Health insurance coverage and healthcare system improve after 15 years of implementation
05/07/2024 02:13 PM
The coverage of health insurance has increased, approaching the goal of universal health insurance, and the healthcare system has been expanded, resulting in improved quality of medical services. Additionally the health insurance fund has been safeguarded and has experienced sustainable growth.
These accomplishments were highlighted by Nguyen The Manh, Director General of Viet Nam Social Security (VSS), in his speech at marking 15 years of implementing the Law on Health Insurance and the 15th anniversary of Viet Nam Health Insurance Day (July 01, 2009 - July 01, 2024). The event was co-organised by the Ministry of Health and Viet Nam Social Security on July 1 in Ha Noi.
Manh said in 2008, there were 39.7 million health insurance participants, with a coverage rate of 46.1 per cent of the population.
By the end of last year, the coverage rate reached 93.35 per cent of the population, equivalent to 93.6 million people participating in the health insurance.
Nguyen The Manh, Director General of Viet Nam Social Security, delivers his speech at the meeting to celebrate the 15th anniversary of Viet Nam Health Insurance Day on July 1 in Ha Noi
During the period from 2022 to present, despite the challenges posed by the COVID-19 pandemic, the expansion of health insurance coverage has shown a consistent annual increase. annually.
This is particularly significant for individuals with low incomes, those living in poverty, and vulnerable social groups as they have been able to access health insurance. These individuals have received support from national, local budgets or other resources to participate in the health insurance programmes.
Currently, there are nearly 13,000 healtcare facilities nation-wide providing essential medical examination and treatment services to those who are covered by the health insurance fund.
The medical facility system, from central to local levels, includes both public and private facilities, had participated in the examination and treatment, covered by the health insurance fund, to ensure convenient access to healthcare services for the population.
Grassroots-level healthcare facilities accounted for 95 per cent of the total healthcare facilities that provide the health insurance-based medical examination and treatment services.
During the period 2018-23, medical visits to grassroots-level healthcare facilities accounted for approximately 75 per cent of total healthcare visits, covered by the health insurance fund, with expenditures at the facilities comprising about 34 per cent of total covered-by- the- health-insurance-fund healthcare expenditures.
Thus, the grassroots-level healthcare facilities had become the "centres", being the first point of access for healthcare needs.
The number of health-insurance cardholders seeking healthcare services has increased annually.
Last year, there were over 174 million healthcare visits, covered by the health insurance fund, almost double the number in 2009.
The health insurance fund, which previously accumulated deficits, had been essentially balanced since 2009 and has built up a contingency surplus.
Last year, the healthcare expenditures from the health insurance fund reached around VND123 trillion (US$4.78 billion), an eightfold increase compared to 2009.
Over the past 15 years, the health insurance fund has disbursed nearly VND1 quadrillion ($38.9 billion) for the health insurance participants’ medical examination and treatment.
“The health insurance fund has truly become a critically important financial source contributing to the healthcare of the people,” VSS General Director Manh said.
In addition, the expenditures, the list of medicines, medical supplies and technical services covered by the health insurance fund had been expanded, meeting the healthcare needs of the health insurance participants.
Participants at the meeting
The health insurance fund had significantly promoted equity between healthy individuals and those with illnesses, and between high and low-income contributors.
The amended Law on Health Insurance in 2014 had increased health-insurance coverage to 100 per cent for poor households, 95 per cent for near-poor households and 100 per cent for social protection groups.
Last year, the average healthcare expenditure for retired groups was VND6.3 million ($244) per person, and VND5 million ($194) per person for social protection groups.
Additionally, expensive medications and targeted cancer treatments had been added to the health insurance reimbursement list.
Expensive medical devices such as artificial hip joints and arterial stents had been reimbursed billions of dong annually by the health insurance fund.
Many health insurance patients receive reimbursements of up to billions of dong annually.
Significantly, regulations on healthcare access, covered by the health insurance, had greatly facilitated the health insurance participants.
Since 2016, the health insurance participants had been able to visit any district-level hospital for healthcare services. And as of 2021, they had been entitled to inpatient treatment at any provincial-level hospital nationwide.
Furthermore, other important achievements after the 15-year implementation of the law, he VSS General Director said, include the institutionalisation of the Party's and State's viewpoints and orientations on universal health insurance development, the regular amendment and supplementation of health insurance legal systems to enhance alignment with each stage of socio-economic development.
As the agency responsible for the health insurance policy implementation, the Viet Nam Social Security had coordinated with ministries and sectors to resolve difficulties and evaluate policy implementation impacts.
Policy communication efforts had been diversified, flexible and appropriate, fostering societal unity for implementing health insurance policies among citizens, businesses and healthcare facilities.
As a result, almost all citizens and businesses comply promptly and fully with the health insurance policies, recognising participation in the health insurance as both a right and a duty, thereby contributing to sustainable health insurance coverage expansion.
The implementation of health insurance policies had been carried out by all levels of authority, from provincial to communal, establishing the health insurance policy implementation steering committees, chaired by the Chairman of the Provincial People's Committee, with the participation of departments and agencies across the locality.
Digital transformation efforts in line with the Government Project 06 were considered a top priority task to reform administrative procedures to better serve citizens and businesses, ensuring timely and full entitlements for the health insurance participants, while combating with profiteering of the health insurance fund.
The national insurance database, managed by the Viet Nam Social Security were integrated and interconnected with the national population database and some ministries and sectors, (validating over 95 million demographic data in the database, managed by the Viet Nam Social Security with the national population database).
This constituted an important foundation for interconnectivity, data sharing and administration improvements.
So far, all 12,581 healthcare facilities had implemented the examination and treatment, covered by the health insurance fund, by using ID cards.
It helped reducing times, simplifying procedures, improving service quality and effectively managing the health insurance fund while preventing fund misuse.
Additionally, the Ministry of Health and the Viet Nam Social Security had closely collaborated in developing electronic health records for each citizen, ensuring the quality of service aligned with health insurance numbers, and supporting cost management for healthcare facilities as well as facilitating online public services such as issuance, renewal and replacement of driver's health examination certificates.
Manh also said that the achievements were made firstly thanks to the Party's and State's guidance and direction and close coordination of relevant ministries and sectors, particularly the regular and close cooperation of the healthcare sector.
He also proposed several future directions for the health-insurance policy implementation.
To continue successfully implementing the Party's and State's directions and strategies towards universal health insurance goals, enhancing healthcare quality and improving people's health, the Viet Nam Social Security hoped to continue receiving guidance and direction from the Party, National Assembly, Government, cooperation from all levels, sectors and the people.
The VSS also hoped that health ministry would continue to enhance the healthcare quality, covered by the health insurance fund, to ensure that all citizens can access quality healthcare services wherever they were, received the best, fastest and most convenient health care, Manh said.
The VSS and the healthcare sector would continue to closely coordinate to propose expanding rights and coverage areas for the health insurance participants, issuing procedures, regulations and control tools for the healthcare expenditures, covered by the health insurance fund; managing and efficiently utilising the health insurance fund, preventing misuse to concentrate all resources on medical treatment, particularly for rare diseases, chronic illnesses, serious illnesses and vulnerable groups.
VSS
Sickness
Work Injury and Occupational Disease
Survivor’s
Old-age
Maternity
Unemployment
Medical (Health Insurance)
Certificate of coverage
VSS - ISSA Guidelines on Social Security