Building a basic health service package within the free scope

On the afternoon of December 1, the Ministry of Health held a workshop to seek opinions on the direction of developing a project to gradually implement the hospital fee exemption policy according to Resolution No. 72-NQ/TW of the Politburo.

This is the first time the Ministry of Health has consulted experts, aiming to realize the policy of regular medical examination and free hospital fees for all people.

Reduce the cost burden on people

Speaking at the workshop, Alternate Member of the Party Central Committee, Permanent Deputy Minister of Health Vu Manh Ha emphasized that in recent years, Vietnam has achieved many important achievements in the field of health care.

“By 2024, Vietnam's health insurance coverage rate will reach 94.29% of the population, the medical examination and treatment network will be widespread down to the commune level, the professional capacity of the specialized, basic and initial levels will be significantly improved, the list of drugs and medical equipment within the scope, and the benefits of patients with health insurance cards will be increasingly expanded.”

However, according to Permanent Deputy Minister Vu Manh Ha, in addition to achievements, we also face major challenges, which are people's out-of-pocket spending, estimated at over 40% of medical examination and treatment costs, still at a high level according 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.

At the same time, financial pressure on households will increase if there are no strong solutions from public policy.

"Therefore, the policy of gradually moving towards free hospital fees is an objective and urgent requirement, both demonstrating the good nature of Vietnam's social policy system and ensuring the people's right to health care," Permanent Deputy Minister Vu Manh Ha emphasized.

According to Permanent Deputy Minister Vu Manh Ha, the hospital fee exemption policy is not only a financial solution for healthcare but also has profound social and humanitarian significance: Reducing the cost burden for people, especially the poor and vulnerable groups; increasing equity in access to healthcare services, ensuring "no one is left behind"; improving the quality of healthcare, because when financial barriers are removed, patients will be examined and treated sooner and more effectively; promoting the improvement of the healthcare system in a sustainable direction, reducing the risk of people delaying or abandoning treatment due to costs.

Currently, many countries in the world have applied free health care policies or universal health insurance and achieved positive results: reducing the rate of medical poverty, increasing access to services, effectively controlling diseases and reducing late treatment costs.

"These are experiences worth referencing for Vietnam to build a model suitable to development conditions, resources and structure of the domestic healthcare system," Deputy Minister Vu Manh Ha informed.

However, this policy must still be based on the pillar of health insurance, with support from the state budget, and implemented on a roadmap. The state budget and health insurance fund will cover basic and essential medical expenses, minimizing the financial burden on people, first of all for social policy beneficiaries, the disadvantaged, low-income people and some other priority groups.

For medical services on demand, exceeding the basic level, patients still have to pay a part to raise awareness of using services reasonably and saving costs.

The policy of free hospital fees must therefore be closely linked to universal health insurance coverage, with everyone participating in health insurance to share risks, with the well-off taking care of the poor, the healthy helping the weak; along with support from the state budget and socialized resources so that patients do not have to pay extra costs when they are unfortunately sick.

Implement basic health service packages according to the roadmap

According to Ms. Tran Thi Trang, Director of the Department of Health Insurance (Ministry of Health), the current burden of medical costs is very large, with people estimated to pay about 40% of the costs themselves. The total amount that the Health Insurance Fund has not paid is estimated at about 24,800 billion VND/year.

The health insurance contribution rate is still low, at 4.5% of the salary/reference level used as the basis for contribution. Regarding the scope of the "free hospital fee" policy, the goal is to cover all people with health insurance, while gradually reducing and moving towards waiving the co-payment rate.

"Regarding the basic medical service package within the free scope, we will determine the list of services, diseases, drugs, and medical equipment. Cover common diseases, prioritize necessary diseases first, gradually expand the scope according to professional requirements suitable to the capacity of the State budget, the Health Insurance Fund, and combine social mobilization. At the same time, build a maximum cost for one medical examination and treatment," said Ms. Trang.

Specifically, the average cost of inpatient/outpatient medical examination and treatment nationwide is adjusted annually or periodically, excluding some diseases and techniques with high costs.

In the immediate future, it is expected to be applied at primary and basic medical examination and treatment facilities, public and private medical examination and treatment facilities.

"The implementation will be according to the roadmap, priority subjects, in accordance with the contribution level, the balancing capacity of the Health Insurance Fund, and socio-economic conditions in each period."

Regarding the source of funding, it will be based on the pillars of health insurance budget, disease prevention fund, and social mobilization. In particular, it is expected to increase budget expenditure and health insurance contribution according to the roadmap 2027-2030, the State budget will support health insurance contribution for priority subjects.

Using the Disease Prevention Fund, at the same time, diversifying financial sources such as supplementary health insurance, commercial health insurance, patient support programs; new financial sources from taxes on products affecting health.

According to this proposal, the 2026-2026 period will focus on increasing the rate and payment level. From 2026, people will be given periodic health check-ups or free screening at least once a year according to priority groups and roadmaps; organize coordination between periodic health check-ups, free screening, health check-ups for students, occupational health check-ups, health check-ups for workers according to regulations and health insurance medical examination and treatment to provide free medical examinations and complete the creation of electronic health books for all people.

Priority groups from 2026, health insurance participants are those from near-poor households, elderly people aged 75 and over who are receiving social pension benefits will be entitled to 100% of medical examination and treatment costs within the scope of health insurance benefits.

Increase the rate and level of health insurance payment for drugs, medical equipment, and technical services.

At the same time, increase health insurance contributions from 2027 (about 5.1%), budget contributions, and support contributions for social policy beneficiaries.

By the 2028 - 2030 period, the goal is to reduce out-of-pocket spending to below 30%; continue to increase the rate and level of health insurance payments for drugs, medical equipment, and technical services; pilot cost-effective screening for 2-3 diseases; pay from the health insurance fund for disease prevention services; increase health insurance coverage to over 95% of the population; increase health insurance contributions from 2030 to 5.4% and pilot supplementary health insurance, diversify health insurance packages...

After 2030, universal health insurance will be covered, and screening for 3-5 diseases will be expanded at a cost-effective rate.

Free hospitalisation for all within the scope of basic service packages, expanded according to roadmap and resources; increase health insurance contribution rate from 2032 to 6%.

Perfecting the grassroots healthcare network and the smart, multi-layered, multi-benefit package health insurance payment system./.

(TTXVN/Vietnam+)

Source: https://www.vietnamplus.vn/xay-dung-goi-dich-vu-y-te-co-ban-thuoc-pham-vi-mien-phi-post1080378.vnp