Raising hospital fees: issues to consider

Under the current difficulties, Ministry of Health (MOH) could increase hospital fees by 7-8 times. Some parts of the population agree with the price increase, but require qualified health care services. But according to some MOH officials, the increased price does not mean increased service quality.

Increased hospital fees must be accompanied with increased service quality

“One should review service quality before requesting increased examination charges,” said Mr Nguyen Tuong Lam, a patient being treated at Bach Mai Hospital. According to Lam, the increased price is not a problem if the equipment and working style of doctors reflects higher standards to satisfy patients. “We are willing to spend big money in exchange for good quality, but not an unguaranteed service.” So, according to this patient, it is necessary to review and reconsider the quality of machines and the level of service before deciding to increase the price.

Agreed with Lam, Hoang Nam – another patient said that the adjustment was necessary but should be accompanied with better service, higher responsibility and a clearer role for health insurance. Most developed countries are trying to minimize the cost to patients who are their citizens, and their services are much better.

Others agree with increased fees but request the state issue other policies supporting the poor with medical expenses instead of maintaining medical rates. In fact, some hospitals still apply 1995 rates. Most upper-level hospitals have increased prices for patient services, with an average examination fee from 15,000 to 30,000 dong.

Increased hospital fees not indicative of increased service quality

According to leaders of the Ministry of Health, the increased hospital rate aims to replace the obsolete rate set in 1995. These leaders confirmed this increase in hospital rate is not designed to increase service quality, nor to address problems of “implicit fees” in hospitals.

The increase of rates of 350 health services this time only covers a partial collection of hospital charges such as drugs, chemicals and materials, treatment, direct administrative costs for diagnostic treatment, electricity, water, and sanitation charges. Other accounts which fall in state budget expenditures, including salaries and equipment investments, will be excluded from hospital charges, said Mr Nguyen Huy Quang, Deputy Director of Legislation Department, MOH.

This increased rate cannot resolve the problem of hospital overload. “Increasing the hospital rate is a source of collection for hospital expansion. It will not impact the problem of overloading of hospitals,” said Mr Quang.

According to the Deputy Director of Examination and Treatment, Mr Tran Quy Tuong, this hospital rate increase is to correct outdated market prices, while increased service quality depends on other factors. Therefore, this increase cannot be expected to improve health care services.

Implicit fees are always a problem for patients, but this increase has yet to have any effect to the “implicit fee.” According to Mr Le Canh Music, Deputy Chief of the Legislation Department, the collection of implicit fees is difficult to control because of the number of sector workers. So solving the problem of implicit fees depends on individual medical workers.

Costs of examination with medical health insurance and referral to the same hospital are estimated to increase from 3,000 to 30,000 – 50,000 dong/visit/head. Bed fees will increase from 10,000 to 50,000 – 120,000 dong/head/day. Services like pregnancy surgery or appendicitis surgery will increase from 5 to 10 times.- VCCI

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