Health costs expected to get even higher

HA NOI — About 774,000 households in Viet Nam fall into poverty due to high treatment costs at hospitals regardless of whether they are given financial support, the World Health Organisation revealed at a two-day conference on Tuesday.

Patients, many from rural areas, queue at the Central Endocrinology Hospital in Ha Noi. Increasing medical costs push hundreds of thousands under the poverty line each year, a study by WHO and Ha Noi Medical University reveals. — VNA/VNS Photo Duong Ngoc.

Speaking at the conference held by the Ministry of Health, Nguyen Thi Kim Phuong, from the Viet Nam-based WHO, said that the study, under the co-operation of WHO and Ha Noi Medical University, showed that costs were increasing year by year. About 598,000 households fell into poverty after having treatment at hospitals in 2004, 694,000 in 2006 and 774,000 in 2008.

The rate of Vietnamese households who have to spend the steep health costs, more than 40 per cent of their income except for necessities, accounts for 6 per cent or nearly 1.2 million households.

Among them, poor households, households near the poverty line, with chronic patients and with the elderly are the most vulnerable groups, Phuong said.

However, the role of health insurance to protect against huge expenses remains limited.

Figures from the Viet Nam Health Economics Association showed that households' spending for health services made up 52.4 per cent of total social spending in 2008. The spending from the Health Insurance Fund only accounted for 17.6 per cent even though about 44 per cent of the population got health insurance.

The reason, according to PhD Nguyen Van Tien, vice chairman of the National Assembly Social Affairs Committee, is that patients have to pay for health services and drugs at prices as high as those in developed countries.

"The poor have high demand for medical care but low access ability. They receive treatment about 3 times per year on average while other groups receive it 5 times per year. For those who even get financial support from health insurance, hospital fees for each treatment are equivalent to 10 months of expenses, excluding food costs," PhD Ly Ngoc Kinh, former director of the ministry's Medical Treatment Department, said.

Meanwhile, total spending for the health sector was only 6.4 per cent of GDP and the average health cost was VND1.1 million ($60) per year.

Apart from expensive healthcare, patients are suffering from low-quality services, especially in rural areas.

Deputy director of the ministry's Health Insurance Department Nghiem Tran Dung reported that Bach Mai Hospital's experts found out that between 7.1 and 48 per cent out of 416 X-ray films from six hospitals in Thanh Hoa, Phu Yen and Yen Bai provinces were substandard due to improper poses and incorrect techniques.

About 22.6 to 61 per cent of X-ray results failed to match experts' diagnoses, resulting in incorrect diagnoses for patients.

A report from a Ha Noi hospital showed that antibiotics were popular at pharmacies, accounting for nearly 100 per cent of prescriptions in several wards, although half of these drugs were said to be unnecessary.

At the meeting, representatives said that increasing hospital fees would improve service quality. PhD Pham Manh Hung, former vice minister of health, said that the current fees have been applied since 1995 and are no longer suitable due to currency depreciation.

"Patients are still spending a large amount of money for drugs and medical materials during their treatments while accepting low-quality services. The health sector faces a shortage of capital for development and the moral hazard of several health staff," he said.

The ministry submitted proposals to increase hospital fees several times this year. The proposal last July was received with hostility from the public as the new costs were between seven and 10 times the existing ones.

Director of the ministry's Finance and Planning Department Pham Le Tuan suggested the financial adjustment be considered carefully, taking into account benefits of health systems, hospitals and patients.

Health insurance payments should be improved and private hospital incomes must be minimised and there must be satisfactory policies for health workers, Tuan said.

Representatives also suggested implementing health insurance for everyone.

The State and the community should encourage the health sector to improve quality.

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