Health insurance is mandatory in Germany, with nearly universal coverage. The statutory health insurance (SHI) system consists of 110 sickness funds (acting as third-party payers) covering around 88% of the population. The self-employed and employees who exceed a certain income threshold may choose to stay with SHI or opt for private health insurance (PHI) provided by 41 insurance companies. PHI covers around 10% of the population, including civil servants; the remainder (e.g. military) are covered through special schemes. An estimated 0.1% of the population, however, does not have insurance due to administrative hurdles or problems paying premiums.

SHI is financed mostly through income-related contributions equally shared between employer and employees. Contributions are pooled in a central fund and reallocated to sickness funds based on the health needs of their constituents. PHI is financed through premiums defined by individual health risk upon entry (“life-time underwriting”).

SHI offers a generous benefit basket, well beyond essential services; home care is covered by long-term care insurance. SHI covers all prescription drugs except for those explicitly excluded by law or following a benefits assessment.

Due to differences in organization and payment, strong fragmentation exists between inpatient hospital care and ambulatory (including primary and specialist) care. Around 160 000 GPs and specialists provide ambulatory care, mostly in private practice, and are reimbursed by SHI, primarily using fee-for-service payments. More than 1900 hospitals exclusively provide inpatient care, paid through a DRG system. Germany had 806 inpatient beds per 100 000 population in 2016, a rate 58% above the OECD average.

Viet Nam is committed to accelerating UHC and strengthening primary health care as the foundation for UHC, especially when faced with emerging challenges of the rise of non-communicable diseases and increasing ageing population. It continues to make progress on addressing the needs of vulnerable populations, including the “missing middle.”

The VSS has serviced a sizable population with a high participation rate in social insurance, health insurance, and health insurance.

One of its most significant responsibilities is always to receive and address public petitions.

The sector receives citizen feedback through a variety of channels, such as the Government Office channel, the VSS Portal, which has a dedicated section for recommendations and feedback, email, social media fan pages, and the customer service and support hotline 1900 9068.
The VSS also organises dialogues on social insurance and health insurance policies on media and its web portal.

Additionally, the VSS hosts discussions on health insurance and social insurance policies in the media and on its website.
When voters submit concerns and opinions about the sector to the NA, the VSS always responds quickly with papers to address issues within its authority.

In 2019, world leaders signed the first Political Declaration on Universal Health Coverage, where they committed to progressively reach one billion additional people by 2023 with quality essential health services and affordable essential medicines. They also committed to stop the rise and reverse the trend of catastrophic out-of-pocket health expenditure and eliminate impoverishment due to health-related expenses by 2030.

Despite these political commitments, UHC has yet to be fully realised . About half of the global population lacks access to essential health services and 100 million people are driven into extreme poverty every year due to out-of-pocket health expenses.[2] And, according to 2019 targets, we still need to reach 710 million people by 2030.
Noncommunicable diseases such as diabetes, cardiovascular disease, cancer, and chronic respiratory disease, are leading causes of death and disability worldwide and account for 71% of deaths globally. A staggering 85% of premature deaths from NCDs occur in low- and middle-income countries.

Many countries are struggling to integrate NCDs into their Universal Health Coverage (UHC) benefit packages and are not on track to reach SDG 3.4, which calls for a one-third reduction in NCD deaths through prevention and treatment, and promotion of mental health and wellbeing.

While data on the inclusion of NCD prevention and care in UHC packages is limited, what does exist tells a story of significant gaps in coverage within and between countries.
Access to high-quality essential services across the continuum of care which leave no one behind

Many countries struggle with providing adequate coverage and access to NCD services across the continuum of care, including screening, diagnosis, treatment, rehabilitation and palliative care. For example, half of adults living with diabetes are undiagnosed and unable to access insulin; hypertension is only under medical control for 1 in 5 people; chronic kidney disease often goes untreated, and over 90% of cancer patients in low-income countries lack access to radiotherapy.

Too often, health systems are fragmented and focused on single-disease care rather than an integrated, life course approach.

The 2023 State of UHC Commitment Review states that while many countries have set UHC as a goal in their national policies and plans, only a small number have developed a clear action plan to achieve it, and efforts have often been focused on vertical health programmess rather than comprehensive care for the population.
UHC should ensure a broad range of high-quality health services to the entire population. While some countries have made progress towards UHC, many still face challenges such as discriminatory practices, lack of quality in healthcare services, and unequal access to medicines and diagnostics.