They include Bac Ninh, which became the first locality in the country Tuesday to adopt new rates, equal to 84 percent of the maximum allowed by a joint fee table the Health and Finance Ministries issued in February.
Soc Trang went so far as to propose a sickbed fee that is 127 percent of the ceiling, while Son La expects its prices to be 13 percent higher than the maximum.
In addition to raising revenues, Vietnam Social Insurance vice general director Nguyen Minh Thao said local authorities are increasing fees because they made faulty calculations.
Thao said they have not complied with Health Ministry instructions to determine prices, and in some cases, input the wrong costs. For example, Lao Cai computed fees using prices for medical supplies that are 150 percent to 200 percent of the prices in other provinces.
Thao added that officials should not use prices that have been inflated by flawed bidding on medicine and medical supplies.
The Health Ministry’s report notes that 18 provinces and cities are seeking fees below 80 percent of the ceiling set out in the fee table, which regulates the prices for 447 different health services. Another 14 provinces and cities chose levels below 90 percent of the ceiling, while 16 want prices equal to 90 percent to 100 percent of the maximum.

People waiting to pay hosital fees at Binh Dinh General Hospital in Binh Dinh Province, which has lowered fees to 54 percent from 91 percent of the ceiling (Photo: Tuoi Tre)
The latter tend to be jurisdictions struggling to close budget gaps and further socio-economic development. All local health departments have the right to calculate and set prices according to local needs, but require final approval from their People’s Councils.
Lowering unreasonable rates
Dang Thi Minh, director of Nam Dinh Province Health Department, said her agency has proposed health rates equal to 60 percent of the highest permitted, but provincial authorities wanted lower prices because just 43 percent of the province have health insurance cards.
Other provinces, too, are realizing they have overshot their estimates and are looking to lower rates, according to Pham Luong Son, head of the Vietnam Social Insurance’s Board for Health Insurance Policy Implementation.
Bac Ninh province had earlier planned to charge 100 percent of the maximum rates, but changed tact after consulting with Vietnam Social Insurance.
Similarly, Binh Dinh has lowered fees to 54 percent from 91 percent of the ceiling, while Thanh Hoa is considering a similar move.