Health insurance reform in Vietnam: a review of recent developments and future challenges

Abstract

Vietnam is undertaking health financing reform with a view to achieve universal coverage of health insurance within the coming years. To date, around half of the population is covered with some type of health insurance or prepayment. This review applies a conceptual framework of health financing to provide a coherent assessment of the reforms to date with respect to a set of key policy objectives of health financing, including financial sustainability, efficiency in service provision, and equity in health financing. Based on the assessment, the review discusses the main implications of the reforms focusing on achievements and remaining challenges, the nature of the Vietnamese reforms in an international perspective, and the role of the government. The main lessons from the Vietnamese experiences, from which other reforming countries may draw, are the need for sustained resource mobilization, comprehensive reform involving all functions of the health financing system, and to adopt a long-term view of health insurance reform. Future analysis should include continued evaluation of the reforms in terms of impacts on key outcomes and the political dimensions of health reform.

The Caring State? On Rural Welfare Governance in Post-reform Vietnam and China

“…Not until the mid-2000s did both governments start to increase health insurance coverage in rural areas (Ekman et al 2008;Zhang, Yi, and Rozelle 2010). The move was part of a program to build a 'new socialist countryside', which aims to improve rural infrastructure, social services, and rural human quality (Ekman et al 2008;Klotzbücher, Peter Lässig, and Weigelin-Schwiedrzik 2010). By 2009, official statistics suggest that 94 percent of the Chinese rural population are covered under the New Cooperative Medical Scheme (Liu and Darimont 2013, 102), a revival of the pre-reform Cooperative Medical Scheme.…”

Sustainability Criteria for CBR Programmes – Two Case Studies of Provincial Programmes in Vietnam

“…While poverty in Vietnam has been substantially reduced as a result of economic progress, unequal access to and utilisation of health care has increased (Ekman et al, 2008). Inequalities in health are increasingly concentrated in some geographic areas and among ethnic minorities (Ekman et al, 2008).…”

“…Inequalities in health are increasingly concentrated in some geographic areas and among ethnic minorities (Ekman et al, 2008). The majority of the Vietnamese population (76%) lives in rural areas, where rehabilitation services are limited or non-existent (Yoder, 2004).…”

Protecting, Balancing, and Confronting: Health-Seeking Among Homeless Youth in Ho Chi Minh City, Vietnam

“…For comparison, approximately 30,000 young people live on the streets in Thailand (Khaopa, 2010), and approximately 3,000 homeless adolescents live in Cambodia's major cities (Maza, 2017). How to address the rising population of homeless young people in Vietnam has become a focus of increasing concern for the international community (Ekman, Liem, Duc, & Axelson, 2008;Fern, 2006;Terre des Hommes Foundation, 2004).…”