As part of the process of the Health Insurance Law revision, the Government of Viet Nam is currently identifying the core social health insurance (SHI) policies to be reformed and defining alternative options. Resolution 20 of the Communist Party of Viet Nam, dated 25 October 2017, formulated the need to “diversify health insurance packages; strengthen linkages and cooperation between social health insurance and commercial health insurance”. On that basis, the Ministry of Health is exploring the option of diversifying the benefit package(s) to provide more services or cover a greater share of the cost of the current service package to those willing and capable to contribute more.
The joint technical note recommends a compulsory or automatic participation in a single scheme to ensure the creation of a large, diverse risk-pool. This allows health systems to make efficient and equitable use of limited resources, cross-subsidising from the healthy to the sick and from the high-income to low-income earners. Setting up an additional benefit package usually requires setting up a separate pool to avoid the risk that the basic SHI fund might have to cross-subsidize the additional benefit package if it goes into deficit. The implementation of this option would also signal to the population that priority is being given to those who belong to higher income groups who can generate resources for the scheme, instead of addressing problems that impact everyone, such as ensuring quality and efficiency of care.
It is recommended Viet Nam VSS should not offer a diversified benefit package to meet the demand of better-off population groups who are willing to pay higher contributions for more services or more financial coverage. Rather, it is recommended to preserve the current SHI scheme, specifically the features of compulsory participation, with no one permitted to opt out. Additional coverage should be accessible on a voluntary basis from private health insurance.
The technical note has been jointly prepared by ILO, World Bank, and WHO Country Offices for Viet Nam, based on the policy reform orientation of the Ministry of Health of Viet Nam and the ILO report on country experiences in providing additional benefits package.
The technical note is available for download in the attachment.
