>> Health insurance coverage up, but targets remain difficult: Minister

Phan Van Hien of the Mekong Delta province of Ca Mau voluntarily bought health insurance and registered for treatment at his commune health centre. In the past, whenever he had to go to the HCM City Hospital for Tropical Diseases, the insurance covered 30 per cent of the cost.

But when he went to the HCM City Oncology Hospital for screening for liver cancer on January 15, he was refused coverage for the screening and subsequent hepatitis treatment. The reason? He did not go to the hospital designated on his insurance card.

"I was surprised," he said.

"How irrational this provision is!"

He said he does not trust the doctors at his local clinic.

"That is why I came to this hospital."

Like Hien, Duong Thi Mai, 39, of the southern province of Dong Nai, who has multinodular goitre, which enlarges the thyroid gland because of iodine deficiency or thyroid disorder, went to the HCM City Oncology Hospital instead of her provincial hospital.

"I am ready to lose the health insurance benefit," she said. The designated hospital is her provincial one.

Luu Thi Thanh Huyen, deputy head of the HCM City Social Insurance, said the amended law forces people to go to local hospitals to reduce the overload on city and central hospitals.

But under the law, patients cannot designate any city or central hospital.

Many people go to city- and central-level hospitals in major cities like HCM City and Ha Noi for treatment even when their ailment is not serious, leading to severe overload at these hospitals, Huy?n said.

Now health facilities in provinces, districts and wards and even communes are equipped well and doctors there cure common ailments, she said.

The amended law provides benefits for insured patients, she said, explaining that for poor and ethnic minority people living in disadvantaged areas the entire treatment cost is now covered by health insurance compared to 95 per cent in the past.

The country has more than 14 million poor people ethnic minorities and 3 million just above the poverty line all of whom get free health insurance provided by the government.

If health facilities at grassroots level cannot treat a patient, they will transfer them to a city- or central- level hospital, Huyen said, adding that the patient's insurance cover has been enhanced. Now 40 per cent of their treatment costs at city and central level hospitals are covered compared to the earlier 30 per cent.

This goes up to 60 per cent from the earlier 50 per cent if treated at provincial-level hospitals, and 100 per cent from 2021.

But many people with insurance prefer to go to city and central hospitals in HCM City and Ha Noi.

Dr Diep Bao Tuan, deputy head of the HCM City Oncology Hospital's planning division, said since the amended law took effect the number of patients has not decreased.

Dr Truong Huu Khanh, head of the HCM City Paediatric Hospital No.1's neurology and infectious diseases ward, said to improve treatment quality at grassroots and provincial levels, the expertise of doctors there should be improved.

Doctors at city- and central-level hospitals should provide more training for them, he said.

The Ministry of Health should make a list of ailments that hospitals at grassroots and provincial levels can treat and publicise it, he suggested.

In an online meeting with health personnel in provinces and cities, Minister of Health Nguyen Thi Kim Tien said with many programmes to improve the skills of doctors at grassroots health facilities carried out for many years and modern equipment provided, the treatment quality there has improved.

"It is important that hospitals provide information about their improvement to the public."

Reducing the load on major hospitals would also help reduce infection risks there, she pointed out.

Hospitals should take the initiative to work with the media to communicate this information to the public, she said.

But she heard residents' complaints about some irrational provisions in the amended law and promised to work with the Viet Nam Social Insurance Agency to review them.