How will basic medical fees be waived for all citizens?

Members of the National Assembly have proposed early exemption from hospital fees for cancer and hemodialysis patients. It is expected that from 2026, the Ministry of Health will implement a program of free periodic health checkups for all citizens, gradually implementing a policy of basic hospital fee exemption.

People register for health insurance coverage at a hospital in Bac Ninh - Photo: HA QUAN

On December 2nd, the National Assembly discussed the draft resolution on some breakthrough mechanisms and policies for the protection, care, and improvement of people's health.

Along with that is the policy of investing in the National Target Program on healthcare, population and development for the period 2026 - 2035. Contents related to expanding healthcare benefits and reducing medical costs for the people, including free hospital treatment, received many comments from delegates.

Clearly define the scope, roadmap, mechanism, and operation.

Representative Nguyen Anh Tri (Hanoi) suggested that there are four key areas that need to be clearly defined in the regulations regarding hospital fee exemptions. Specifically, these include improving the quality of medical examination and treatment with good quality medicines, standardized and updated diagnostic and treatment protocols.

In addition, convenience is essential, meaning proactive access to healthcare at the nearest and most convenient location, implementing a truly independent healthcare system, and eliminating the health insurance payment ceiling.

Simultaneously, equality in access to healthcare means organizing a three-tiered healthcare system as stipulated in the 2023 Law on Medical Examination and Treatment, where the basic level of medical examination and treatment must be located closest to the people and must have sufficient medicine to treat the population, ensuring that all citizens, depending on the severity of their illness, receive equal access to healthcare.

The fourth point, according to Mr. Tri, must be feasible and effective, and free hospital care needs a reasonable roadmap. However, the current draft stipulates that free hospital care will be provided to all citizens by 2030, so he suggested implementing it early for those being treated for difficult-to-treat and chronic diseases, patients undergoing hemodialysis, and cancer patients receiving expensive targeted therapy. "I really hope to help those patients immediately, without waiting until 2030," Mr. Tri proposed.

Representative Pham Thi Kieu (Lam Dong) suggested that the concept of the basic level of exemption from hospital fees needs to be clearly defined and quantified, and that the scope, roadmap, and operating mechanism should be more clearly regulated.

Representative Nguyen Tam Hung (Ho Chi Minh City) proposed considering adding criteria to identify target groups and increasing benefit levels based on the level of health risk and high disease risk, instead of relying solely on social and administrative criteria. In reality, those with high risks such as chronic diseases, genetic diseases, and early metabolic disorders always require significant and prolonged treatment costs.

Allowances will be increased for healthcare workers.

In her subsequent explanation regarding the policy of free hospital admissions and diversified health insurance packages, Minister of Health Dao Hong Lan proposed including general principles in the resolution, on the basis of which the Government would provide guidance for implementation. She argued that including overly detailed regulations on eligible individuals and timelines in the resolution could lead to difficulties if resources or implementation conditions change, making it impossible to amend the law or resolution immediately.

Regarding salary and allowance policies for healthcare workers, the Minister stated that healthcare worker policies have faced many difficulties recently. She informed that the Ministry is currently submitting to the Government a draft decree on special regulations, such as on-call duty and other allowances, for healthcare workers in rural areas...

During the discussion, delegates also proposed waiving one year of voluntary health insurance premiums for residents of provinces directly affected and severely damaged by recent storms and floods.

The proposal suggests adding individuals in difficult circumstances or suffering from serious illnesses, especially cancer, to the list of those eligible for 100% health insurance coverage. It also proposes increasing allowances for healthcare workers, developing a specialized salary scale for the healthcare sector linked to risk, responsibility, and seniority, and applying allowances based on job position instead of a uniform system based on qualifications...

Encourage businesses to develop digital healthcare products and services.

Representative Nguyen Thi Suu (Hue City) proposed that the draft resolution should prioritize investment in building a national health database system, digital infrastructure, and a shared platform capable of interconnecting between healthcare facilities, preventive health units, and health insurance agencies.

The goal is to achieve 100% digitization of electronic medical records by 2030 and to apply information technology to 80% of healthcare services by 2035.

In addition to encouraging businesses to invest in the development of digital healthcare products and services through public-private partnerships (PPP), public-private partnerships or contracts for the purchase of medical technology services are also required. Businesses will benefit from tax incentives, land allocation, and streamlined investment procedures that meet quality criteria and other data requirements to ensure the quality of medical examination and treatment.

What benefits do citizens receive when basic hospital fees are waived?

The Ministry of Health is seeking feedback to develop a list and scope of benefits for citizens under the basic hospital fee exemption policy.

According to Ms. Tran Thi Trang, Director of the Health Insurance Department (Ministry of Health), the health insurance fund currently covers most medical examination and treatment costs. However, with the policy of waiving basic hospital fees, the scope of payment will be expanded, not only covering treatment but also including preventive medical services such as disease screening and some basic service packages.

Prioritize primary healthcare and initial medical examination and treatment.

Ms. Trang stated that the policy's scope of benefits will be designed to prioritize primary healthcare and initial treatment, then gradually expand according to a roadmap. Initially, the policy will focus on vulnerable groups including the poor and near-poor, middle-income earners, the elderly, and other disadvantaged groups.

Regarding the scope of free medical services, the Ministry of Health aims to achieve universal health insurance coverage and gradually reduce the co-payment rate. The basic medical service package included in the free coverage will be clearly defined, encompassing a list of diseases, medications, medical equipment, and common treatment services. Expansion will be implemented as needed and in accordance with available resources...

According to the roadmap, by 2030, Vietnam aims for universal health insurance coverage and the design of appropriate benefit packages, ensuring that all citizens receive a certain level of basic free hospital care. The costs beyond the basic package will be allocated according to target groups, depending on people's income and ability to pay.

Increase health insurance contributions according to a planned schedule.

Permanent Deputy Minister of Health Vu Manh Ha emphasized that for the policy of waiving hospital fees to be implemented effectively, it must be based on a solid foundation of the health insurance fund, combined with the state budget and socialized resources.

Regarding the roadmap for increasing health insurance contributions, Ms. Trang stated that the adjustment will be implemented according to a reasonable schedule, consistent with the affordability of individuals, businesses, and the budget, avoiding sudden pressure. When mobilizing additional financial resources, policy design must ensure that it does not affect the rights of patients.

Ms. Trang believes that only when the health insurance fund is strong enough can the benefits of the free hospital care package be fully expanded. In most countries that apply a free hospital care policy, people still have to co-pay a certain amount to ensure reasonable and responsible use of services.

The economic equation needs to be clearly calculated.

According to Ms. Nguyen Khanh Phuong, Director of the Institute of Health Strategy and Policy (Ministry of Health), to ensure the feasibility of the policy, the plan for gradually implementing the free hospital care policy must answer the following questions: who will be covered, what services will be covered, what are the financial sources and mechanisms, and at what level of the health system will the services be implemented? These four issues determine the success of the policy and form the basis for establishing a "basic level" scope that is appropriate to Vietnam's economic conditions.

According to Ms. Vu Thi Hai Yen, Deputy Head of the Department of Finance and Sectoral Economics (Ministry of Finance), resources allocated to healthcare are still limited.

The Ministry of Finance has proposed a comprehensive resource mobilization strategy, with a focus on mobilizing social resources.

THANH CHUNG - NGOC AN - TIEN LONG - DUONG LIEU

Source: https://tuoitre.vn/mien-vien-phi-co-ban-toan-dan-ra-sao-20251202231549179.htm