Vietnam - Don’t let the poor suffer from high health fees: official

New fees on health services at hospitals must be based on people’s living conditions to make them reasonable and affordable, said deputy head of the Tra Vinh Province Health Department Nguyen Van Thang.

While many other provinces and cities have applied their new fee rates at over 90 percent of the caps regulated by the Ministries of Health and Finance in February, Tra Vinh authorities have yet to announce local rates, though they will be much lower, Thang told Tuoi Tre.

The provincial Social Insurance Agency has allowed for current fees to be raised to 80 percent of the ceiling, but the provincial health department and other relevant agencies have decided the rate will be just 53 percent, which they consider appropriate with people’s living conditions.

“Tra Vinh is a poor province, so if we suddenly raised the fee rates too high, poor people would not be able to afford them,” Thang said.

Phan Thanh Dung, Thang’s deputy and the director of the Tra Vinh General Hospital, said, “Increasing a fee by two times is already too much, so if that fee were raised tenfold, then many patients, especially the poor, would likely die from diseases for which treatment costs have become unaffordable to them.”

Unlike many other localities, where higher fees have been imposed on the health services that are most common, for instance, sickbeds, Tra Vinh will apply increased fees mainly for technical services that are less frequent.

With the expected new fees, revenue from 25 percent of the total number of services will not be enough to cover cost, but local authorities said they would fill the gap by using part of the revenue from high-priced services.

The local authorities have also outlined a roadmap for increasing health fess from now to 2015. Accordingly, at times when the local economic strength is better, the fees on certain health services will be increased to improve hospitals’ revenue, Thang said.

As previously reported, 33 provinces and cities have applied their new health service fees since August 1. Of these localities, four will have fees that are over 90 percent of the ceiling allowed by the two ministry’s schedule, which covers 447 health services.

Under the schedule, most prices will rise 2 to 10 times current costs, but some may jump 20 times.

Fees are not quality a meter

Asked if such low new fees can affect the quality of health services , Dung said, “Even when we do not increase fees, we still serve patients in accordance with relevant regulations by the Health Ministry. We do not serve patients only on the basis of how much they pay for health fees.”

The province’s health sector pledges to ensure the quality of medical examination and treatment, Dung said, adding that treatment procedures, patient wards, medical equipment and facilities, and other items will meet required standards.

“With the new fees to be applied, hospitals will face difficulties in balancing their revenue and spending, but we will not loosen management over quality or limit the use of advanced medical techniques,” Dung said.

He emphasized that “hospital fees are not a gauge for quality. Quality should be measured through the results of treatment.”

He also said hospitals’ management should use the additional revenue earned from higher fees in proper ways. “This extra revenue must be spent mainly on improving medical examination and treatment conditions.”

TUOI TRE