Vietnam: Huge progress in expanding social health insurance, but challenges remain in reaching universal coverage

September 17, 2014

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, 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. 

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