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To well implement policies of health insurance for military personnel via enhanced direction

Health insurance for in-service military personnel is a new issue in terms of both awareness and implementation. Therefore, we are in need of strengthened directions and demands from leadership and Party committees at all levels in order to ensure good health care for our personnel and contribute to the successful implementation of national insurance policy of our Party and Government.

On September 1st, 2015, the Government released Decree No. 70/2015/NĐ-CP, which provides detailed regulations and introductions for implementing Law of Health Insurance regarding the  Vietnam People’s Army (VPA), the Vietnam People’s Police and encryptography staff. The inclusion of servicepeople in health insurance reflects the great care of our Party and Government for the VPA and the responsibilities and proactiveness of the VPA in implementing the Law of Health Insurance. Within the new regime, military personnel are provided 100% free health care in 1,170 hospitals and other medical units nationwide. Good application of health insurance for military personnel will be an important contribution to the implementation of the national policy of health insurance of our Party and Government. It will also utilize various social resources - of which the national health system and Social Insurance is on the top of the list - instead of only Military Medicine forces in providing health care for our military.

Snr. Col. Nguyen Van Dinh delivers the opening speech of the training course on military social insurance and health insurance (photo:

In implementing the above-mentioned Government’s Decree, the Central Military Commission published Instruction No. 210-CT/QUTW, dated April 1st 2016, titled “On the Application of Heal Insurance to in-service military personnel during 2016-2020 and beyond” to deliver proper directions and demands across the VPA. Basing on those documents, Defence Ministry’s Social Insurance has applied the insurance regime to various organs and units of VPA. After over one year, we have seen good results, such as: generally, servicepeople are in good health; healthy person ratio continues to be high; military and civil hospitals are connected, which allows some cases to be moved to the civil ones when it is needed (this connection was absent); the expenses for health care services are totally paid by health insurance fund as they were before. With the insurance, grass-roots military medicine units are able to improve their expertise as well as their equipment and facilities, allowing them to receive more patients and thus helping to decrease the number of those taken by hospitals at higher levels(1). This new progress fits into the recent strategy of medical development designed by our Party and Government. With the medical services using health insurance, low-level medical units will have greater income which can be used to acquire better equipment and improve their doctors’ and nurses’ qualifications and livelihood. However, there still remain several drawbacks in the application of this new insurance regime, which include: the flawed awareness of some officers about insurance policy for military personnel; long and nonsynchronous procedures and proceedings in certificate and qualification awarding; the lack in quality and/or quantity of medical equipment, facilities and human resource in some military medical units. Moreover, the features of military activities also have certain negative impacts on the procedure to provide health care for our officers and soldiers.

According to the above-mentioned roadmap, beginning from 2018, 100% health care expenses of in-service military personnel will be paid by health insurance budget. The key for the successful implementation of that policy is the directions and demands of leadership and Party committees at all levels, with a focus on the following points.

First, strengthen education and propagation to make all officers and soldiers fully and thoroughly aware of their benefits and obligations as well as encourage them to take part in implementing the policy of health insurance for military personnel, thus ensuring the policy will be carried out in a timely and proper way from initial stage. Leadership and Party committees at all levels should continue to disseminate relevant laws, policies, decrees and resolutions of our Party and the Central Military Commission, focusing on Resolution No. 21-NQ/TW on “strengthening the leadership of our Party in 2012-2020 social and health insurance”, dated 22nd November, 2012, by the Politburo; Law of Health Insurance; Decree No. 210-CT/QUTW released on 1st April 2016 by the Central Military Commission. First of all, we need to agree that this new policy just changes the procedures of and alternates financial source from Government’s budget to health insurance fund in providing regular health care for servicepeople in peacetime. Budgets for other medical missions such as combat readiness, search and rescue, combating, special, medical missions, etc. of our military forces remain regulated by current laws and regulations of the Government and Ministry of Defence. What is more, we should diversify the instruments used in propagating activities and intensify the propagation about the new health insurance policy and regime through mass media. In doing so, more attention should be paid to answering questions of our officers and soldiers.

Second, improve facilities and equipment of our military medical units so that they can provide good health care for their patients. Medical facilities, equipment and human resources act as the determinants to the success of the new health insurance regime. Therefore, relevant leadership and Party committees should give necessary directions and demands to ensure all military medical units, doctors and nurses are qualified and certificated as required by related laws as they provide health-insurance-funded services. At the same time, our military medical system needs to be provided adequate doctors and nurses as required by our rules. In low-level units, many doctors and nurses are inexperienced and in short of modern medical equipment. To deal with the problem, these units should be proactive in planning and sending out their doctors and nurses to attend training courses, ensuring that they have opportunities to learn medical advances and can operate modern equipment and use information technology proficiently. Furthermore, we should also continue to improve professional responsibilities and morality of our doctors and nurses to meet their jobs’ requirements.

As regulated by the Law of Health Insurance, if the annual medical insurance budget allocated to a unit is not used up, the provincial insurance agency is allowed to keep 20% of the remaining and provided the money for hospitals and other medical units in the province to make acquisition or do technical maintenance. Hence, military medical units should use their medicines, medical materials and services efficiently. This will help them to ensure the interests of patients and, at the same time, well manage the health insurance budget for savings, which, in combination with finance from Defence Budget, can be used to build and maintain buildings as well as improve and buy new medical equipments for military medical units, especially those at low levels.

Third, closely cooperate with other relevant bodies to early detect and tackle emerging problems. Health insurance for military personnel is a new policy applied to our Army and servicepeople; therefore,  its implementation requires synchronous participation of many branches (including military medicine, finance, personnel, social insurance, etc.). As a result, it is important to have strengthened directions and commands from leadership to improve the awareness of each branch and help them to well play their roles and have good coordination so that the insurance policy can be led to success.

Accordingly, personnel departments and divisions should proactively suggest the commanders of each unit to instruct their subordinates to provide all needed and accurate background information, which will be collected and included in classified reports sent to the Defence Social Insurance Agency. The original information needs to be incorporated into the system accurately and properly to avoid mistakes, which can lead to waste of time and effort. Besides, each person should chose the most appropriate medical unit to register in his/her insurance card to minimize the possibility of applying for a new one. When someone is moving to new units and locations, relevant bodies should complete all necessary procedures as soon as possible to get new insurance cards for them.

Information technology should be further utilized in bearing physicians’ expenses which are covered by health insurance. Professional and financial principles need to be followed to ensure that patients enjoy their lawful interests and health insurance budget is well managed. Towards that end, medical units should make their list of services that are conformable with the available equipment and ability of the units, and have it approved. They also need to produce a catalogue of medicine and medical materials which are in accordance with rules by Ministry of Health and conformable with the professional area of each medical unit. The units have to provide each patient with a good prescription following his/her diagnosis and health problem. Notably, some kinds of medicine and medical materials which are not on the catalogue covered by standard health insurance can be paid by medical insurance for military personnel when it is necessary for officers and soldiers’ treatment. Medical units are forbidden to take any money from servicemen and servicewomen even temporarily, and should not allow them to take medicine and services from other providers if the units have qualified ones.

Military medical units need to inform all regulations and instructions to civil hospitals in order to facilitate the patient transfer. Hotlines between two sides should be established for each one to solve problems arising during implementation. Leadership and Party committees at all levels should have regular instructions for good inspection and observation of the operation of all relevant bodies and detect and tackle corruption in time.

Health insurance for servicepeople is a politically and socially valuable policy. Initially, its implementation, however, will encounter many difficulties. This fact requires comprehensive and strong directions and demands from leadership and Party committees at all levels to implement this policy effectively, contributing to good health of our officers and soldiers as well as the success of our Party and Government’s guidelines of health insurance for the whole people.

Sr. Col. Nguyen Van Dinh, Director of Defence Ministry’s Social Insurance

(1) According to initial estimates, in 2016, officers and soldiers treated in grass-roots-level military hospitals increased by 10% - 14%, while the number in military-districts’, corps’ and General Department of Logistics’ hospitals decreased by around 5%.

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