Hospitals in Ho Chi Minh City have thousands of billions of dong in health insurance 'suspended'

In just two years 2023 and 2024, the Ho Chi Minh City Department of Health recorded that the Social Insurance Agency (SIA) has not paid the cost of exceeding the estimated health insurance examination and treatment expenses for hospitals with an amount of nearly 2,500 billion VND.

In just two years 2023 and 2024, the Ho Chi Minh City Department of Health has recorded that the Social Insurance agency has not paid for the cost of medical examination and treatment exceeding the estimated budget for health insurance. In the photo: people waiting for medical examination - Photo: THU HIEN

Exceeding the budget estimate for too long is causing difficulties for units in ensuring operating funds, and drug debt is prolonged.

Hospitals have thousands of billions of health insurance "suspended", why?

Struggling to keep hospitals from running out of medicine

Faced with the current situation of nearly 2,500 billion VND of health insurance money "hanging", the Ho Chi Minh City Department of Health has sent a document requesting the Ho Chi Minh City People's Committee to consider recommending the Ministry of Health and Vietnam Social Security to guide Ho Chi Minh City Social Security to promptly pay the excess amount of health insurance medical examination and treatment expenditure estimates for 2023 and 2024 to medical examination and treatment facilities.

This Department noted that the Social Insurance agency has not yet paid the cost of exceeding the estimated health insurance examination and treatment expenditure for two years for hospitals with an amount of nearly 2,500 billion VND (including more than 557 billion VND in 2023 and nearly 1,930 billion VND in 2024).

"Exceeding the budget for too long is causing difficulties for units in ensuring operating funds and balancing financial revenues and expenditures. More worryingly, some units are currently in debt for medicine and are not able to pay the companies," the Department of Health stated.

Speaking with Tuoi Tre , the director of a first-class hospital in Ho Chi Minh City said that the hospital has not yet received payment from the city's Social Insurance for tens of billions of dong in excess of the estimated cost of health insurance examination and treatment.

This delay in payment leads to difficulties in hospital operations, especially in the context of financially autonomous hospitals but the prices for medical examination and treatment services have not been calculated correctly and fully.

"When payment is delayed, the hospital will not have money to pay pharmaceutical companies. We have to "work hard" to have enough money to pay salaries for medical staff. As for medicine, we have to "delay" the debt to pay gradually, and try to make sure that patients cannot lack medicine.

Not only medicine, but also medical supplies used for hospital patients must be carefully calculated, which is very difficult for the hospital. The larger the hospital, the more patients, the more difficult it will be to delay health insurance payment," he said.

The director of a second-class hospital added that the delay in paying for health insurance-covered medical expenses exceeding the budget has many different reasons such as: the number of patients receiving medical examination and treatment has increased, the hospital has deployed many new techniques...

When autonomous hospitals increasingly have deficits, there will be no resources to reinvest in facilities, machinery and equipment will become increasingly outdated, the quality of medical examination and treatment will not be improved, there will be no resources to train human resources and attract high-quality resources.

Therefore, it is recommended that the authorities pay early so that the hospital can develop stably.

Petitioned many times but still "waiting"

As one of the hospitals in Ho Chi Minh City that has not been paid for the cost of exceeding the estimated cost of health insurance examination and treatment, Mr. Pham Thanh Viet - Deputy Director of Cho Ray Hospital - said that in 2023 and 2024, Cho Ray Hospital has not been paid for an amount of up to hundreds of billions of VND.

The fact that Cho Ray Hospital has not been paid such a large amount of money will cause difficulties for the hospital's operations.

According to Mr. Thanh Viet, the hospital will use this money to pay salaries for hospital staff and to buy medicine and medical supplies.

Actively propose health insurance settlement for hospitals

Speaking with Tuoi Tre , the leader of the Health Insurance Department, Ministry of Health said that recently the Ministry of Health has been actively requesting the Politburo and Vietnam Social Security to resolve and guide the settlement of health insurance for hospitals.

When the hospital has not been paid such a large amount of money, the hospital also owes money to the companies that supply drugs and consumables to the hospital. Therefore, there is a high risk that these companies will no longer supply the hospital.

"At that time, the companies will not say directly that the hospital owes money so they will no longer supply, but will use this or that reason to not supply the hospital, and this will affect the quality of treatment for patients," Mr. Thanh Viet clearly stated the difficulties of the hospital.

Responding to this issue, Ms. Nguyen Thi Thu Hang - Deputy Director of Ho Chi Minh City Social Insurance - said that in 2023, the cost of health insurance examination and treatment in Ho Chi Minh City exceeded the estimate by more than 743 billion VND. This amount was assessed by Ho Chi Minh City Social Insurance in coordination with the Ho Chi Minh City Department of Health and proposed for payment by Vietnam Social Insurance.

Up to now, the amount exceeding the estimate has been paid 186 billion VND by Vietnam Social Security according to its authority, the remaining 557 billion VND has been submitted by the Ministry of Finance to the Prime Minister for the Ministry of Health to propose a handling method.

In 2024, the cost of health insurance examination and treatment in the whole city will continue to exceed the estimate by more than 1,900 billion VND. Currently, the Ho Chi Minh City Social Insurance is waiting for instructions from competent authorities to resolve this issue.

Solve problems, payment within 12 months

Regarding the guidance on payment of costs exceeding the estimated health insurance medical examination and treatment expenditure, the Government has issued decrees, now Decree No. 188/2025/ND-CP detailing and guiding the implementation of a number of articles of the Law on Health Insurance.

In case the actual health insurance examination and treatment expenses of the medical examination and treatment facility in the year have been assessed by the Social Insurance agency to exceed the expected expenditure (including the number notified at the beginning of the year and the number adjusted during the year), the medical examination and treatment facility shall review and send a document explaining the reasons affecting the excess expenditure compared to the expected expenditure to the Social Insurance agency and the Department of Health of the province or centrally-run city.

In case the budget assigned by Vietnam Social Security is not enough to supplement the budget for medical examination and treatment facilities, the provincial and centrally-run city Social Security shall send Vietnam Social Security to supplement the health insurance budget within the scope of the health insurance expenditure estimate assigned by the Prime Minister.

In case there are problems with the medical examination and treatment costs that have been requested for payment according to regulations, the time to resolve the problem and make payment shall not exceed 12 months from the date the medical examination and treatment facility requests payment.

Why over budget?

According to Tuoi Tre 's investigation, since the beginning of the year, the Ho Chi Minh City Department of Health and the City Social Insurance have repeatedly sent documents requesting payment of excess health insurance medical examination and treatment costs for hospitals to the Ministry of Health and Vietnam Social Insurance. But so far, the hospitals have not been paid.

By early August 2025, the City Department of Health continued to send a document to the City People's Committee requesting the Ministry of Health and Vietnam Social Security to guide Ho Chi Minh City Social Security to make early payments to medical facilities.

Previously, in May 2024, according to statistics from Vietnam Social Security, in the first quarter of 2024, health insurance medical examination and treatment expenses increased abnormally compared to the same period in 2023, many provinces increased by over 20%, with total expenses increasing by nearly 4,000 billion VND.

The Health Insurance Policy Implementation Board assessed that the health insurance costs for drugs increased in the first three months of 2024 due to the fact that in 2023, the Ministry of Health approved the results of contractor selection for drugs under national centralized bidding; the Ministry of Health approved the price negotiation results for 64 drugs on the price negotiation list.

In addition, some provinces that were slow to bid in 2023 have had their contractor selection results approved, leading to increased spending. Also according to the report of the Health Insurance Policy Implementation Board, the review of contractor selection results shows that the winning bid price of drugs varies from place to place.

In particular, there is still a large difference in bidding prices for the same type of medical supplies between hospitals and localities.

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Source: https://tuoitre.vn/benh-vien-o-tp-hcm-bi-treo-hang-nghin-ti-dong-bao-hiem-y-te-20250805232051688.htm