Health insurance payment for services using borrowed machines show inconsistency

MoH informed that the demands on medical equipment of healthcare institutes in Vietnam lately have gone up significantly, while the investment from state budget, the Official Development Assistance (ODA) loan, the financial support, and the fund for operational development of each unit are all limited. Therefore, healthcare institutes have borrowed medical machines and devices from auction winners for medical supplies and chemicals to answer these needs.

On April 12, 2018, the Health Ministry sent formal Dispatch No.2009/BYT-KHTC to Vietnam Social Security (VSS) regarding health insurance payment for technical services related to these borrowed machines. On October 2, 2018, the two units agreed on payment details for this form in Announcement No.1039/TB-BYT-BHXH.

It clearly states that VSS continues to use health insurance to pay for technical services of patients using borrowed medical machines from auction winners for medical supplies, chemicals in accordance with the Auction Law and the signed contract. When the contract expires, contract partners must follow Decree No.151/2017/ND-CP by the Government detailing a number of articles in the Law on Public Property Management and Use.

Since there has been no official dispatch to cancel Announcement No.1039/TB-BYT-BHXH, MoH sees that the payment from health insurance for the use of technical services with borrowed medical machines still observes Dispatch No.6807/BYT-BH, issued on November 9, 2018 by MoH, with no relation to the cancelation of Dispatch No.2009/BYT-KHTC.

MoH is working with VSS for consistency in detailed instruction for regulation adoption. The two units will report to the Government of any case out of their power.

However, many hospitals are reporting that they have encountered difficulties in ensuring patient rights when technical services with borrowed medical machines are offered. The reason is that on May 9, 2022, MoH sent Dispatch No.2348 to VSS to cancel Dispatch No. then on May 12, VSS distributed formal Dispatch No.1261 to its members in provinces and cities about stopping the use of health insurance for payment for technical services with borrowed medical machines.

Statistics from Vietnam National Cancer Hospital reveal that each year it treats around 500,000 patients. 30 percent of people coming for diagnosis and 96 percent patients for treatment use health insurance. Before the Covid-19 pandemic, it carried out 4 million biochemical-immunological tests, 1 million hematological and microbiological tests and 35,000 immunohistochemical tests. Most of them are done on borrowed medical machines.

Hence, without the use of health insurance for payment of these technical services, many hospitals like this one will face trouble, and even have to temporarily stop a lot of medical examination as well as disease treatment activities, negatively affecting the rights of patients with health insurance.

After the introduction of Dispatch No.2348 by MoH and Dispatch No.1261 by VSS, various healthcare institutes in HCMC are also facing much confusion adopting. The HCMC Health Department of HCMC Social Security both have proposed that HCMC People's Committee ask for approval from MoH and VSS about resuming the use of health insurance for payment for technical services with borrowed medical machines. In case of terminating the use of this insurance, there must be a clear roadmap for medical institutes in HCMC to be well-prepared.

By Khanh Nguyen – Translated by Huong Vuong