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The poor, especially those who have not been medically insured, will be at stake when a controversial proposal for increasing hospital fees gets the go-ahead.
The Ministry of Health has suggested higher fees for 350 out of the 3,000 healthcare services, with some shooting up by a whopping seven to 10 times.
The medical service fee range applicable since 1995 is from VND500 to VND3,000 but the newly proposed minimum fee is VND8,000 and the maximum VND30,000. The daily fee for inpatients is 10 times higher than the current level, and for high-tech services, fees would be two to 20 times higher than at present.
As for the current fee for a medical service package, medicines account for around 60% and high-tech medical care makes up 30%. So if the proposed double increases are taken into account, the new fee for this package would soar about 20% and 30-40% for the treble rises.
The ministry is still passing the proposal around for consultation among ministries, hospitals and the public before it probably comes into force in September, but it has been met with outcries as higher fees would make access to medical care even more difficult for the poor.
Speaking at a meeting with the ministry in Hanoi on Wednesday, the local media grilled ministry representatives over the viability of the proposal and cast doubt over how the ministry would ensure medical care service quality and successfully implement the healthcare policy for the poor.
Hospital overload is widespread at the moment, with two or even three patients sharing the same bed, so the ministry was asked at the meeting how the fee is charged. Nguyen Huy Quang, deputy director of the ministry’s legal affairs department, said in response that the fee would apply to one bed for one patient and that the ministry had yet to have any regulations governing the media-mentioned case but a certain percentage of cost sharing could be considered.
However, media representatives expressed skepticism, saying who would guarantee hospitals would charge patients fairly and improve or maintain service quality when the new fees were enforced.
According to the ministry proposal, patients would achieve value for money but the chronic hospital overload puts this in doubt. Under the prevailing rules, each physician is responsible for a maximum of 30 patients a day and one patient has one bed.
The country now has a total of 37 centrally managed hospitals but about 60% of them have sufficient staff. At these hospitals, the fact that three to four patients share the same bed is common and a doctor may handle up to 100 patients a day, and a solution to these problems remains to be found.
The current requirement that patients –particularly those suffering from life-threatening diseases – must contribute 5% of the hospital fees is already a heavy burden for the poor. For the retired and children who are subject to a 20% contribution, they would pay much more.
If there is no policy support for poverty-stricken patients, especially those struggling with chronic diseases, a staggering 33 million patients who are not yet medically insured will suffer most.
Therefore, some proposed at the meeting that the ministry should launch a pilot scheme to raise fees at some designated hospitals to evaluate its impact on the poor.
(Source: The SaigonTimes)
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