Prevent and fight diseases from the root

In 2024, the country will record 183.6 million medical examinations, an increase of 9.7 million compared to 2023. Of which, about 40 million people will have regular health insurance (HI) examinations. The burden of medical costs on people is still large, the co-payment rate of some subjects is estimated at VND 21,905 billion; the part that the Health Insurance Fund has not paid is estimated at VND 24,800 billion.

The Ministry of Health said that although Vietnam has achieved a health insurance coverage rate of up to 94.2% by 2024, the health care network has expanded to every commune; professional capacity at both basic and specialized levels has made significant progress; the list of drugs and equipment covered by health insurance is more extensive than before; but direct costs paid by people still account for more than 40% of total health expenditure. This is still a high level compared to the recommendations of the World Health Organization. The risk of impoverishment due to illness still exists, especially for the poor, vulnerable groups, people with chronic diseases or long-term treatment; financial pressure on households is also increasing if there is no strong solution from public policy.

To achieve the goal of universal health insurance coverage by 2030, free basic hospital fees, reducing the burden of medical costs, aiming for comprehensive, equal, and quality health care for the people; in addition to the state budget, investment will be increased; one of the solutions proposed by the Ministry of Health is to increase the health insurance contribution rate in each stage, up to 6% of the basic salary by 2032. "Whether there is a policy of free hospital fees or not, health insurance contributions must still be increased to meet the treatment needs of the people because the current level is low, while the demand is increasing, the disease model makes the proportion of medical spending increase", said a representative of the Department of Health Insurance (Ministry of Health). Currently, the health insurance contribution rate is 4.5% of the basic salary.

The arguments and solutions proposed by the Ministry of Health above are relatively reasonable. However, we also need to remember the issue of "the nature of health is early disease prevention" as General Secretary To Lam noted when commenting on the investment policy of the national target program in the health sector. The General Secretary commented that the health sector is still heavily focused on medical examination and treatment, so we must change, the top priority must be to improve the quality of primary health care and preventive medicine. The General Secretary requested that the program set clear goals so that within 5 years, some infectious diseases such as tuberculosis and malaria, which many countries have eliminated, can be completely eliminated. If prevention and control are maintained half-heartedly, it will only lead to waste and create a burden on the system.

The General Secretary also emphasized the need to address the root causes of non-communicable diseases, which originate from the living environment, domestic water, and food safety. “Water must be clean enough to drink from the tap. Food must be controlled from the root. If the root cause is not addressed, building more hospitals or training more doctors will not be enough,” said the General Secretary.

Returning to the project to move towards free hospital fees, many opinions believe that it is necessary to base on the above fundamental orientations, both preventing diseases early and from afar, and taking care of people's mental health, avoiding ignoring the root cause and only focusing on solving the tip of the problem.

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