Tighten health insurance spending to avoid profiteering

According to statistics from Vietnam Social Insurance, by the end of November, the whole country recorded over 177.8 million medical examinations and treatments covered by health insurance, an increase of nearly 10.3 million (more than 6%) compared to the same period in 2024. The number of payments since then has also increased by 16%, the estimated utilization rate of the health insurance medical examination and treatment fund of the whole country is 100.1%. In the cost structure, medical examination fees increased the most with nearly 32%, followed by the cost of hospital beds, diagnostic imaging tests and medical supplies…

The provinces with the highest rate of using estimates are Thanh Hoa, Dong Nai, Quang Tri, Nghe An, Son La, Ninh Binh, An Giang, Ha Tinh, Da Nang, Quang Ninh. Many medical facilities in these localities have inpatient treatment days and bed expenses accounting for a high proportion (over 40%) of total inpatient expenses (long hospital stays); Continuously increasing spending on original brand-name drugs (high prices), complementary drugs, mineral and vitamin drugs…

Thanh Hoa has the highest estimated usage rate in the country, with a high increase in medicine costs, especially traditional medicine products of more than 132 billion VND, an increase of nearly 33% over the same period last year. This local average outpatient cost also increased continuously from February to October; Inpatient treatment at traditional medicine facilities, rehabilitation rate of over 99% is very high; even measuring cerebral blood flow – the technical service group with the highest spending rate nationwide.

Ho Chi Minh City ranks 4th in terms of number of medical examinations and treatment but health insurance payments rank second. Of these, the largest concentration is at specialized medical examination and treatment facilities, about 59% of health insurance costs paid; Increased costs of surgical procedures; High prices for beds and medicine; Some medical facilities are increasingly ordering magnetic resonance imaging (MRI)…

Faced with the complicated situation of fund abuse, Vietnam Social Insurance directed the social insurance of provinces and cities to thoroughly review establishments with rising costs, early identify signs of profiteering to correct. This agency affirms that it will strictly implement the appraisal process and will definitely not pay for unreasonable or illegal expenses.

Today, the National Assembly agreed to increase health insurance premiums from 2027 to exempt hospital fees at a basic level for the entire population according to a roadmap suitable to the country’s conditions from 2030. The Ministry of Health is building a roadmap to waive hospital fees for the entire population through three stages, corresponding to the health insurance premium also increasing by 5.1% in 2027; to 5.4% in 2030 and 6% in 2032.

Currently, the applicable health insurance premium is 4.5% of the base salary, pension or unemployment benefit. With a base salary of 2.34 million VND, employees pay 105,300 VND per month. For the household model, the contribution level gradually decreases from the second member onwards, equal to 70%, 60%, 50% and 40% of the first person’s fee, respectively. Overall, the country currently has more than 95.5 million people participating in this safety net, reaching a coverage rate of over 94% of the population.