The Vietnam Social Security has actively participated in and closely coordinated with the Ministry of Health to timely issue, amend, supplement and implement legal documents and regulations relating to health insurance policies and benefits to bring them in line with each period; particularly in issuing legal documents to implement the Law on Health Insurance and the Law amending and supplementing a number of articles of the Law on Health Insurance, such as adjusting and setting the same prices for health check-up and treatment services using health insurance among hospitals of the same level across the country; and building and guiding the implementation of the basic medical service package covered by the Health Insurance Fund.

In order to increase the efficiency of the health insurance fund and prevent corruption, Vietnam Social Security from 2017 carried out a method to examine health insurance based on Information Technology. The health insurance examination information system consists of an electronic examination and supervision system, connecting data with health clinics providing medical services covered by health insurance, from communal level to central level across the nation, to better manage medical service expenses covered by health insurance. The system will be regularly updated and develop examination regulations with transparent information; detect unusual increases in medical service payments by the health insurance fund to prevent corruption, contributing to ensuring the effective use of the health insurance fund.

The management of the use and payment of drug and medical supplies has also been implemented effectively. Vietnam Social Insurance has actively participated and coordinated with the health sector in bidding for procurement of drugs used in medical examination and treatment funded by the health insurance; directly participated in a group appraising plans to select contractors at central hospitals under the Ministry of Health and hospitals under ministries and sectors; group of experts evaluating bids at National Mall (Ministry of Health); directed and guided provincial and municipal social insurance agencies to participate in local medicine procurement bidding councils; and publicised the winning bid prices of drugs and medical supplies of provinces and cities and the average bid-winning drug price on the Vietnam Social Security website to ensure transparency and control of the prices of drugs and medical supplies.

The expansion of the number of health insurance participants needs firm steps via feasible and suitable mechanisms and policies in line with the development conditions of the country, labour structure and medical financial mechanism reforms. It is necessary to put into consideration medical examination and treatment demand of health insurance card holders when defining a roadmap for expanding health insurance participants.

At this time, it can be confirmed that it is feasible to fulfil the target of having 95 per cent of the population joining health insurance, as the rate is now at 90 per cent. Together with economic development, health insurance policies need not only focus on increasing and maintaining the rate of health insurance participants but also to focus on ensuring an increase in scope of services and benefits and the level of financial protection.  

However, challenges remain in the implementation of health insurance policies, such as the rate of health insurance participants being high but lacking sustainability; complicated development of diseases; and quality of medical services failing to meet increasing demand of the public and remaining different among hospitals at different levels./.