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Estimated health insurance spending 110,000 billion VND for 2022

The total cost of medical examination and treatment covered by health insurance, assigned by the Government to the Social Insurance of localities, is nearly VND 110,000 billion.

According to the decision signed by Deputy Prime Minister Le Minh Khai on May 13, the above health insurance expenditure estimates are assigned to the Social Insurance of provinces and cities; Social Insurance Ministry of National Defense; Social Insurance of the People’s Police.

Ho Chi Minh City was assigned the most 20,000 billion VND; Hanoi 19,000 billion VND; Bac Giang VND 1,500 billion; An Giang 1,400 billion VND…

In 2020, the Government assigns a health insurance spending estimate of VND 103,000 billion; in 2021 is 106,000 billion VND. Thus, this year’s expenditure estimate is nearly 4,000 billion dong higher than last year.

If the health insurance expenditures in 2022 and previous years exceed the estimate and are appraised by the Vietnam Social Insurance, ensuring objective causes, the Social Insurance Management Council shall temporarily provide funding to the localities. direction. The maximum amount of temporary funding is 80% of the funding assessed by the Vietnam Social Security.

People go for medical examination and treatment at Ho Chi Minh City Oncology Hospital, April 2021.  Photo: Quynh Tran

People visit the Oncology Hospital in Ho Chi Minh City, April 2021. Image: Quynh Tran

The Chairman of the Provincial People’s Committee directs the units to effectively use the health insurance fund and estimate the costs of medical examination and treatment covered by the assigned health insurance. Vietnam Social Insurance guides the procedure for implementing a simple and convenient health insurance regime for participants.

The Health Minister shall guide the payment of medical examination and treatment expenses. Hospitals that fully supply drugs, chemicals, supplies and technical services within the scope of benefits of health insurance participants; to combat waste in the indications for testing and inpatient treatment, especially in the use of technical services and expensive drugs.

Expenditure estimates are the basis for localities to allocate funds for medical examination and treatment covered by health insurance. This is also the basis for localities to balance health insurance funds and spending on medical examination and treatment.

However, in October 2021, during a discussion at a group at the National Assembly, Finance Minister Ho Duc Phuc said that conflicts between the health insurance fund management agency and hospitals often occurred. The reason is that the Ministry of Health advises and promulgates policies, but the expenditure is on the hospital, the management is the Insurance. While hospitals often prescribe drugs, supplies are huge, making health insurance spending can be short. Therefore, the units are studying regulations to both ensure a balance between spending on health insurance participants and preserving and developing the fund.

From January 1, 2021, holders of health insurance cards will go to the wrong hospital for medical examination and treatment – that is, not at the place of initial medical examination and treatment registration, without a referral at provincial hospitals, if they are designated and treated. Inpatient treatment, the cost will be paid 100% by the Health Insurance Fund according to the benefit level of that group, instead of 60% as before. This provision does not apply to outpatient treatment.

The government aims to have 95% of the population covered by health insurance by 2025.

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