Ever since she knew of the forthcoming hospital fee increase, Dao Thi Cam, 47, from the central Quang Ngai Province, has turned into nothing but a nervous wreck. Her son, Huynh Van Tot, 20, suffering from chronic kidney disease, has been staying at Da Nang Hospital for four years and though they have social insurance, the prolonged treatment has taken a severe toll on her family’s financial well-being
Part 1: Patients burdened with hospital fee increase
Part 2: Public hospitals join private clinics in rip-off
The news of an increase in hospital fee stung them with the fiercest sting of despair.
“I’m so worried about the fee increase. Poor patients like us can’t afford to spend any more penny on hospital costs,” Cam says sadly.
These worries of hers and many others in the same situation have come on the heels of the Ministry of Health’s proposal to the government to hike up hospital fee from 30 to 100 percent.
Debts piled up on debts
To pay for their hospital costs, some patients have had to borrow money at a steep interest rate.
At the Oncology Hospital in Ho Chi Minh City, in room 202, B.T.H., a breast cancer patient, burst into tears: “We know that we must go to the hospital to save our lives. However I have accumulated debts I don’t think I will ever be able to pay off. Though I have the health insurance policy, I still have to pay VND4 million (US$195) out of my own money for a series of tests. I don’t know how much more I have to pay because each chemotherapy session costs 5 million dongs ($240).”
N.T.L. 46, from Tien Giang Province, is also suffering from breast cancer. The estimated preliminary cost can reach VND10 million ($480), according to the doctor examining her. She and her husband have decided to borrow the sum from a loan-shark lender at an interest rate of VND1 million ($48) a month.
Since she is not a subscriber to any insurance program, her treatment costs are much higher than others. The couple say they will try their best to cope with the hospital fees and will cancel the treatment to come back home in case their financial ability reaches its limit.
At one end of Giai Phong Street, opposite to Bach Mai Hospital in Hanoi, is a “dialyzer community” – an area where poor renal failure patients huddle together for survival.
Nguyen Van Thu and his brother Nguyen Van Chinh, two long-time kidney patients, have to undergo dialysis three times a week at Bach Mai Hospital. They have sold off all their belongings to keep up with the treatment. Yet, apart from the costs covered by health insurance, Thu still has to come up with more than VND400,000 ($19) per month to pay for the treatment. Once the proposed hospital fee increase goes into effect, the poor man will have to pay a doubled amount each month.
According to an estimate by the Ministry of Health, the cost of dialysis treatment will more than double from VND150,000 ($7) to about VND300,000 – 400,000.
A number of kidney patients in the community have sent their petitions to the authorities in the hope of keeping the treatment at the current costs, which has already been draining all of their financial resources.
Big question on treatment quality
Given the existing problems in the public hospital system of patient overload, infrastructure deterioration, sketchy diagnosis, and irresponsible treatment, will this bitter pill called “hospital fee increase” prove to be a cure-all?
Nguyen Bich Hanh, from Hanoi, has been suffering a long-lasting pain that resulted from the infections caused by irresponsible doctors in Hanoi Maternity Hospital leaving the gauze in her uterus after a surgery. And one of the most serious complications is that she may be infertile though she is just 22 years old.
Nguyen Duy Dai, a resident in Can Tho City, was rushed to Can Tho Central Hospital on 30th August 2011 in an emergency as he suffered appendicitis. He underwent a surgery and showed signs of positive recovery. Unfortunately, during the following night, his conditions deteriorated and he passed away during the night due to serious infections.
Explaining the cause of his death, Dr. Dang Quang Tam, head of Can Tho Central Hospital, said: “We’ve made a serious mistake of not informing the patient’s family of his true health problem, which is a lot more serious than they were told. That’s why they were so shocked when they knew that he was dead!”
When will the quality be improved?
L.V.Q whose mother was being hospitalized at Da Nang Hospital disagreed with the proposed hike in hospital fee, doubting if this would solve the current problem of poor quality treatment in overcrowded hospitals.
Inpatients and their relatives have to occupy the corridor of Oncology Hospital in Ho Chi Minh City while receiving treatment (Photo: Tuoi Tre)
“I’m willing to pay a hundred million dong for my mother to receive the best treatment here. However, if my mother has to share her bed with another patient as she does now, the fee increase is totally nonsense!”
A doctor at the Pediatrics Hospital No.2 in Ho Chi Minh City attributes the poor quality in treatment to the overwhelming number of patients checking in at the hospital each day.
As each doctor has to examine on average 60 to 100 patients per day, they can spend only 2 to 5 minutes for each patient. As a result, doctors cannot provide meticulous examination and detailed consultation for the patients. Even if the hospital fee is increased, the quality will likely remain unchanged.
According to Dr. Tran Thanh My, head of the Orthopedic Hospital in Ho Chi Minh City, the overload of patients at large hospitals in Ho Chi Minh City results from the poor medical services and the public lack of trust in provincial hospitals and clinics at lower administrative levels. He strongly believes that an increase in hospital fees is not a feasible answer to the problem.
The treatment quality at large hospitals in Ho Chi Minh City cannot be improved unless local hospitals prove they are competent and well-equipped enough to meet local patients’ needs, he argues.
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