Vietnam may base health insurance upgrade on Thai model

Vietnam is looking at developing its health-insurance system based on Thailand’s successful model.

“Vietnam is going to send officials to Thailand to study how the health-insurance systems are working here,” said National Health Security Office (NHSO) secretary-general Dr Winai Sawasdivorn.

He said he had met with Vietnam’s deputy minister of health on the sidelines of a recent meeting of the Asean Social Security Association in that country.

“We had some discussions on the health-insurance system,” Winai said.

The NHSO operates the universal-healthcare scheme that covers 48 million people in Thailand.

Under the scheme, the NHSO allocates flat subsidies annually to participating medical facilities that have provided free treatment to patients covered by the scheme.

Although the scheme does not yet cover all types of illnesses, it has been very comprehensive.

Dr Nghiem Tran Dung, vice director of Vietnam’s Department of Health Insurance, said the country’s civil registration had not yet covered all people in the country. But Winai said that if Vietnam wanted an efficient health-insurance system, it should first of all develop an accurate database of its citizens.

“The country needs to know the exact size of the population for proper planning,” Winai pointed out.

He said information-technology infrastructure must also be developed for financial reimbursement and related issues.

He recommended that Vietnam make healthcare-insurance schemes compulsory for all.

The population of Vietnam is about 88.57 million, of whom 30 per cent participate in compulsory healthcare schemes while 11 per cent have joined voluntary programmes.

People outside the schemes have to fend for themselves should unexpected illnesses or diseases hit them or their family members.

According to a World Bank report, even though Vietnam has made significant moves to improve its healthcare system and its coverage, it has a high incidence of catastrophic household health spending – a large proportion of households make out-of-pocket payments for healthcare that exceed a reasonable proportion of their income.

“The government should provide subsidies and prepare efficient collection of people’s contributions to the health-insurance schemes,” Winai suggested.

Vietnam first experimented with a health-insurance system in 1989. In the following decade, two crucial decrees were passed to improve healthcare services.

In 2003, the Vietnam Social System (VSS) took over the health-insurance system from the Ministry of Health. Even after the Department of Health Insurance was established in 2005, the VVS has continued to play a crucial role in the system. The two agencies are jointly pursuing a road map towards a Universal Coverage Citizens’ Health Insurance law by 2014.

The road map was prepared in response to the Health Insurance Law, which took effect on July 1 last year.

Despite its serious efforts to push for the efficient delivery of healthcare services, Vietnam has faced many challenges such as the high cost.

Thanh Nhan Hospital vice director Chu Thi Du revealed that her hospital was operating at a huge loss each year.

“Last year, the loss was 18 billion dong,” or Bt28 million, she said.

Thangh Nhan Hospital is the fourth-biggest medical facility in Hanoi, with about 1,000 patients seeking treatment from it each day. Du said the hospital’s income came mainly from the VSS, patients, and other sources.

She said some patients were so poor that they could not afford treatment and they were not covered by any healthcare scheme.

“So they have to seek help from the media in publishing their stories so that they can get some donations,” she said. – nationmultimedia.

Tags: Vietnam Health Insurance