Insurance profiteering a plague

Hanoi (VNA) – Health insurance profiteering is still common in private hospitals and health clinics, with medicine improperly prescribed and purchased, leading to an imbalance of the health care fund, health experts have said.

The statement was made at a recent dialogue on legal policies on health insurance between Vietnam Social Insurance and Vietnam Private Hospitals Association.

The dialogue was a chance for representatives of private hospitals and health clinics to highlight difficulties in implementing the amended Law on Health Insurance.

Deputy General Manager of Vietnam Social Insurance Pham Luong Son said that since the amended regulations were implemented two years ago, the number of hospitals providing health insurance services and patients increased greatly.

Figures from the organisation showed that 365 private hospitals and health clinics signed contracts to provide health insurance services in 2015, and this number increased to 444 in 2017.

In 2015, the fund paid 2.8 trillion VND (123 million USD) to more than 6.5 million insurance card holders. In 2016, the fund paid 6.6 trillion VND (290 million USD) to more than 16.6 million cald holders, with this year’s number expected to rise strongly - 1.58 trillion VND (69 million USD) for 4.2 million card holders within the first three months.

However, there were shortcomings in health insurance services at private clinics.

Nguyen Ta Tinh, head of the organisation’s Medicines and Medical Equipment Unit said that clinics persisted in selecting, purchasing and using drugs and medical supplies that were not cost-effective.

Some private hospitals held drug bidding, but the selection of contractors remained ineffective.

For example, 92 types of drugs sold at Vinmec International Hospital cost more than at Saint Paul Hospital with total difference value of 2.8 billion VND.

Some facilities prescribed expensive drugs or offered many medical techniques for health insurance holders to attract more patients.

Duong Duc Tuan, Director of the Centre for Health Insurance Coverage and Multi-level Payment in the north agreed, saying that some services were unnecessarily prescribed and the prescriptions were often repeated.

At the dialogue, Vietnam Social Insurance signed a coordination agreement with Vietnam Private Hospitals Association to solve difficulties and improve the effectiveness of the implementation of the health insurance regulations.-VNA