Provincial social security agencies promptly consult Party committees and authorities for implementation guidance and actively take measures to expand the coverage. In which, it is necessary to closely follow the “scenario” of coverage expanding, monitor its implementation; emphasize leadership responsibility in following VSS directives; proactively apply innovative and creative approaches and learn from the experiences of successful localities for implementation within their own units and areas. In particular, localities also need to focus on administrative reform, electronic transactions, and digitizing data for Social Insurance, Health Insurance participants.

With the efforts mentioned above, VSS expects that in 2023, the number of people participating in the social insurance, health insurance, and unemployment insurance systems will continue to be maintained and grow compared to the same period in 2022, specifically, in the field of health insurance, it may achieve the target of covering 93% of the population, contributing to ensuring social security and the sustainable development of the country.

According to WB: 

• Vietnam has made significant progress towards achieving universal coverage (UC). Rapid progress has been made in increasing enrollment rates and budgetary resources.

• The Government of Vietnam has also invested substantially in hospitals, health centers, etc. and human resources for health in recent years.

Some challenges Vietnam face

- Enrollment rates remain low even amongst those enrollment is compulsory, such as the formal sector, and despite large increases in the partial subsidy extended to the near-poor. 

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- In 2010, when nearly 60% of the population was already enrolled, their out-of-pocket (OOP) share in health expenses was still almost 60%. High OOP payments leave households exposed to financial risk. 

Road map of reforms

- Expanding the breadth of coverage:

  • Substantially increase general revenue financing to subsidize enrollment for the near poor and/or informal sector;

  • Enhance information, education and communication about health insurance to both providers and beneficiaries;

  • Encourage family enrollment; and

  • Enforce enrollment compliance in the mandatory enrollment group, particularly formal sector workers.

- Improving equity and financial protection

  • Strengthen implementation of the co-payment policy, including grievance mechanisms;

  • Further reduce or waive co-payments for the poor and vulnerable groups such as ethnic minorities; and

  • Introduce catastrophic cost coverage.

- Strengthening health financing arrangements for Social Health Insurance (SHI)

  • Generate additional revenues by raising tobacco taxes and gradually increasing the premium contribution rate;

  • Rationalize and cost out the benefits package;

  • Reduce inefficiencies arising from the current mix of provider payment mechanisms;

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  • De-fragment the procurement of and payment for pharmaceuticals.

- Strengthening Organization, Management and Governance of SHI

  • Define the objectives of UC more clearly, and revise and define the roles and mandates of key agencies; 

  • Strengthen the organization of SHI by putting in place a specialized health insurance medical review division and eventually VSS;

  • Strengthen SHI management arrangements 

  • Strengthen SHI governance and accountability by clearly specifying financial accounting arrangements, conflict resolution arrangements and penalties.