Le Van Phuc, Deputy Director of VSI’s Department for Health Insurance Policy,said that health insurance spending in the first eight months of this year hasreached over 50 trillion VND (2.17billion USD), accounting for 70 percent ofthis year’s planned allocation.
As many as 51 provinces and cities have overspent the fund. Some provinces suchas Nghe An, Thanh Hoa, Thai Binh and Quang Nam, and Da Nang city overspent from500 billion VND (21.7million USD) to 1 trillion VND (43.4million USD).
Quang Nam and Quang Trị reportedly used up 90 percent of the year’s allocation.
“If the overspending continues, the health insurance fund can only afford 2018and 2019,” Phuc said.
Only two southern provinces – Dong Nai and Binh Duong and two cities - Hanoiand HCM City - are able to balance the fund.
These localities have a high number of health insurance card holders and haveeffectively utilised the fund, Phuc said.
VSI also estimated that the reserve fund to balance the health insurance fundwill be exhausted by 2020.
It blamed the overspending for abuse by both health care organisations andpatients aiming to siphon money.
Phuc said that some health care facilities ask patients to conduct unnecessarymedical tests. Others have increased hospital fees by over 40 per cent byadding more beds to allow unnecessary hospitalisations.
In Ha Tinh province, health care quality at some hospital departments is notensured. They mobilise far fewer medical workers per bed than the standard ofone worker per bed. Doctors still prescribe high-cost drugs instead of cheaperrelevant ones.
According to VSI, health insurance overspending has also been blamed for increasinghealth care service prices, and a health insurance policy that came into effectearly last year. Accordingly, people with health insurance cards at thedistrict level can get health check-ups or treatment at any health facility theywant within their own district without the requirement of showing referralpapers as before. Many people have taken advantage of this new regulation to goto health care facilities many times for check-ups and to get free drugs.
According to Dam Hieu Trung, deputy director of VSI’s centre of healthinsurance assessment and multi-level payment in the northern region, in thefirst seven months of this year, there were over 91 million check-ups of healthinsurance card holders with total payment of nearly 46.7 trillion VND (2.03billion USD).
As many as 31 provinces have increased health examination and treatmentspending by over 40 percent compared to the same period of 2016. Some provincessuch as Kon Tum, Lang Sơn, Khanh Hoa provinces have increased the allocation byover 70 percent, he said.
Using its the supervision system, VSI discovered 1,580 patients havingcheck-ups eight or more times in July.
For example, patient Tien Van B had 132 check-ups at seven health carefacilities in the first eight months of the year. The total health insurancepayment added up to more than 30.3 million VND (1,317 USD).
Phuc from the Department for Health Insurance Policy said thatpenalties imposed on health insurance fund abuse have not been strict. Except forcriminal punishment for some cases, in some other cases, disallowed expendituredeductions are applied.
Trung said that VSI has asked provinces and cities to assess abusive actions,revoke illegal spending and publicise this information on local web portals.-VNA