Reporter: Could you tell us about the important results in the implementation of the health insurance policy?

Deputy General Director Nguyen Duc Hoa: The health insurance policy was deployed with many new points this year, such as adjusting groups of participants; improving benefits for health insurance participants; promulgating a new health-insurance assessment process; synchronising a technical list with new health service prices; accelerating administrative reform and public services related to examination and treatment, covered by the health insurance fund, on the National Public Service Portal; and expanding coverage and increasing health insurance participants according to the Government’s goals.

The insurance sector has coordinated with the Ministry of Health in formulating and amending the Law on Health Insurance, promptly deploying new regulations to ensure the interests and create favourable conditions for the health insurance participants when they go to medical facilities to be examined and treated.

The sector has also worked with relevant ministries and agencies to apply information technology (IT) in examination, treatment, assessment and payments of medical costs covered by the health insurance fund; connect data among medical facilities, and organise training courses for staff nationwide, who verify the payments of medical expenses, covered by the health insurance fund.

One of the outstanding results in the implementation of the health insurance policy last year was that the number of participants increased. The proportion of people participating in health insurance has gradually increased over the past years, realising the goal of universal health insurance coverage. 

The health insurance fund has contributed to effectively replacing the financial mechanism for health care. Health insurance coverage reached 57 per cent of the population in 2009 and 74.7 per cent of the population in 2015. The number has reached 92 per cent of the population so far, exceeding the target set by the Government.

The guarantee of examination and treatment benefits for health insurance participants has achieved many progressive results. Every year, there are more than 100 million arrivals for examination and treatment covered by the health insurance fund. The fund also paid medical expenses of up to hundreds of millions of dong for thousands of people, and up to billions of dong for some participants.

For example, in the first quarter of this year, the fund paid medical costs of over VND500 million (US$21,000) for 99 patients, and over VND1 billion ($42,000) for eight patients.

Due to the impact of the COVID-19 pandemic, the fund and the State budget have contributed significantly to preventing and controlling the pandemic as well as remedying the consequences of the pandemic, affirming the pivotal role of the policy in the national social security system.

We have strived to fulfil and exceed the goals set by the Politburo's Resolution No 21 for the whole political system, especially Viet Nam Social Security.

 Deputy General Director of Viet Nam Social Security Nguyen Duc Hoa

Reporter: Currently, Viet Nam Social Security is considered one of the agencies effectively implementing digital transformation and IT applications. What has the digital transformation and IT brought to participants, medical facilities and the social insurance agency?

Deputy General Director Nguyen Duc Hoa: In addition to the administrative reform, the agency has promoted the application of IT in health insurance, bringing many good results, and creating favourable conditions for participants. The agency has successfully connected with the National Database on Population since the database was officially put into operation. The agency’s system has verified more than 90 million pieces of demographic information, including the National Database on Insurance with the National Population Database so far.

There are nearly 13,000 medical facilities, covered by the health insurance fund, providing information on health insurance cards for participants through their chip-based identity cards. The number accounts for nearly 93 per cent of the total number of medical facilities in the country.

The simplification of administrative procedures, and transparency of information, has created favourable conditions for health insurance participants to go to medical facilities for examination and treatment and helped effectively to manage the health insurance.

The agency has proposed to the Government to deploy biometric authentication technology in examination and treatment covered by the health insurance fund. Currently, the pilot has been applied at medical facilities covered by the fund nationwide.

The agency has integrated registration of examination and treatment, covered by the fund, and registration of participating in health insurance on the National Public Service Portal. The system has received and processed the renewal of more than 15,000 health insurance cards.

Notably, since June 2023, users of the VssID – the social insurance application can also use the health insurance card image on the application to go to medical facilities for examination and treatment.

It is considered a step in line with the requirements of administrative reform and digital transformation of the agency, bringing practical benefits to both health insurance participants and medical facilities.

Currently, all administrative procedures of the insurance sector are carried out in the digital space. It creates convenience, saves time and costs for individuals and organisations to enjoy the health insurance policy’s benefits. These benefits show that the digital transformation of the insurance sector is on the right track, contributing to better serving participants and ensuring better social security.

Viet Nam Social Security strives towards universal health insurance

Reporter: July 1 is Viet Nam Health Insurance Day. Could you tell us some of the sector's outstanding activities to celebrate the day?

Deputy General Director Nguyen Duc Hoa: Disseminating activities to celebrate the day this year were widely and synchronously conducted at all levels of the sector and localities with diverse and practical forms. The message of the day this year is "Joining health insurance to share the burden of sickness and disease". The message is short, accurate, and easy to understand, creating favourable conditions for people to have full access to information on health insurance policies and laws; demonstrating the meaning, role and benefits of the health insurance policy for the people's health care.

The message also mentioned to the health insurance participants, who received payments for medical expenses from the health insurance fund. It helped to reduce the patients’ financial burden, make them feel secure in treatment, consolidate and create belief in human values and pre-eminence in the welfare policies of the Party and the State.

The agency has ordered social security offices in provinces and cities to actively consult the provincial/municipal Party Committee and People's Council to promote the dissemination and implementation of Resolutions and Directives on health insurance.

It also actively organised disseminating activities to celebrate the day in localities through coordination with the Department of Health, medical facilities, and local press. The activities had far-reaching effects, spreading the health insurance policy to the masses.

Reporter: Can you share more about the sector's determination to implement the health insurance policy?

Deputy General Director Nguyen Duc Hoa: The sector's responsibility will become larger, the sector will strive to reach the participation rate of health insurance of 95.15 per cent by 2025, towards universal health insurance following the goal set in Resolution No 20-NQ/TW; fully and promptly provide health insurance benefits for participants. To accomplish that goal, we need to focus on a few things.

It should strongly promote coordination with relevant ministries and sectors in compiling relevant documents in the health insurance field, promptly solving problems arising in practice. The social security offices in provinces and cities have to promote its advisory role with the provincial/municipal Party Committee and People's Committee to direct the implementation of the health insurance policy and laws in the locality, expand health insurance coverage and prevent illegal acts. It also needs to ensure the balance of the health insurance fund in the localities in a sustainable way.

It is required to strengthen the management of the health insurance fund for examination and treatment in medical facilities; invest more in improving the quality of medical examination and treatment at the commune-level medical facilities in order to attract people coming for examination and treatment, and reduce overload for higher-level medical facilities.

The sector needs to further apply IT in the implementation of the health insurance policy, enhance the verification of the electronic health-insurance assessment information system; apply a new health insurance assessment process; proactively work with the health sector to control unreasonable expenses at medical facilities, covered by the health insurance fund.

The sector is tasked to conduct more inspections, and provide more professional guidance on verification information related to examination and treatment, covered by the health insurance fund, for the social security offices in provinces and cities as well as medical facilities to promptly detect and prevent profiteering and abuse of the health insurance fund.

The sector is told to boost the dissemination of policies and laws on health insurance; the role and importance of the health insurance policy in the social security system to encourage more people to participate in health insurance in the future.

With the efforts of the whole insurance sector, and the whole society, the sector is believed to definitely complete the roadmap for universal health insurance coverage, stably and sustainably develop the health insurance fund, and ensure the goal of social security.