In addition to fundamentally resolving problems that have arisen in the past, the Law ensures the unity and uniformity of the legal system; ensures social security, rights and interests of health insurance participants, medical examination and treatment facilities, etc. and strengthens the management and effective use of the health insurance fund.
Expanding rights and trust
According to statistics from the Vietnam Social Security, by the end of 2024, the whole country will have about 95.5 million people, equivalent to about 94.2% of the population participating in health insurance and the goal is to reach over 95% of the population participating in health insurance by 2030. In order to quickly bring the health insurance policy into life, relevant agencies are always researching, expanding the scope and benefits for people when examining and treating diseases. After 15 years of implementing the Health Insurance Law, many shortcomings have been revealed and it is not consistent with newly issued laws, so at the 8th Session, the 15th National Assembly passed the Law amending and supplementing a number of articles of the Health Insurance Law, which will take effect from July 1, 2025. The new law is assessed to clearly demonstrate the spirit of administrative reform, medical examination and treatment procedures, reduction of paperwork, increased application of information technology, maximum decentralization and delegation of power, creating convenience for people, agencies and organizations, ensuring gender equality, in accordance with international conventions of which Vietnam is a member.
Director of the Health Insurance Department ( Ministry of Health ) Tran Thi Trang said: The Law amending and supplementing a number of articles of the Health Insurance Law this time has eight outstanding new points: Amending and updating to add a number of subjects participating in health insurance. The new Law adjusts regulations on health insurance examination and treatment, including initial medical examination and treatment registration, transferring patients between medical examination and treatment facilities according to the technical expertise level of the 2023 Law on Medical Examination and Treatment. The Law stipulates the rights of health insurance card holders to register for initial medical examination and treatment at primary and basic medical examination and treatment facilities; stipulates that the transfer of medical examination and treatment facilities is carried out according to the professional requirements and response capacity of the medical examination and treatment facility, and the transfer of health insurance patients to initial medical examination and treatment facilities for treatment and management of chronic diseases.
The level of health insurance benefits when implementing the universal medical examination and treatment is not distinguished by administrative boundaries, maintaining the rate of benefits according to the provisions of current law and expanding to some cases. Health insurance participants are entitled to 100% of the benefits when examining and treating at the initial health insurance medical examination and treatment facilities nationwide; 100% of the benefits when going for inpatient medical examination and treatment at the basic health examination and treatment facilities nationwide... In some cases of rare diseases, serious diseases... patients are taken directly to specialized medical examination and treatment facilities; Health insurance also covers the treatment of strabismus and refractive errors of the eyes for people under 18 years old...
The new law also adds a mechanism for payment of drugs and medical equipment transferred between medical examination and treatment facilities and payment of paraclinical service costs transferred to other facilities in case of shortage of drugs and medical equipment and stipulates a mechanism for the health insurance fund to pay for these cases. At the same time, it adds specific regulations on late payment, evasion of health insurance payment and measures to handle these cases; regulations on application of information technology, digital transformation, data sharing in the field of health insurance; promulgate principles and criteria for developing a list of drugs, medical equipment, and medical services covered by health insurance to ensure standards, transparency, and publicity. Add regulations on issuing electronic health insurance cards... With the new health insurance policies, it is forecasted that the total number of health insurance examinations and treatments in 2025 may exceed 195 million people, of which the rate of out-of-line medical examinations and treatments will increase by about 10 to 15%.
The right policy, on target, but still challenging
The expansion of health insurance benefits is a remarkable step forward, but it also poses challenges for the health system, especially the end-line hospitals, in terms of management, payment and quality of medical examination and treatment. It is forecasted that after July 1, 2025, costs may increase by VND 5,000 to 8,000 billion due to the sharp increase in the number of patients choosing to receive treatment outside the line.
Associate Professor, Dr. Dao Xuan Co, Director of Bach Mai Hospital shared: When the national inpatient health insurance policy takes effect, there will be an increase in patients choosing to go directly to higher levels. This is an opportunity for hospitals to affirm their quality, but at the same time, it is also a great pressure on human resources, infrastructure, and treatment processes for end-line hospitals. Currently, the hospital has implemented three routes: admission, emergency, and treatment according to the role of the end-line, not refusing any cases. In order to reduce the load when the new health insurance policies take effect, the hospital has deployed a center to train high-quality medical personnel and transfer techniques to lower levels to improve the capacity of the entire industry. When the grassroots health care system is strong, people will receive good primary health care, many diseases will be treated right at the lower level, significantly reducing travel costs, and at the same time reducing the burden on the health system...
In parallel with the implementation of a series of health insurance policies, previously hospitals such as Bach Mai, Viet Duc Friendship, Central Obstetrics, E Hospital... have made changes to meet the new regulations of the health insurance policy. Hospitals have been focusing on changing procedures, upgrading internal software, adding card scanners, smart support devices to help register and receive patient information quickly, shortening the time for procedures. At the same time, training, coaching, and propaganda for the entire team of doctors, nurses, and staff on health insurance procedures and policies, ensuring friendly, transparent, and fast services; instructions on the use of electronic health insurance cards or chip-embedded citizen identification cards, helping patients save time on hospital admission procedures...
According to Deputy Minister of Health Tran Van Thuan, Vietnam is moving towards 100% health insurance coverage for the population by 2030. The policy of paying 100% for inpatient treatment outside the health care system not only encourages people to participate in health insurance, but is also a strong commitment to ensuring fairness in access to health care.
However, for the policy to be truly effective, it requires synchronous coordination between ministries, branches and local authorities, along with initiative from the people. With the new points applied, health insurance will be truly valuable, bringing people confidence in a fair and effective health system.
sustainable
Source: https://nhandan.vn/them-nhieu-quyen-loi-cho-nguoi-tham-gia-bao-hiem-y-te-post890838.html
![[Photo] National Assembly Chairman attends the seminar "Building and operating an international financial center and recommendations for Vietnam"](https://vphoto.vietnam.vn/thumb/1200x675/vietnam/resource/IMAGE/2025/7/28/76393436936e457db31ec84433289f72)
Comment (0)