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Urgent request for payment of health insurance for technical services on borrowed machines

Ho Chi Minh City and 7 hospitals have just sent urgent documents to the Ministry of Health and Social Insurance asking to continue paying health insurance for technical services performed on borrowed machines, due to the impact on medical examination and treatment for people.

On May 13, Cho Ray Hospital sent an urgent dispatch to the Ministry of Health and Social Insurance of Vietnam, petitioning to continue to be paid for technical services on borrowed machines and machines from the winning contractors. , chemical put.

This hospital is said to be a last-line general hospital located in Ho Chi Minh City, receiving severe patients, exceeding the capacity of hospitals in the southern provinces and the Central Highlands. Every year, Cho Ray provides medical examination and treatment for more than 1.5 million outpatients (60% health insurance) and 150,000 inpatients (80% health insurance), the number of patients covered by health insurance is very large. Meanwhile, 80% of the testing machine system currently operating at the hospital is borrowed and ordered from the winning companies for materials and chemicals. The technical portfolio performed on these machines are essential tests for the diagnosis and treatment of patients.

However, on May 9, the Ministry of Health annulled the official dispatch (2018) of this Ministry sent to the Vietnam Social Insurance on payment for technical services using borrowed machines and machines provided by the winning units. fourth, chemical set. Right after that, on May 12, Vietnam Social Security issued an official dispatch requesting localities to stop paying health insurance for these services. This makes many hospitals suddenly fall into a difficult position because it will greatly affect medical examination and treatment activities as well as the rights and lives of patients.

Cho Ray Hospital believes that if health insurance is not paid, there will be two possibilities. The first, This place stops performing all tests on borrowed machines, machines ordered from the winning companies for materials and chemicals. This means that the hospital will stop working because there is not enough paraclinical equipment to serve the diagnosis and treatment and the patient’s life will definitely be at risk.

Second, in order not to affect and threaten the patient’s life, Cho Ray will continue to perform tests on borrowed and ordered machines, but patients must pay for themselves. But this will affect the benefits of patients with health insurance, and will likely have a great impact on social security.

“Therefore, for the legitimate interests of health-insured patients, Cho Ray Hospital urgently requests to continue to pay the cost of technical services performed on borrowed machines or ordered machines from the winning company. , chemicals or have a roadmap that allows the hospital to gradually switch to an alternative solution”, quoted from the petition.





Testing system at Cho Ray Hospital.  Photo: Provided by the hospital

Testing system at Cho Ray Hospital. Image: Hospital provides

On May 14, related to this issue, the People’s Committee of Ho Chi Minh City sent an urgent document to the Ministry of Health and Social Insurance of Vietnam to report difficulties and problems when terminating the payment for medical technical services. Actual implementation on borrowed and ordered machines.

The city believes that most of the testing machines (immunology, microbiology, hematology) are new generation machines, closed machines (which can only use chemicals of the company but cannot use chemicals of other brands). or if using chemicals from another company will give incomplete results or inaccurate results). Therefore, the organization of bidding for testing machinery and equipment is not suitable with reality.

According to the People’s Committee of Ho Chi Minh City, in the condition that the state budget investment as well as the non-business revenue of hospitals are limited, the investment in testing machines may not be effective (the initial investment cost is large, the investment Repairs arise, machines quickly become obsolete, chemicals according to machines do not win the bid…) so most of the testing machines in hospitals are being implemented in the form of winning companies for the package of testing chemicals. is responsible for providing equipment for the hospital to run testing chemicals (ie borrowed, installed machines).

There are about 412 medical examination and treatment establishments in the city, of which 185 are covered by health insurance. From May 9 to May 12, more than 9,400 medical examination and treatment visits were tested out of a total of more than 113,400 medical examination and treatment visits covered by health insurance, with a testing cost of 47/528.3 billion VND. The average cost of testing every day for health insurance patients is over 4 billion VND.

Thus, when implementing the new official dispatch of the Ministry of Health, the cost of testing performed for patients covered by health insurance in the city in the past 4 days is estimated at about 16 billion VND – will not be paid by health insurance. maths. In addition, this will lead to medical facilities suspending testing technical services on ordered and borrowed machines, which means that patients are not diagnosed and treated in time. This can seriously affect the quality of treatment, health and life of patients.

Therefore, the People’s Committee of Ho Chi Minh City proposes to the Minister of Health and the General Director of Vietnam Social Security to consider and approve the payment of testing costs by health insurance for technical services performed. from ordered or borrowed machines until there are new instructions from competent authorities. If the payment has to be stopped, it is necessary to have a roadmap so that medical facilities have enough time to prepare.

Currently, the Ministry of Health has not replied to the reason for issuing the above dispatch and how to solve it to ensure the interests of medical examiners.

Le Phuong

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