Ministry of Health proposes roadmap to implement free hospital fees

(Dan Tri) - According to the proposal of the Ministry of Health, the implementation of the hospital fee exemption policy will follow a roadmap, prioritize subjects, and be suitable to the contribution level, the balancing capacity of the health insurance fund, and socio-economic conditions.

Out-of-pocket health spending remains high

On December 1, the Ministry of Health held a workshop to seek opinions on the direction of developing a project to gradually implement the policy of free hospital fees.

Speaking at the workshop, Mr. Vu Manh Ha, Permanent Deputy Minister of Health, pointed out that people's out-of-pocket spending is still high, accounting for over 40% of medical expenses. The risk of impoverishment due to illness still exists, especially for the poor, vulnerable groups, and people with chronic diseases or long-term treatment.

The financial pressure on households will be even greater if there is no strong solution from public policy. Therefore, the policy of gradually moving towards free hospital fees is an objective and urgent requirement, which both demonstrates the good nature of the Vietnamese social policy system and ensures the people's right to health care.

Mr. Vu Manh Ha, Permanent Deputy Minister of Health (Photo: Tran Minh).

According to the Deputy Minister, the policy of free hospital fees is not only a financial solution for healthcare, but also has profound social and humanitarian significance. Accordingly, it reduces the cost burden for people, especially the poor and vulnerable groups; increases equity in access to healthcare services, ensuring "no one is left behind".

At the same time, improve the quality of health care, because when financial barriers are removed, patients will be examined and treated sooner and more effectively...

“This policy must still be based on the pillar of health insurance, with support from the state budget, and implemented with a roadmap.

The state budget and health insurance fund will cover basic and essential medical expenses, minimizing the financial burden on people, first of all for social policy beneficiaries, the disadvantaged, low-income earners and some other priority groups,” Deputy Minister Ha analyzed.

Meanwhile, for on-demand medical services, beyond the basic level, patients still have to pay a portion to raise awareness of using services reasonably and saving costs.

Ms. Tran Thi Trang, Director of the Department of Health Insurance (Ministry of Health), said that currently the burden of medical costs is very large, with people estimated to pay about 40% of the costs themselves. The total amount of health insurance fund that has not been paid is estimated at about 24,800 billion VND/year. The health insurance contribution level is still low, 4.5% of the salary/reference level used as the basis for contribution.

The goal of the free hospital policy is to cover all people with health insurance, while gradually reducing and moving towards eliminating co-payment rates.

Ms. Tran Thi Trang, Director of Health Insurance Department, Ministry of Health (Photo: Tran Minh).

Specifically, the health sector will determine a basic health service package within the free scope, including a list of services, diseases, drugs, and medical equipment. This will cover common diseases, prioritize necessary diseases first, and gradually expand the scope according to professional requirements in accordance with the capacity of the State budget and the health insurance fund, combined with social mobilization," said Ms. Trang.

At the same time, the Ministry of Health will also establish a maximum cost for a medical examination and treatment.

Specifically, the average cost of inpatient/outpatient medical examination and treatment nationwide is adjusted annually or periodically, excluding some diseases and techniques with high costs. In the near future, it is expected to be applied at primary and basic medical examination and treatment facilities, public and private medical examination and treatment facilities.

"The implementation will follow a roadmap, prioritize subjects, and be suitable to the contribution level, the balancing capacity of the health insurance fund, and socio-economic conditions in each period," said Ms. Trang.

The source of funding for payment will be based on the pillars of health insurance, budget, disease prevention fund, and social mobilization.

Proposed roadmap for implementing the hospital fee exemption policy

According to the proposal of the Ministry of Health, the 2026-2027 period will focus on increasing the rate and level of health insurance payments for drugs, medical equipment, and technical services.

From 2026, people will be given free periodic health check-ups or screenings at least once a year according to priority groups and routes.

In particular, the organization coordinates between periodic health check-ups, free screening, health check-ups for students, occupational disease check-ups, health check-ups for workers according to regulations and health insurance examination and treatment to provide free medical examinations and complete the creation of electronic health books for all people.

Priority groups from 2026, health insurance participants are those from near-poor households, elderly people aged 75 and over who are receiving social pension benefits (applying a benefit level of 100% of medical examination and treatment costs within the scope of health insurance benefits).

At the same time, increase the health insurance contribution rate from 2027 (about 5.1%), budget contribution, and support contribution for social policy beneficiaries.

By the 2028-2030 period, the target is to reduce out-of-pocket spending to ≤30%.

Specifically, continue to increase the rate and level of health insurance payment for drugs, medical equipment, and technical services; pilot cost-effective screening for 2-3 diseases; pay from the health insurance fund for disease prevention services; increase health insurance coverage to over 95% of the population; increase health insurance contribution from 2030 to 5.4% and pilot supplementary health insurance, diversify health insurance packages...

After 2030, universal health insurance coverage will be achieved, with cost-effective screening for 3-5 diseases expanded. Hospital fees will be exempted for all people within the scope of the basic service package, expanded according to the roadmap and resources; health insurance contribution rate will increase to 6% from 2032.

Source: https://dantri.com.vn/suc-khoe/bo-y-te-de-xuat-lo-trinh-thuc-hien-mien-vien-phi-20251201172740257.htm