Patients pay out of pocket to buy health insurance drugs, what does Ho Chi Minh City Social Insurance propose?

The Standing Committee of the Ho Chi Minh City People's Council held a session to explain the management and use of drugs at medical examination and treatment facilities - Photo: CAM NUONG

On June 14, the Standing Committee of the Ho Chi Minh City People's Council held a session to explain the management and use of drugs at medical examination and treatment facilities and pharmaceutical businesses in the city.

Ensuring health insurance benefits for patients

Mr. Tang Chi Thuong - Director of the Ho Chi Minh City Department of Health - said that for many years, the city's health sector has not only been responsible for providing health care for more than 10 million people living in the area, but has also received millions of patients from other localities and abroad.

With the widespread number of medical facilities and the continuously increasing number of medical examinations and treatments, providing enough medicine for treatment needs is truly a big challenge for the city.

Delegates asked whether health insurance will cover the cost of medicine that patients have to pay out of pocket for.

Ms. Nguyen Thi Thu Hang - Deputy Director of Ho Chi Minh City Social Insurance - said that there are currently no regulations on refunding payments to patients. The Ministry of Health is drafting a circular to ensure the rights of patients.

Currently, the City Social Insurance Department is giving opinions. If it is proposed to let insurance pay back, it will be against the law on medical examination and treatment, because the supply of medicine to patients belongs to medical examination and treatment facilities.

According to Ms. Hang, recently the drug supply has been interrupted due to lack of supply, slow circulars and bidding on drugs, some items will be in short supply and cannot be purchased...

Ho Chi Minh City Social Insurance has proposed a solution to expand centralized bidding at the local level so that any hospital lacking medicine will be able to receive medicine from other hospitals.

If we continue to bid for individual drugs as it is now, any hospital will run out of drugs if it cannot purchase them in time.

In addition, the hospital must estimate the number of drugs and quantity of drugs for 3-6 months to organize bidding.

"The Ministry of Health's recent draft on refunds still has many shortcomings such as: poor patients have to wait to go through procedures at the insurance agency for payment, social insurance staff have to evaluate each prescription, making it difficult for patients...", Ms. Hang said.

Difficulty in managing drugs in cyberspace

At the explanation session, delegate Tran Thi Phuong Hoa raised the issue of managing drug advertising on cyberspace.

Explaining this content, Deputy Director of the Department of Information and Communications of Ho Chi Minh City Nguyen Ngoc Hoi said that there are currently 22 million accounts on social networking platforms, of which Zalo accounts account for 16 million.

Most accounts are cross-border, the data is located abroad, so management is under the authority of the Ministry of Information and Communications , national data to identify accounts of provincial/municipal information and communications departments is not provided.

According to Mr. Hoi, advertising on the internet today has many variations, not only inserting advertisements but also forming video clips with advertising content; there are even many forms of cutting and pasting information from official press agencies to create trust for people...

Therefore, it is extremely difficult to review and detect false advertisements on cyberspace.

Recently, the Department of Information and Communications has managed and handled according to Decree 72 on management of provision and use of Internet services and online information.

In her closing speech, Chairwoman of the Ho Chi Minh City People's Council Nguyen Thi Le also acknowledged that advertising functional foods on social networking sites is currently widespread and untrue.

Testing the quality of functional foods; testing functional foods containing medicinal herbs still has many difficulties; the rate of functional foods violating quality standards every year is still high (7-8%/total number of samples tested)...

Thereby, Ms. Le requested the City People's Committee, based on practice, to evaluate and synthesize all problems related to institutions, policies and laws to propose the National Assembly, the Government, and central ministries and branches to promptly resolve them.

First-line drugs for patients are also scarce.

At the explanation session, Ms. Hoang Thi Diem Tuyet - Director of Hung Vuong Hospital (HCMC) - said that in addition to rare drugs that are difficult to access, cheap drugs are also scarce.

The reason is because it is so cheap that companies importing it do not have high profits, such as high blood pressure medicine for pregnant women.

These are "first-line drugs", hospitals are forced to use other more expensive drugs, so there needs to be mechanisms and policies.

Source: https://tuoitre.vn/nguoi-benh-bo-tien-tui-mua-thuoc-bao-hiem-y-te-bhxh-tp-hcm-de-xuat-gi-20240614180206975.htm