Medical bills accumulate despite Vietnam's rising insurance cover

By Le Nga   April 7, 2021 | 05:15 am PT
Medical bills accumulate despite Vietnam's rising insurance cover
People line up to pay for their medical bills at a hospital. Photo by VnExpress/Van Cuong.
Vietnamese have to pay nearly half their own medical expenses, twice the rate recommended by the World Health Organization (WHO).

Specifically, 43 percent of medical costs have to be personally covered, which is "quite high compared with many other countries," Le Van Kham, head of the health insurance department under the Ministry of Health, told a Tuesday conference on healthcare.

The same rate in developed countries is often around 24 percent, he added.

Vietnamese on average go for medical checkups 2.1 times a year, spending an average $129 per person. Around 35-37 percent of the cost goes to medicine, according to the ministry.

While about 91 percent of Vietnamese have health insurance, they still have to cover around 43-44 percent of their medical bills, it added.

Such an amount places Vietnam above Laos, Cambodia and Myanmar regarding personal payments for medical costs, but still below Indonesia, the Philippines, Thailand and Malaysia.

"By 2025, we want families to only have to cover less than 35 percent of their medical bills, and by 2030, less than 30 percent. However, it's a big challenge and not much has changed in the past several years," said Kham.

To pay less from their own pockets, Vietnamese should readjust their insurance contributions to cover more categories. Increased contributions could come from state-subsidized sources, business income or personal income. The current insurance contribution rate is 4.5 percent of one's basic salary.

However, who should increase their insurance contributions and by how much should be considered beforehand, Kham stressed, adding hospital spending efficiency also needs to be taken into account. He said current health insurance schemes help patients pay for individual services, but that this could lead hospitals to intentionally provide patients with more services to obtain more insurance money.

Starting July, the Health Ministry would apply a new payment method, where inpatients would know how much they would have to pay for each of their diagnosis. That way, doctors could give patients the most appropriate and cost-efficient treatment plan, said Kham. Such a model is currently being tested in certain localities like Quang Ninh, Yen Bai and Can Tho with promising results, he said.

According to a WHO financial expert, Vietnam’s health insurance coverage a decade ago was only 50 percent, and its citizens have to pay around 49 percent of their medical bills out of their own pockets. While insurance cover has significantly increased since then to around 91 percent, the amount of money patients have to pay for medical services has not proportionately decreased as planned.

It means Vietnam’s health insurance fund has not been used effectively, and while raising insurance contributions could be a solution, it would be meaningless if the services they provide are not used appropriately, the expert stated.

Each year, Vietnam’s health insurance fund spends up to VND120 trillion ($5.2 billion) on average for diagnosis and treatment. Throughout the last four years, the fund has been decreasing, forcing the government to use another emergency fund to keep the system afloat. Right now, around VND35 trillion is left in the fund.

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