Health Care Financing for Viet Nam

Health Care Financing for Viet Nam

June 20, 2013

The “doi moi” reforms launched in 1986, marked a shift from a centrally planned to a “socialist oriented market economy under State management”. Although this process led to marked improvements in overall well being for most of the people of Viet Nam, many still live at risk of falling back into poverty. Evidence of a widening disparity between urban and rural populations is a cause for concern as is the need to include ethnic minorities fully in the development process.

The health sector has been successful in providing preventive health services, controlling key communicable diseases and in achieving relatively good health statistics. Until the mid-1980s, Viet Nam’s health system was fully subsidized. Today, as in most countries, three mechanisms are used to finance health care: government budget allocations; fees for service; and prepayment schemes or health insurance. Recently, the Communist Party and the Government have reiterated the need to “enact policies on health allowances and insurance for the poor, (and) gradually advance toward universalisation of health insurance...”. This position was also reflected in the Comprehensive Poverty Reduction and Growth Strategy. Nevertheless, there is no defined strategy or master plan for the phased implementation of these long-term goals.

The review of various health financing options indicates that, in the present economic conditions, the best course of action is to increase the government health budget and to expand health insurance coverage further.  This is also the most appropriate way to contribute to protect the legacy of past achievements, improve equity and move towards the goal of universal coverage.

Key challenges affecting the expansion of the current health insurance scheme include: strengthening the legislative framework; capacity building of the social insurance agency, redefining the role of the Ministry of Health and improving coordination within a framework that promotes satisfaction among both providers and consumers of health care.

The paper concludes that universal coverage can be achieved in the next 20 years provided that there is sufficient political support, as well as an increase in government budgets complemented with additional resources from official development assistance and other sources of sustainable financing. The need for effective partnerships among all stakeholders is also highlighted. This achievement will lead to tangible improvements in health and decreased inequalities and do much to assist Viet Nam meet the Millennium Development Goals.

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