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The Ministry of Health said that by 2024, salary costs and direct costs will be fully included in the price of medical examination and treatment services.
Regarding the roadmap for adjusting prices of medical examination and treatment services with management costs and depreciation costs according to the roadmap for public service prices, the Ministry of Health said that, implementing the direction of the Government's leaders, the Ministry has developed a specific roadmap and proposed in the draft Decree detailing the implementation of a number of articles of the Law on Medical Examination and Treatment that by 2024, full salary costs and direct costs will be included in the price of medical examination and treatment services.
By 2024, fully calculate salary costs, direct costs, and management costs into the price of medical examination and treatment services. From 2025 onwards, gradually incorporate depreciation costs into the price of medical examination and treatment services. The draft has been sent to the Ministry of Justice for appraisal to complete and submit to the Government for promulgation.
The Ministry of Health has issued Circular No. 13/2023/TT-BYT regulating the price framework and pricing method for on-demand medical examination and treatment services provided by state-owned medical examination and treatment facilities; accordingly, the price of this service is calculated based on four cost factors. Although the subject of application is patients using on-demand medical examination and treatment services, it is a step forward in implementing the roadmap for public service pricing.
Regarding the adjustment of medical examination and treatment service prices according to the basic salary of 1.8 million VND, the Ministry of Health said that currently, the price of medical examination and treatment services under health insurance and the price of medical examination and treatment services for subjects without health insurance cards are implemented according to the basic salary of 1.49 million VND/person/month. The Ministry has developed circulars according to regulations and assessed the impact of the issuance of the circular. The adjustment of medical examination and treatment service prices according to the basic salary of 1.8 million VND is a step in the process of implementing the roadmap to correctly and fully calculate the price of medical examination and treatment services.
The Ministry of Health has coordinated with the Ministry of Finance and relevant agencies to propose not to change the price structure of medical examination and treatment, but only to change the basic salary from 1.49 million VND to 1.8 million VND. At the same time, review and supplement the prices of some services such as: payment for technical services performed by anesthesia, review some medical examination and treatment services that have problems in the payment process for medical examination and treatment costs....
Regarding the impact on the Health Insurance Fund, according to the Ministry of Health, if the salary structure is adjusted to the price according to the basic salary of 1.8 million VND, the average increase rate of the price of medical examination and treatment services is 5%, the Health Insurance Fund's expenditure increases by about 2,700 billion VND/year. The salary adjustment has been implemented since July 1, 2023, accordingly, the Health Insurance Fund's revenue also increases at the same time. Based on data in Report 352/BC-CP of the Government on the results of management and use of the Health Insurance Fund in 2021, if the price of medical examination and treatment under health insurance is adjusted according to the basic salary of 1.8 million VND, the Health Insurance Fund is still able to balance.
According to the General Statistics Office, it is estimated that the application of the new basic salary will increase the average CPI nationwide in 2023 by about 0.16 - 0.25 percentage points. The General Statistics Office has proposed scenarios, according to which, if the price of medical examination and treatment is adjusted, the CPI will still be within the allowable range.
The Ministry of Health affirmed that adjusting the price of medical examination and treatment services according to the basic salary of 1.8 million VND does not affect the people. The poor, ethnic minorities living in areas with difficult socio-economic conditions, people living in areas with especially difficult socio-economic conditions, children under 6 years old, people living in island districts and island communes; people with meritorious services to the revolution, relatives who are fathers, mothers, wives, husbands, children of people with meritorious services to the revolution, social policy beneficiaries who are eligible to buy health insurance cards from the state budget and other financial sources, when going for medical examination and treatment, are 100% covered by health insurance, so they are not affected.
For the near-poor, they only have to pay 5%, so the impact is insignificant. Those with health insurance cards who have to pay 20% of the cost of medical examination and treatment are affected, but the impact is not much because the additional payment is only for the part paid according to the price of medical examination and treatment services; the cost of medicine and supplies paid according to actual use is not changed.
For those who do not participate in health insurance (about 10% of the population has not participated in health insurance), it only affects the payment according to service price (46.5% of total medical examination and treatment expenses). The Ministry of Health has widely collected opinions on the Government's Electronic Information Portal about the draft circular.
On the other hand, for those who have participated in health insurance for 5 consecutive years or more and have gone to the right medical facility for examination and treatment, when the co-payment amount in the year is greater than 6 months of basic salary, they only have to pay a maximum of 6 months of basic salary. Adjusting the price of medical services to the salary level of 1.8 million VND creates conditions for these cases to have their medical examination and treatment costs covered by health insurance paid more than when implementing the price level according to the draft circular.
For medical facilities, the salary according to the basic salary level of 1.8 million VND will be implemented from July 1, 2023, when the circular takes effect, which is later than the time of adjusting the basic salary level. Accordingly, medical examination and treatment facilities have had to use regular expenditure funds to pay during the period when they have not yet implemented the collection according to the price level in the circular, especially Group 1 and Group 2 units that are not subsidized by the state budget but must ensure their own payment sources.
Following the direction of Deputy Prime Minister Le Minh Khai, the Ministry of Health is coordinating with the Ministry of Finance and the Ministry of Planning and Investment (General Statistics Office) to assess the impact, especially inflation, before submitting it to the Prime Minister for comments.
At a recent meeting of the Steering Committee for Price Management, Deputy Prime Minister Le Minh Khai expressed his dissatisfaction that the basic salary has increased from July 1, 2023 while the circular has not been issued yet, which is too slow. “Increasing cost structure and increasing service prices are normal,” the Deputy Prime Minister emphasized.
