National health insurance plans reviewed for affordability

A resident in the northern Yên Bái Province registers for medical examination using her health insurance card. — VNA/VNS Photo Việt Dũng

HÀ NỘI — The Vietnam Social Security has proposed that health insurance plans be expanded to respond to people’s financial ability.

The suggestion comes as the agency, the health ministry and relevant departments are reviewing the execution of the Law on Health Insurance during 2009-2023. 

More than 93.3 million people in Việt Nam have health insurance, equivalent to 93.35 per cent of the national population and exceeding by 0.15 per cent the target set in Government Resolution 01/NQ-CP. 

In 2023, there were approximately 174.8 million medical examinations and treatments covered by national health insurance, totalling VNĐ124.3 trillion (US$5.06 billion). 

The insurance covered 1,037 types of medications and pharmaceutical products, alongside 229 oriental and 349 traditional medicines. 

As of the end of 2023, Việt Nam had nearly 13,000 medical facilities partnered with the national health insurance, of which there were 1,768 public and 1,067 private facilities, alongside over 10,000 commune-level health stations. 

Deputy health minister Trần Văn Thuấn pointed out several shortcomings in the implementation of the health insurance law, such as the differences in participation rate among those who are required to have health insurance, those whose premium payment is partially covered by the state budget, and those who voluntarily enrol in health insurance schemes. 

Meanwhile, there is still room for improvement regarding health examination and treatment quality, especially at the community levels and in facilities in remote areas due to limited infrastructure and capacity, he said, while provincial and central-level hospitals are often overloaded. 

Insufficient regulations have also led to exploitation and overspending of the health insurance fund in recent years, with unnecessary use of equipment installed with private capital or false reports of medical services and medications administered. 

Modest communication activities mean that people in several localities are still unaware of new regulations related to health insurance, he added. 

Lê Văn Phúc, director of the Department of Health Insurance Implementation at Vietnam Social Security (VSS) suggested that all citizens should be enrolled in national health insurance in a comprehensive and constant manner, especially those in the informal sector or temporarily laid off. 

In addition to expanding the health insurance plans to better fit people’s financial ability, Phúc said that it is also necessary to review insurance benefit packages.

According to VSS deputy general director Nguyễn Đức Hòa, the three principles for effective execution of the health insurance law are the financial commitment from the government to support policy beneficiaries, community engagement and experiences in execution, and the balance between needs and interests of state management agencies, enforcement agencies and policy beneficiaries. 

VSS will also work with the health ministry on amending the health insurance law and addressing the current shortcomings, especially issues related to payment, medical examination and treatment standards, and advanced technology application in management and operations. — VNS