How is basic hospital fee exemption for all people?

Miễn viện phí cơ bản toàn dân ra sao? - Ảnh 1. — People register for health insurance examination and treatment at a hospital in Bac Ninh - Photo: HA QUAN

On December 2, the National Assembly discussed a draft resolution of the National Assembly on a number of breakthrough mechanisms and policies for the work of protecting, caring for and improving people's health.

Along with that is the investment policy for the National Target Program on health care, population and development for the period 2026 - 2035. The contents related to expanding health care benefits and reducing medical costs for people, including free hospital fees, received many opinions from delegates.

Clearly define the scope, roadmap, mechanism and operation

Delegate Nguyen Anh Tri (Hanoi) said that there are 4 contents that need to be clearly defined in the content of free hospital fees. Specifically, improving the quality of medical examination and treatment with good medicine, standard and updated diagnosis and treatment regimens.

Along with that, it must be convenient, that is, proactively seeking medical examination and treatment at the nearest and most convenient place, implementing real-life medical clearance without dependence, and removing the health insurance payment ceiling, which must be done for real.

At the same time, equality in benefits means organizing a 3-level specialized health care system like the 2023 Law on Medical Examination and Treatment, in which the basic level of medical examination and treatment must be arranged closest to the people and must have enough medicine to treat the people, all people, depending on the level of illness, receive the same benefits.

The fourth content, according to Mr. Tri, must be feasible and effective, and free hospital fees need to have a reasonable roadmap. However, the current draft stipulates that by 2030, all people will be exempt from hospital fees, so he proposed to implement free hospital fees early for those who are being treated for difficult-to-treat and chronic diseases, patients on dialysis, and cancer patients who are receiving very expensive targeted drug treatment. "I really hope to help those patients immediately, without waiting until 2030," Mr. Tri proposed.

Delegate Pham Thi Kieu (Lam Dong) suggested that it is necessary to clearly define and quantify the concept of the basic level of hospital fee exemption and to have clearer regulations on the scope, roadmap and operating mechanism.

Delegate Nguyen Tam Hung (HCMC) suggested considering adding criteria to identify target groups, increasing the benefit level according to the level of health risks and high risk of disease, instead of only basing on social and administrative criteria. Because in reality, people with high risks such as chronic diseases, genetic diseases, early metabolic disorders... always need large and prolonged treatment costs.

Will increase allowances for medical staff

Explaining the policy of free hospital fees and diversified health insurance packages, Minister of Health Dao Hong Lan proposed to include general principles in the resolution, on the basis of which the Government will guide implementation. If the resolution stipulates too much detail about the subjects and roadmap, it may lead to difficulties when resources or implementation conditions change, and the law or resolution cannot be amended immediately.

Regarding the salary and allowance policies for medical staff, the Minister said that the policies for medical staff in the recent past have faced many difficulties. She informed that the Ministry is currently submitting to the Government a decree on special policies, such as on-duty regimes and other allowances, for medical staff in villages...

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

It is proposed to add subjects with difficult circumstances, those with serious illnesses, especially cancer, to enjoy 100% health insurance. It is proposed to increase the allowance level for medical staff, build a specific salary table for the medical sector linked to risk, responsibility and seniority, apply allowances according to job position instead of equalizing according to qualifications...

Encourage businesses to develop digital health products and services

Delegate 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 connecting medical facilities, preventive medicine units and health insurance.

The goal is to achieve 100% digitalization of electronic medical records by 2030 and apply information technology in 80% of medical examination and treatment services by 2035.

In addition to encouraging businesses to invest in developing digital health products and services under the form of public-private partnerships (PPP), they must also transfer public-private services or contracts to purchase medical technology services. Businesses enjoy tax incentives, land and investment procedures that meet quality criteria and other data to ensure the quality of medical examination and treatment.

People's rights when "basic hospital fees are exempted"

The Ministry of Health is seeking opinions to develop a list and scope of people's rights in the basic hospital fee exemption policy.

According to Ms. Tran Thi Trang, Director of the Department of Health Insurance (Ministry of Health), the health insurance fund has basically covered the cost of medical examination and treatment. However, with the basic hospital fee exemption policy, the scope of payment will be expanded, not only stopping at treatment but also including preventive medical services such as disease screening and some basic service packages.

Priority for primary health care and initial medical examination and treatment

Ms. Trang said the scope of benefits of the policy will be designed to prioritize primary health care and primary medical examination and treatment, then gradually expand according to the roadmap. In the immediate future, the policy will focus on vulnerable groups including the poor and near-poor, middle-income people, the elderly and other disadvantaged groups.

Regarding the scope of free hospital fees, the Ministry of Health aims to move towards universal health insurance coverage, gradually reducing the co-payment rate. The basic health service package within the free scope will be clearly defined, including a list of diseases, drugs, medical equipment and common treatment services. Expansion will be carried out according to the level of necessity and in accordance with resources...

According to the roadmap, by 2030, Vietnam aims to cover all people with health insurance and design appropriate benefit packages, ensuring that all people enjoy a certain level of basic hospital fee exemption. The cost of the additional basic package will be divided into groups of subjects, depending on the income and ability to pay of the people.

Increase health insurance premiums according to schedule

Deputy Minister of Health Vu Manh Ha emphasized that the policy of free hospital fees, to be effectively implemented, 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 premiums, Ms. Trang said that the adjustment will be made in a reasonable manner, consistent with the payment capacity of people, businesses and the budget, avoiding creating sudden pressure. When mobilizing additional financial resources, the 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 package be maximized. In most countries that apply a free hospital policy, people still have to pay a certain amount of co-payment to ensure reasonable and responsible use of services.

Need to calculate economic problems clearly

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 project to gradually implement the free hospital policy must answer the questions: who is covered, what services are covered, what are the financial sources and financial mechanisms, and at what level of the health system is the service implemented. These are four issues that determine the success of the policy and are the basis for establishing a "basic level" scope in a way that is appropriate to Vietnam's economic conditions.

According to MSc. Vu Thi Hai Yen, Deputy Head of the Department of Finance and Industry Economics (Ministry of Finance), currently, resources for healthcare are still limited.

The Ministry of Finance proposes a comprehensive resource mobilization orientation, focusing 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