With the goal of focusing on the benefits of participants and beneficiaries, recently, VSS has decisively directed local social security offices in provinces and centrally-run cities (provincial social security) to effectively implement health insurance policies. Accordingly, implementing Directive No. 38, the implementation of health insurance policies during the 2009-2024 period has achieved many significant accomplishments and results, such as: the health insurance coverage rate has steadily increased each year and is approaching the goal of universal health insurance; the benefits of health insurance participants have been timely ensured with increasingly simplified procedures, enhancing the satisfaction of beneficiaries...

Sustainable Coverage Rate Development, towards the Goal of Universal Health Insurance

As one of the main pillars of the social security system, the entire political system from the central to local levels has actively effectively implemented health insurance policies. To date, the provinces have established Steering Committees on the health insurance policies implementation, with the chairman of the provincial People's Committee as the head. The network of social insurance and health insurance collection service organizations continues to expand, set up collection points and deploy collection staff to each village, hamlet, and residential group.

As the organization is responsible  for implementing health insurance policies, the entire VSS sector has closely followed practical conditions, utilized the leadership and direction of the Government and the Prime Minister, and proactively coordinated with ministries, departments, industries, Party committees, and local authorities to timely propose synchronous, correct, and decisive solutions.

As a result, the number of health insurance participants has always been higher each year than the previous year, especially the sustainable growth rate of health insurance participants amid a more challenging economic environment. Specific figures are as follows:

- In 2008: The whole country had 39.7 million health insurance participants, with a coverage rate of 46.1% of the population.

- In 2009: After the issuance of Directive No. 38, the whole country had over 50 million health insurance participants (an increase of over 10 million compared to 2008), with a health insurance coverage rate of 58.2% of the population.

- In 2023: Over 93.6 million people participated in health insurance, an increase of 2.3 times compared to 2008, before Directive No. 38 was issued, the health insurance coverage rate is 93.35% of the population, exceeding the target by 0.15% as set in Government Resolution 01/NQ-CP.

Notably, the growth of household health insurance participants has been particularly impressive: from 3.76 million participants (in 2009) to 24.89 million participants (in 2023), an increase of 6.6 times compared to 2009.

Maintaining the growth rate of health insurance despite the difficulties in people's lives once again affirms the determination and decisiveness of the entire political system in general and the VSS industry in particular in effectively implementing the roadmap for universal health insurance. This is both a political task and a responsibility of the industry in ensuring social security and caring for people's health in the new situation.

General Director of VSS, Nguyễn Thế Mạnh, speaks at the online conference summarizing 15 years of implementing Directive No. 38-CT/TW dated September 7, 2009, of the Secretariat on "Strengthening Health Insurance Work in the New Situation."

Flexible, Creative and Renewal in Health Insurance policy Communication and Consultation

The health insurance coverage rate in our country has approached the goal of universal health insurance. This is not only a testament to the efforts of the entire Party and people but also highlights the role and responsibility of Party committees and local authorities, and the improved awareness and understanding of the people, businesses, and workers about the meaning, value, and benefits of health insurance policies, as well as the obligation to comply with health insurance laws.

To achieve these positive results, health insurance policy communication and consultation play an important role as a bridge to spread health insurance policies to the people. "Communication work must always go ahead " is the consistent viewpoint of the entire VSS industry, from direction and management to action. On August 24, 2017, the Communist Party of VSS issued Resolution No. 96-NQ/BCS on renewing and improving the quality and effectiveness of social and health insurance communication in the new situation, creating a strong shift in information and communication work regarding health insurance policies.

Recently, the communication work on health insurance policies has been implemented comprehensively, enhanced, and broadly, deeply and professionally innovated. The content, form, and methods of communication have become increasingly diversified and rich, suitable to the characteristics of each subject group and regional cultural features, the information is easily accessible, understandable, and actionable for people.

In addition to closely coordinating with ministries, departments, industries, and mass organizations, and news agencies at both central and local levels to successfully organize over 1,000 conferences and seminars, and publish more than 170,000 news, reports, and broadcasts, issuing tens of millions of various publications, VSS has also proved the strengths of digital and modern communication. This includes building and operating social media channels (Fanpage, Zalo OA) of VSS; effectively providing advice and information to the public through customer service systems, the VssID - Digital Social Insurance application, and the application of artificial intelligence (AI) on hotlines and the VSS portal. Specifically, Call Center, operating 24/7, has received, supported, and provided consultations related to health insurance policies for 18,851 calls, helping VSS promote the shift from direct transactions to the use of online public services. Particularly, VSS has applied artificial intelligence (AI) to develop a bank of 3,000 questions/answers with over 110,000 training data points and soon operated an Automatic Response System to enhance support capabilities for individuals and organizations interacting with the social security office.

Increasing Beneficiaries and Ensured Timely Benefits

With the consistent viewpoint of "Taking people and businesses as the subjects and center of service," VSS strives to ensure that the benefits of health insurance participants and policy beneficiaries are fully and timely provided, in accordance with regulations. The number of health insurance cardholders accessing medical care has rapidly increased each year. Specifically:

- In 2009: there were 88.64 million health insurance medical examniation and treatment visits with a total expenditure of 15,396 billion VND.

- In 2015: there were 130.17 million health insurance medical examniation and treatment visits (an increase of 46.8% compared to 2009).

- In 2020: there were 167.34 million health insurance medical examniation and treatment visits (an increase of 28.6% compared to 2015).

- In 2023: there were 174 million health insurance medical examniation and treatment visits (an increase of 4% compared to 2020).

From 2009 to 2023, the average number of health insurance medical examniation and treatment visits per year was over 141 million visits/year (an increase of 59.5% compared to 2009), with an average annual medical care expenditure of 66.2 trillion VND (an increase of 330% compared to 2009).

Notably, during the period of the Covid-19 pandemic, the pivotal role of health insurance policies in the social security system was further demonstrated, contributing to health care and stabilizing people's lives, and creating stronger trust in the humane social security policies of the Party and the State.

VSS held an online conference to summarize 15 years of implementing Directive No. 38-CT/TW dated September 7, 2009, of the Secretariat on "Strengthening Health Insurance Work in the New Situation."

Increasing Service Quality, Growing Public Trust, and Satisfaction

Alongside the timely and proper resolution and payment of health insurance policies, VSS has focused on implementing comprehensive solutions to create numerous benefits for participants and beneficiaries, as well as state management agencies in detecting and preventing health insurance fund abuse and exploitation.

In this regard, the entire industry has vigorously advanced administrative procedure reforms, reducing number of procedures from 115 (in 2015) to 25; strongly applied information technology and digital transformation for professional operations, such as digitizing most health insurance participation procedures and health insurance card issuance; implementing electronic transactions for organizations and individuals; providing 100% online public services at level 4 for VSS's administrative procedures; integrating and offering these services on the VSS Public Service Portal, the National Public Service Portal, and the VssID - Digital Social Insurance application on mobile platforms. As a result, VSS' system has received and processed nearly 300 million online transaction records in recent years, including over 170 million annual requests for health insurance medical examination and treatment cost reimbursement through the Health Insurance Verification Information System.

The Health Insurance Review Information System, built and officially operated by VSS since July 2016, has interconnected data between VSS and nearly 13,000 health insurance medical facilities nationwide. This system integrates with professional software to update and monitor the registration of initial medical examination and treatment at different levels, interconnect data with centralized accounting software to manage advances and payment of health insurance medical expenses at each medical facility, and prevents fraudulent claims for sickness and maternity benefits.

Notably, VSS is among the leading units in implementing tasks assigned under Project 06 and Decision No. 422/QD-TTg dated April 4, 2022, by the Prime Minister, with prominent highlights such as:

- Collaborating with the Ministry of Public Security to test sharing social insurance information and health insurance medical examination and treatment  information included in the VNeID application. Sharing health insurance card information to facilitate health insurance medical examinations using a chip-based ID card or the VNeID application.

- Implementing multi-platform usage for health insurance medical examination and treatment using a chip- based ID card, VssID - Digital Social Insurance, and the VNeID electronic identification application. To date, 100% of health insurance medical facilities have implemented health insurance medical examinations using a chip-embedded ID card (meeting the requirement to look up health insurance card information using a personal identification number/ID card), with over 55.7 million successful lookups for health insurance card information using a personal identification number/ID card for health insurance medical examination procedures.

- Pilot application of biometric authentication information on chip-embedded ID cards in health insurance medical examinations, facilitating quick procedures and enhancing state management efficiency in health insurance medical examinations.

- Coordinating and supporting the Ministry of Health in interconnecting data for driver's health examinations, birth certificates, and death certificates: As of now, 1,216 medical facilities nationwide have submitted 2,058,654 driver's health examination records; 1,582 medical facilities have submitted 852,542 birth certificate records; and 596 medical facilities have submitted 8,575 death certificate records.

Prioritizing Health Insurance Participants' Benefits, throughout the process of resolving and paying health insurance premiums , VSS has closely coordinated with the Ministry of Health and related ministries and industries to address difficulties and obstacles in organizing and implementing health insurance policies. This collaboration facilitates medical facilities in providing healthcare services, ensuring the best benefits for health insurance participants, and jointly enhancing the effective management and use of the health insurance fund.

The 15 - year achievements on implementing Directive No. 38 of the Secretariat on promoting health insurance work reflect the efforts of the entire political system, particularly VSS and the Ministry of Health. Along with the country's socio-economic development, health insurance policies have not only increased the rate of health insurance participation, approaching the goal of universal health insurance, but also ensured the benefits of health insurance beneficiaries; expanded the scope and quality of health insurance medical examination and treatment services. Consequently, people have become more aware of the role, significance, and superiority of health insurance policies and trustfully and actively participate in our Party and State's social security system./.