National UHC Dynamics Card Viet Nam

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General Information

Viet Nam is a southeast asian country, bordered by China, Cambodia and Laos. It’s population was estimated to be 94,6 million in 2016, with a life expectancy of 76 years (in 2015). 30% of the Vietnamese population lives in urban areas.

While many progresses have recently been achieved on the way to UHC in Viet Nam, some important reforms are being considered in order to further strengthen efficiency and equity, while reducing OOP spending.

Map of Viet Nam
Capital

Hanoi 21°2’N 105°51’E

National language

Vietnamese

Religion

Folk or Irreligious 73.2%, Buddhism 12.2%, Christianity 8.3%, Caodaism 4.8%, Hoahaoism 1.4%, Other 0.1%

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Viet Nam can be found in the attached print version of the card.

 
 

1992 - 2002

HEALTH INSURANCE PROGRAM
1992
Viet Nam enshrined the right to health care and protection for all citizens in its 1992 Constitution.

The national Viet Nam Health Insurance program was introduced the same year after a pilot experience. Aiming at facilitating financial access to health care, the scheme provided mandatory coverage for certain population groups (civil servants, employees of state-owned enterprises, pensioners and employees with an employment contract of min. 3 months).

Remaining groups could still benefit from a voluntary scheme.

 
1992-2002

The Government issued a series of legal documents progressively expanding population coverage. In 2002, the administration of the Health Insurance is transferred from the Ministry of Health to Viet Nam Social Security, following Decision 20/2002/ QĐ-TTg.

2002 - 2019

HIL
THE HEALTH INSURANCE LAW
 
2002
The Health Care Fund for the poor (HCFP) was set up.

It provides social health protection for the poor, ethnic minorities, and the disadvantaged.

2008
The Health Insurance Law (HIL) integrated the HCFP into the existing insurance scheme.

The Health Insurance Law (HIL) integrated the HCPF to the existing insurance scheme and made coverage compulsory.

2009
OUTCOME ON HEALTH 2009

The HIL was a highly fragmented and inefficient health financing system.

2012
Farmers, workers in agriculture, forestry, fishery sectors and salt producers were integrated into the HIL.
 
2014
The government revised the HIL, reinforcing compulsory enrolment for all and creating a single pool.

The Health Insurance scheme provides a unique and broad benefit package to all members, with co-payment ranging from 0 to 20% of a free schedule, depending on the group members belong to. The benefit package covers basic medical services and preventive services, including immunizations.

 
OUTCOME ON HEALTH 2014

The access to the broad benefit package was hindered by limited health facilities equipment and low quality of services at primary level.

 
MINISTRY OF HEALTH IN 2014

The MOH has an oversight and regulatory function. The MOH is responsible for monitoring and evaluation of HI and reports on the scheme’s performance to the National Assembly of Viet Nam. It is also responsible for setting prices of medical services.

The HI Fund is implemented and managed by the Viet Nam Social Security (VSS), a public agency.

The Ministry of Labour, Invalids and Social Affairs (MOLISA) is responsible for identifying vulnerable households and of beneficiaries of social assistance, meritorious programs and other subsidized programs.

2016

Domestic Government Health Expenditure represented 47% of Current Health Expenditure, and between 8 and 10% of General Government Expenditure after the adoption of the HIL.

2019

 

Viet Nam reached a population coverage of 87% and is now targeting 99% by 2020, with 100% coverage of the poor, elderly and other vulnerable groups.

 

Proportion of population with out-of-pocket health spending exceeding 25% of household’s budget or income:

VIET NAM (VSS) HEALTH INSURANCE ENROLMENT
HI COVERAGE BY GROUPS
OUTLOOK
Significant challenges remain, especially in terms of improving quality and financial sustainability.
FINANCIAL SUSTAINABILITY

The double challenge is to ensure financial sustainability of the health insurance scheme while guaranteeing benefits adequacy, in a context of a rapid aging population and a double burden of disease, contributing to a general increase of the costs of care in Viet Nam.

POPULATION COVERAGE

An additional challenge consists in maintaining the current achievement of high population coverage, ensuring that people who are now benefiting from state’s subsidies will start contributing after graduating out of poverty, and that Viet Nam will manage to further expand coverage to the missing middle.

PURCHASING MECHANISM

The MoH is considering to adopt DRG as a possible move towards more strategic purchasing and provider payment mechanisms, favoring cost containment.

 

Source references

• Barroy, H., Jarawan, E., & Bales, S. (2014): Vietnam: Learning from Smart Re-forms on theRoad to Universal Health Coverage. The World Bank, Washington,DC.

• Government of Vietnam (2008): Health Insurance Law 2008. No. 25/2008/QH12.

• Government of Vietnam (2013a):Decision 538/QĐ-TTg, approving a masterplan on theroadmap towards universal health insurance for the period of 2012-2015 and 2020.

• GovernmentofVietnam(2014): HealthInsuranceLawAmendment2014. No.46/2014/QH13.

• GovernmentofVietnam(2018): Decree146/2018/NĐ-CP,adetailedguideline onthe implementation of health insurance law.

• International Labour Organization (2020): Vietnam country case study on SocialHealthProtection, 100 years of social protection: The road to universal social pro-tection systems andfloors.

• Viet Nam Social Security website/research and statistics (Online: https://vss.gov-.vn/english/research/Pages/detail.aspx).

 

This card was created in friendly collaboration with Ms. Marielle Phe Goursat / Ms. Dung Doan Thuy – Program Manager - Social Health Protection, International Labor Organization (ILO) Country Office; P4H Focal Person.

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Viet Nam can be found in the attached print version of the card.