Reporter: Could you please elaborate on Vietnam Health Insurance Day’s significance to the implementation of health insurance policies?

General Director Nguyen The Manh: To fully understand the significance of Vietnam Health Insurance Day, it is essential to first grasp the history and development of the country’s health insurance policies.

During the 1980s, Vietnam faced a severe shortage of funding for healthcare services, particularly for the general public and labourers seeking treatment at medical facilities. Under such circumstance, some localities took bold initiatives to alleviate the financial burden of healthcare by mobilising and collection donations from the community through various forms: The Health Insurance Fund in Hai Phong, The Humanitarian Medical Treatment Fund in Vinh Phu, The Voluntary Health Insurance Fund in Ben Tre and Quang Tri, or the railway sector’s Medical Treatment Fund, among others.

In early 1990, following the implementation of certain pilot models, the Council of Ministers (now the Government) submitted the Draft Health Insurance Ordinance to the State Council. After careful consideration of the actual socio-economic conditions, the State Council decided to authorise the Council of Ministers to pilot health insurance on a wider scale. On that foundation, in 1992, the Council of Ministers issued Decree No 299-HĐBT dated August 15, 1992 , promulgating health insurance regulations, marking the official birth of the health insurance policy in Vietnam.

After two years of implementing the Decree, the health insurance organisation system from Central to local levels was established under the management of Ministry of Health’s Vietnam Health Insurance. In 2002, the Government issued Decision No 20/2002/QĐ-TTg, transferring Vietnam Health Insurance to Vietnam Social Security.  Since then, the two important social security policies, health insurance and social insurance, have been implemented in a unified manner from the Central to local levels, following the model of a single national fund.

Of note, on November 14, 2008, the National Assembly approved the Law on Health Insurance, effective from July 1, 2009. The enactment of the Law on Health Insurance marked a significant step forward in the legal system on health insurance, aiming to realise universal health insurance, creating favourable conditions for the implementation of the policy of socialised protection, care, and improvement of people’s health. 

On that basis, on June 16, 2009, the then Prime Minister promulgated Decision No 823/QĐ-TTg designating July 1 as Vietnam Health Insurance Day. The move demonstrates the determination of the Party, State and Government in realising the goal of universal health insurance coverage, creating conditions for all people to receive healthcare through the health insurance policy.

 Vietnam Health Insurance Day is the annual occasion to intensify communication and advocacy efforts, encouraging the community to join hands and contribute to the effective implementation of the Law on Health Insurance, paying the way for universal health insurance

Vietnam Health Insurance Day is the annual occasion to intensify communication and advocacy efforts, encouraging individuals to join hands and contribute to the effective implementation of the Law on Health Insurance, paying the way for universal health insurance, for the sake of their own, their family and community, as well as for the national welfare.  Also, Vietnam Health Insurance Day serves to raise awareness among the people about the position, role and significance of health insurance. As a crucial insurance mechanism established by the Party and State, health insurance aims to provide healthcare for the population. It is protected by the State and implemented by social security agencies, with a focus on non-profit initiatives.

Reporter: It can be seen that the role, benefits, and significance of the health insurance policy is huge. As the agency entrusted by the Government to implement this policy, could you please speak about the outstanding achievements the industry has made in the past 15 years since the inception of Vietnam Health Insurance Day and the benefits it brings to participants?

General Director Nguyen The Manh: The year 2009 marked a turning point in Vietnam’s healthcare landscape with the enactment of the Law on Health Insurance and the issuance of Directive No 38-CT/TW dated September 7, 2009 by the Secretariat on “promoting health insurance in the new situation and the establishment of Vietnam Health Insurance Day. Since then, after 15 years, with the unwavering commitment of the entire political system, the health insurance policy has been deeply embedded in society, bringing about a profound transformation in the perception and actions in leading, directing and implementing health insurance policy from the Central to local levels. Localities have established a Steering Committee for the implementation of health insurance policies, which is headed by the local People’s Committee chairman.

As the agency responsible for implementing the health insurance policy, Vietnam Social Security has remained steadfastly committed to aligning its efforts with the guidance of the Government and Prime Minister; and proactively collaborated with ministries, departments, sectors, local Party Committees and People’s Committees to timely develop comprehensive, proper and decisive solutions.

 General Director Nguyen The Manh visits and expresses his support for patients covered by health insurance at a medical facility

Regarding the formation of legal framework: Recognizing the challenges in implementing social insurance, health insurance and unemployment insurance, Vietnam Social Security has proactively assessed the implementation process and the impact of any obstacles and inconsistencies to timely recommend and propose the competent authorities for amendments and supplementation to health insurance policies, ensuring their effectiveness.

Regarding health insurance coverage: Health insurance coverage has witnessed rapid and sustainable expansion. In 2008, before the establishment of Vietnam Health Insurance Day, only 39.7 million people were enrolled in health insurance nationwide, with a coverage rate of 46.1 per cent of the population. In 2009, the first year of implementing Vietnam Health Insurance Day, health insurance participants amounted to over 50 million (up 10 million as compared to 2008), with a coverage rate of 58.2 per cent of the population. And as of the end of 2023, the whole country recorded over 93.6 million health insurance participants, a 2.3-fold increase compared to 2008, with a coverage rate of 93.35 per cent of the population.

Regarding health insurance-based medical examination and treatment: The number of health insurance cardholders seeking medical care has markedly increased over the years. In the past 15 years, over 2.12 billion visits have been made under the health insurance scheme, with a total expenditure of over VND993 trillion. The figures were 88.6 million, VND15.3 trillion; 130.1 million, VND47.85 trillion; 167.3 million, VND101.7 trillion; and 174 million, nearly VND121.8 trillion in 2009, 2015, 2020, and 2023 respectively. The health insurance-based medical examination and treatment system is well organised from the Central to local levels and encompassing both public and private healthcare facilities, which facilitates easy access and utilisation of healthcare services for the population.

Regarding the review, inspection: There have been positive changes, contributing to improving the quality and efficiency of health insurance fund use and management. Vietnam Social Security ahs strengthened its guidance for social security offices in provinces and cities to collaborate with local departments and sectors to implement synchronous solutions to combat the abuse and exploitation of the health insurance fund and ensure the rights and benefits of health insurance participants. These efforts have led to the timely detection of cases with signs of abuse or unreasonable use of the health insurance fund, contributing to saving billions of Vietnamese dong for the health insurance fund.

Regarding IT application, administrative reform and digital transformation: The entire industry has made significant strides in cutting administrative procedures, from 115 in 2015 to 25 currently; and vigourously applied information technology, and digital transformation in jointly implementing health insurance-based medical examination and treatment. Vietnam Social Security has collaborated with relevant ministries and sectors to implement a multi-platform approach for health insurance-based medical services using citizens’ identity cards, the VssID application and the electronic identification application - the VneID. The adoption of health insurance-based medical examination and treatment using identity cards has simplified the process, saved time for both patients and medical workers, and reduced costs for social security agencies in printing and issuing health insurance cards. Besides, Vietnam Social Security is currently piloting the use of biometric authentication on chip-embedded identity cards for health insurance-based medical examination and treatment. This initiative aims to enhance the effectiveness of State management on health insurance-based medical examination and treatment and better protect the rights and benefits of participants.

 Vietnam Social Security has always proactively collaborated with relevant agencies to remove obstacles in health insurance-based medical examination and treatment activities, ensuring the rights and benefits of participants

Reporter: As far as you’re concerned, which is the most decisive factor for sustainable and effective implementation of the health insurance policy?

General Director Nguyen The Manh: Health insurance is a short-term fund, pooling contributions from citizens alongside the State financial support to finance healthcare activities. The effective and optimal management of this fund plays a pivotal role in ensuring the policy’s sustainability, particularly as healthcare benefits and service quality continue to expand and improve. Therefore,  the theme of Vietnam Health Insurance Day 2024 is “Efficient use of Health Insurance Fund, ensuring rights and benefits of patients and improving the quality of health insurance-based medical examination and treatment services at healthcare facilities”.

Over the past time, Vietnam Social Security has adhered to the regulations of the Law on Health Insurance, the Government’s Decree and the Prime Minister’s decisions on financial management of the Health Insurance Fund. The fund use has been conducted in an transparent, accountable, economical and efficient manner. This approach aligns with the tasks of premium collection, expenditure management, fund management and expansion of participants.

Controlling health insurance-based medical costs is a critical responsibility of Vietnam social security industry, with legal foundations stipulated in the Law on Health Insurance and the Government’s Decree No 75/2023/NĐ-CP. By controlling health insurance-based medical costs , Vietnam Social Security aims to optimize the utilisation of the Health Insurance Fund, prevent and minimise unreasonable and wasteful expenditures, and thereby allocate resources for practical tasks that directly benefit patients, especially those with severe and chronic illness.

PV: Thank you for your time!