporter: Thank you very much!

Source: https://baosonla.vn/bao-hiem-xa-hoi-tinh-son-la/tao-thuan-loi-cho-nhan-dan-tiep-can-dich-vu-y-te-QGDblg1Hg.html