Moving Toward Universal Coverage of Social Health Insurance in Vietnam

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Key findings


• Vietnam has made significant progress towards achieving universal coverage (UC). Rapid progress has been made in increasing enrollment rates and budgetary resources.

• The Government of Vietnam has also invested substantially in hospitals, health centers, etc. and human resources for health in recent years.



- 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 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.      


in Hanoi
Nguyen Hong Ngan

in Washington
Diana Chung