Vietnam’s shift from a centrally planned to a market economy has transformed the country from one of the poorest in the world into a lower middle-income country. Vietnam now is one of the most dynamic emerging countries in East Asia region.
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Hanoi, September 17, 2014 – Vietnam has made great strides in expanding social health insurance, now covering more than half of its population, but reforms, such as providing premium subsidies, ... Show More +greater family enrollment and introducing catastrophic cost coverage can help the country reach universal coverage, according to a new report the World Bank released today.“Vietnam has made significant progress toward achieving universal coverage for its population, and the government has made ambitious plans toward reaching that goal.” said Victoria Kwakwa, the World Bank Country Director for Vietnam. “This study shows us how Vietnam can speed up this process in order to ensure a healthy Vietnamese population while reducing the health financial burden on the poor.” The report, Moving Toward Universal Health Coverage of Social Health Insurance in Vietnam: Assessment and Options, offers a comprehensive assessment of Vietnam’s implementation of its social health insurance program, as well as recommendations on key reforms that the country can undertake to achieve universal coverage. During its preparation stage, it already contributed to the dialogue on the revision of Vietnam’s Health Insurance Law. Propelled by higher government spending in health care, the insurance program, which was piloted in 1989, has greatly boosted the number of people with health coverage. In 2010, nearly 60 percent of Vietnamese had health insurance, up from 10 percent in the early 1990s. The Master Plan for Universal Coverage, which was approved in 2012 by the Prime Minister, aims to expand coverage even further, to at least 70 percent of the population by 2015 and 80 percent by 2020. It also sets the goal of reducing patients’ out-of-pocket costs to less than 40 percent of total health care spending by 2015.But challenges remain. Despite large increases in subsidies for the near-poor, low enrollment rates persist, even among those in the formal sector, where enrollment is mandatory. Meanwhile, out-of-pocket costs still made up nearly 60 percent of health care costs in 2010, leaving households vulnerable to financial shocks. To reach the goals set out in the Master Plan, the report recommends reforms in several areas: (1) Further increasing coverage through premium subsidies, greater family enrollment and enforcement of enrollment compliance.(2) Improving equity and financial protection by cutting down on extra charges outside of policy and introducing catastrophic cost coverage(3) Strengthening health financing arrangements by ensuring money is spent more effectively and efficiently on drugs, providers etc.(4) Strengthening accountability by strengthening the organization, management and governance of social health insurance. For more information, please visit www.worldbank.org/vn Show Less -
Challenges- Enrollment rates remain low even amongst those enrollment is compulsory, such as the formal sector, and despite large increases in the partial subsidy extended to the near-poor. - In ... Show More +2010, when nearly 60% of the population was already enrolled, their out-of-pocket (OOP) share in health expenses was still almost 60%. High OOP payments leave households exposed to financial risk. Road map of reforms- Expanding the breadth of coverage: • Substantially increase general revenue financing to subsidize enrollment for the near poor and/or informal sector; • Enhance information, education and communication about health insurance to both providers and beneficiaries; • Encourage family enrollment; and • Enforce enrollment compliance in the mandatory enrollment group, particularly formal sector workers.- Improving equity and financial protection • Strengthen implementation of the co-payment policy, including grievance mechanisms; • Further reduce or waive co-payments for the poor and vulnerable groups such as ethnic minorities; and • Introduce catastrophic cost coverage.- Strengthening health financing arrangements for Social Health Insurance (SHI) • Generate additional revenues by raising tobacco taxes and gradually increasing the premium contribution rate; • Rationalize and cost out the benefits package; • Reduce inefficiencies arising from the current mix of provider payment mechanisms; and • De-fragment the procurement of and payment for pharmaceuticals.- Strengthening Organization, Management and Governance of SHI • Define the objectives of UC more clearly, and revise and define the roles and mandates of key agencies; • Strengthen the organization of SHI by putting in place a specialized SHI Division and eventually SHI Agency; • Strengthen SHI management arrangements • Strengthen SHI governance and accountability by clearly specifying financial accounting arrangements, conflict resolution arrangements and penalties. Show Less -