The 2013 Constitution of the Socialist Republic of Vietnam reaffirmed the country’s strong, high-level commitment to UHC. And it’s been making considerable progress.
GDP per capita
10% of household
consumption or income
Source: World Health Organization: Tracking universal health coverage: 2019 Global Monitoring Report
OVERVIEW OF UHC DEVELOPMENTS
Vietnam’s efforts to roll out UHC are currently being driven by initiatives to expand social health insurance coverage. An impressive 87% of the population are already covered by Vietnam Social Security (VSS), and the government is now targeting 90.7% of the population, including 100% of vulnerable groups, such as the poor and elderly, by 2020.
The country’s VSS not only covers curative and rehabilitative services but also preventive services, such as immunizations and control and prevention of infectious diseases, such as AIDS. The level of financial protection varies between income groups, with higher out-of-pocket payments incurred by households in higher-income deciles.
Challenges to continued UHC progress include:
- The complexity of the legal framework since the adoption of the Health Insurance Law in 2014. The Government of Vietnam issued a series of legal documents progressively expanding mandatory enrolment to the entire population, now categorized into 6 groups and 35 different sub-groups. The fragmentation of the legal framework, and design of systems, makes it difficult to apply the law.
- Inconsistent governance, due to the split of responsibility between the Ministry of Health and Vietnam Social Security.
- Ensuring high-level commitment to investing sustainably in UHC, especially as the health insurance scheme has been in deficit since 2016.
- Covering the ‘missing’ middle, ensuring compliance from non-subsidized members, and maintaining coverage of those benefiting from subsidies and progressively transitioning them to a non-subsidized population group.