More than 400 delegates of 75 organisations in 35 countries worldwide attended the forum, including those from the Asian Development Bank (ADB), the International Labour Organisation (ILO), and the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP). Deputy Director General of Vietnam Social Security Dao Viet Anh led the Vietnamese delegation.

Photo: Malaysian Deputy Prime Minister Datuk Seri Dr Wan Azizah binti Dr Wan Ismail delivers a speech at the forum.

Social security a global strategic goal

Global social security is an important goal and strategy of the whole world. However, social security organisations in the region are facing formidable challenges due to rapid changes in the economy, society, and labour market. Thus, it is necessary to initiate new approaches to maintain benefits, expand insurance coverage, and improve the quality of social welfare services.

Malaysian Deputy Prime Minister Datuk Seri Dr Wan Azizah binti Dr Wan Ismail underlined that the forum was organised with a view to promoting the comprehensive development of social security.

Policymakers, managers of social security systems, and international experts gathered at this year’s event to seek solutions to forming a breakthrough strategy for the future of social security in the Asia-Pacific region, she said.

Meanwhile, Malaysian Minister of Human Resources M. Kulasegaran laid stress on the rising roles of the social security system for the people and economic development in recent years.

Developing social security means investing in human resources towards better productivity, he said, adding that this also helps to improve living quality and equality in the community, thus stabilising the socio-economy of each country.

In fact, the coverage of the social security system still shows limitations, especially in Asia where more than 1 billion workers are classified as vulnerable. They include farmers, fishermen, and unofficial workers who have not received protection from the social security system.

Photo: Deputy Director General of Vietnam Social Security Dao Viet Anh attends the forum.

The forum, held under the theme “Excellence in Social Security: Enhancing Protection for Tomorrow’s Society”, took place in the context of countries across the five continents seeking ways to increase the coverage of social security systems.

It served as a venue for ISSA members and representatives from Asian countries to share experience in building an effective social security system.

Overcoming challenges

With four general sessions and eight parallel sessions, the forum focused on a wide range of issues – including the main challenges for social security in the Asia-Pacific, achievements in social security management, innovation for expanding and maintaining social security, and building social security systems to adapt to sweeping reforms.

According to ISSA Secretary General Hans-Horst Konkolewsky, social security in the Asia-Pacific has seen significant developments. Increasing social security coverage requires competent organistions to work out strategies to overcome challenges.

Based on global reports and surveys announced at the previous forum, ISSA highlighted 10 main challenges to social security system in the Asia-Pacific. They include narrowing the spending gap, long-term health care, technological transformation, high expectations amongst citizens, an aging population, the labour market and digital economy, jobs for young labourers, inequality, new risks and unpredictable developments in the future, and protection for migrant workers.

Regarding the “long-term health care” concern, the ISSA Secretary General shed some light on the current situation of countries in the region. In the context of rapid aging populations and increasing chronic diseases, the healthcare insurance system would be able to improve medical examinations and healthcare for citizens, the competence for a more sustainable health care system and taking into account to include preventive care.

The achievements of Vietnam’s social security system include the expansion of health insurance holders in recent years and the issuance of the list of essential medicines and medical instruments integrated with regulations on payment rates and conditions, Deputy Director of the VSS’ Institute of Social Security Sciences Nguyen Thi Hong Van said. The VSS has also succeeded in controlling prices of medicine and medical instruments thanks to significant reforms in medicine bidding, the public listing of drug and medical instrument prices on the VSS’ website, and the launch of national centralised bidding for commonly-used drugs, she noted.

In addition, the achievements include the adjustment of healthcare service fees to shift the medical financial mechanism from subsidy to autonomy in order to improve service quality and ensure the patients benefit, as well as the application of information technology in VSS management, she added.

Speakers from the VSS later talked about challenges in expanding health insurance coverage and greater pressure on the agency to serve an increasing number of insurance holders. The VSS has also faced challenges in balancing the premium payments and benefits of the holders, controlling health insurance expenditure, addressing population ageing in Vietnam, and developing the social security system.

During a parallel session on practical approaches towards improved management on social security, delegates discussed two topics on administrative solutions for the expansion of social security coverage and ensuring social security compliance and settle violations. The discussion of the second topic saw the presence of a speaker from Vietnam, Director of the VSS’ Southern Centre for Medical Review and Tertiary Care Payment Duong Duc Tuan.

Duc said health insurance is one of the two main pillars of Vietnam’s social security system. Health insurance enrollees in Vietnam are covered for most health care services and over 40,000 medicines and medical instruments, 18,000 medical procedures; and since 2015, they have been able to select any district-level health care provider to get checkups and treatment, he noted. He also mentioned that fee for services reimbursement and autonomous hospital mechanism in verifying and payment to health care providers remain among the top challenges for the VSS.

He moved on to say that, to solve these issues, the VSS has focused on developing a database system for health insurance verification, connected to nearly 14,000 medical establishments across the country. It has also formulated a code of conduct for verification as well as analysis, assessment, and forecast of medical payments.

From 2017, the VSS has officially deployed a database system for health insurance verification that allows the online sharing of information and medical records of patients with health care service providers and helps them check a patient’s insurance coverage, monitor their medical history, and provide a response to the verification. Accordingly, all health insurance claims have been checked against the code of conduct for verification. The system has automatically rejected non-eligible and repeated claims, and given warnings about those that need further examination.

Honouring the VSS’ achievements

A highlight of the forum was the ISSA’s Good Practice Award for Asia and the Pacific, recognising achievements in the region. The Republic of Korea’s National Pension Service received the regional award while the ISSA also honoured eight other national social security agencies, including the VSS.

The VSS was recognised for their efforts in applying IT in managing health insurance payments. According to ISSA, by the end of July 2018, Vietnam had more than 81.69 million health insurance holders, accounting for 87.2 percent of the population. It has put the VSS under great pressure to manage such a large database of holders with hundreds of millions of health insurance claims each year. In such a context, the VSS’ database system has proven effective in monitoring and examining healthcare services provided by medical establishments to the holders, contributing to improving the national social security system.

ISSA has highly appreciated such achievements made by the VSS as it is a significant and effective step to serving the people with IT-based public services./.