Moving toward Universal Coverage of Social Health Insurance in Vietnam

Universal Health Coverage (UHC) is a critical component of sustainable development and poverty reduction, and a key element to reduce social inequities. For these reasons, policy makers in ASEAN should advocate for UHC as one of the health priorities beyond ASEAN Economic Community 2015 (AEC 2015) Health Development Agenda. Being highlighted by the World Bangkok, Vietnam is one of the countries having fully adopted UHC as a national strategy and made strong progress toward its goal of affordable access to needed and quality health services.

However, there are still significant challenges remain in terms of improving equity with continuing low rates of enrollment. Ensuring financial protection also remains an elusive goal. The Master Plan for Universal Coverage approved in 2012 by the Prime Minister directly addresses both these deficiencies in coverage.

This report published by the World Bank is a joint assessment with development partners, World Health Organization, United Nations Children's Fund (Unicef) and Rockefeller Foundation. And the objective of this report is to assess the implementation of Vietnam SHI and provide options for moving towards UC. The report indicates that expanding breadth of coverage, particularly for those hard to reach groups such as the near-poor and informal sector would require substantially increasing general revenue subsidies and fully subsidizing the premiums for the near-poor. Please see the abstract of the report below and the link to download the full report

Abstract

To address the growth in resultant out-of-pocket (OOP) payments and associated problems of financial barriers to access, the government issued several policies aimed at expanding coverage throughout the 1990s and 2000s, particularly for the poor and other vulnerable groups. Universal coverage (UC) can be an elusive concept and is about three objectives: (a) equity (linking care to need, and not to ability to pay); (b) financial protection (ensuring that health care use does not lead to impoverishment); (c) effective access to a comprehensive set of quality services (ensuring that providers make the right diagnosis and prescribe a treatment that is appropriate and affordable; and (d) to ensure that the financing needed to achieve UC is mobilized in a fiscally sustainable manner, and is used efficiently and equitably. The objective of this report is to assess the implementation of Vietnam social health insurance (SHI) and provide options for moving toward UC, with a view to contributing to the law revision process. It analyzes progress to date on the two major goals of the master plan. The report assesses Vietnam's readiness to meet these goals, the challenges it will face in achieving UC, and key reforms needed to overcome those challenges. It does so through a health financing lens, focusing on how resources are mobilized, pooled, and allocated, and how services are purchased. The report also examines the stewardship of financing that is, the organization, management, and governance of SHI as it has direct implications for achieving UC. The report ends by pulling together the recommendations in the form of an implementation road map.

For more information, please refer to the World Bank

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