New insurance plans bankrupt poor patients

Published: 23/01/2010 05:00

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Health insurance holders at An Binh Hospital in Ho Chi Minh City’s District 5 on Thursday.

Policyholders no longer enjoy full payment and pay up to 20 percent instead.

Tran Van Hoang says he might not be able to pay his bills at An Binh Hospital after being admitted last Thursday for urolithiasis and asthma.

Although 42-year-old Hoang from Ho Chi Minh City’s District 8 has health insurance, he now has to pay 20 percent of his total bill, which he expects to be several millions of Vietnamese dong.

But a poor volunteer worker like Hoang can’t afford the expense.

Hoang and thousands of other patients nationwide are suffering from a recent change in the country’s health insurance policy.

In Vietnam, the government has traditionally paid all health costs for the poor, children under six years old, war veterans, orphans, those who contributed to the nation’s fight for independence and several other groups.

But the new Health Insurance Law changed all that.

On January 1 this year, several of these groups were required to begin paying 5-20 percent of their health fees.

Broke families

Hoang said he used to slaughter pigs but he retired in 1998 because he felt guilty killing the animals. Since then, he has worked as an unpaid charity worker assisting patients at An Binh Hospital, where he himself was admitted last week.

“Sometimes, the patients’ relatives paid me the small amount of money that I live on,” he said. “My wife is a sanitation worker with a meager income and we’ve had to raise three children of school age. My illnesses will surely bankrupt the family.”

Ngo Duy Bao of a poor family in HCMC said paying for the treatment of his wife’s high blood pressure, diabetes and heart disease would be “unbearable” under the new law.

“I have to pay more than VND1 million (US$54) for only three days of treatments,” the war veteran said, adding that his wife had been under treatment at the hospital since 2004 but had only recently had to pay such fees.

Bao also complained that the insurance agency only paid VND8,000 ($0.43) per bed per night at the hospital while such fees were actually between VND50,000 ($2.7) and VND150,000 ($8.12). “That means I have to pay the extra,” he said.

Many other patients, many of whom are orphans and senior citizens, have also complained about the new policy.

Statistics from Vietnam Social Insurance, which also oversees health insurance management, showed that around 15 million poor people used to receive free health care and another 15 million living near the poverty line only used to have to pay 50 percent of their insurance fees to receive full coverage.

Poor children suffer

A 14-year-old boy named Canh from Long An Province says he’s worried that his family can’t afford to pay for his kidney disease treatment, which used to be paid for by the insurance agency.

“The doctors told my mother that we would have to pay some VND5 million ($270.78) this year,” he said. “My father is dead and my mother lives on the hospital’s charity kitchen everyday as she cares for me here.”

Canh is one of dozens of poor children being treated for kidney diseases at Children’s Hospital No. 2 in Ho Chi Minh City. Most are now having trouble paying their hospital bills.

Most of these children are from poor families in Mekong Delta provinces, including Kien Giang, Ca Mau, Ben Tre and Tien Giang.

Dang Viet Trieu, another child under treatment at Children’s Hospital No. 2, has congenital cataracts. But his poor family in Kien Giang Province has been even more hard up since he developed kidney problems two years ago and the new hospital fees will surely worsen their poverty.

Tran Thi Minh of Dong Thap Province said she would have to take her daughter, a cancer patient, home from the HCMC Tumor Hospital due to the new fees.

“Each period of chemotherapy costs around VND5 million and we can’t afford 20 percent of that,” she said. “I will take her home sooner or later, even though I love her so much.”

SEEKING SOLUTIONS

Bui Minh Dong, deputy director of HCMC Social Insurance Agency, said his organization and the municipal Health Department had agreed to request support from the city administration to help the poor patients suffering from the policy change.

Doctor Phan Van Bau, deputy director of the HCMC Health Department, said it had asked hospitals to donate money to help poor patients and had also asked Vietnam Social Insurance to reduce the portion of hospital fees that these patients have to pay.

Complaints from patients have also led the Health Ministry to consider possible support.

Deputy Health Minister Nguyen Thi Xuyen said her agency and the Finance Ministry had convened a meeting and agreed that they would spend government money to pay for hospital fees required by orphans and senior citizens. However, the move can only be applied after an official decision on the issue from concerned agencies.

Hospitals nationwide will set up funds to support patients in the most extreme cases, she said.

Xuyen also said the Ministry of Health could ask the Prime Minister to approve a policy change regarding the country’s medical treatment fund, which helps poor people in need, so that the fund could be used to pay the 5-20 percent many patients were now having trouble meeting.

Reported by Thanh Nien staff

Provide by Vietnam Travel

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