Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options

To address the growth in resultant out-of-pocket (OOP) payments and associated problems of financial barriers to access, the government issued several policies aimed at expanding coverage throughout the 1990s and 2000s, particularly for the poor and other vulnerable groups. Universal coverage (UC) can be an elusive concept and is about three objectives: (a) equity (linking care to need, and not to ability to pay); (b) financial protection (ensuring that health care use does not lead to impoverishment); (c) effective access to a comprehensive set of quality services (ensuring that providers make the right diagnosis and prescribe a treatment that is appropriate and affordable; and (d) to ensure that the financing needed to achieve UC is mobilized in a fiscally sustainable manner, and is used efficiently and equitably. The objective of this report is to assess the implementation of Vietnam social health insurance (SHI) and provide options for moving toward UC, with a view to contributing to the law revision process. It analyzes progress to date on the two major goals of the master plan. The report assesses Vietnam's readiness to meet these goals, the challenges it will face in achieving UC, and key reforms needed to overcome those challenges. It does so through a health financing lens, focusing on how resources are mobilized, pooled, and allocated, and how services are purchased. The report also examines the stewardship of financing that is, the organization, management, and governance of SHI as it has direct implications for achieving UC. The report ends by pulling together the recommendations in the form of an implementation road map.

Bibliographic Details

Main Authors:	Somanathan, Aparnaa, Tandon, Ajay, Dao, Huong Lan, Hurt, Kari L., Fuenzalida-Puelma, Hernan L.
Format:	Publication biblioteca
Language:	English en_US
Published:	Washington, DC: World Bank 2014-06-26
Subjects:	ABILITY TO PAY, ACCESS TO HEALTH SERVICES, ACCESS TO SERVICES, ADMINISTRATIVE COSTS, ADMINISTRATIVE EFFICIENCY, ADVERSE SELECTION, AGED, AGING, AUDITORS, BUDGETARY IMPACT, BUDGETARY RESOURCES, CAPITATION, CAPITATION PAYMENTS, CASE MANAGEMENT, CATASTROPHIC HEALTH SPENDING, CHILD HEALTH, CITIES, CLINICAL PRACTICE, COMPETENCIES, CONSULTATION PROCESS, CONSUMERS, CONTRIBUTION RATE, CONTRIBUTORY INSURANCE, COST EFFECTIVENESS, COUNSELING, DELIVERY SYSTEM, DEMAND FOR HEALTH, DEMAND FOR HEALTH CARE, DIAGNOSIS, DIAGNOSTIC ASSESSMENT, DRUGS, EMPLOYMENT, ENROLLEES, ENTITLEMENT, EPIDEMIOLOGICAL TRANSITION, EXPANSION OF COVERAGE, EXPENDITURES, FAMILIES, FEE SCHEDULES, FEE-FOR-SERVICE, FINANCIAL BARRIERS, FINANCIAL CATASTROPHE, FINANCIAL INCENTIVES, FINANCIAL PROTECTION, FINANCIAL RISK, FLAT RATE, GYNECOLOGY, HARD TO REACH GROUPS, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE FINANCING, HEALTH CARE PROFESSIONALS, HEALTH CARE PROVIDER, HEALTH CARE USE, HEALTH CENTERS, HEALTH COVERAGE, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INSURANCE, HEALTH INSURANCE COVERAGE, HEALTH INSURANCE PROGRAM, HEALTH INSURANCE SCHEME, HEALTH INSURANCE SCHEMES, HEALTH INSURANCE SYSTEM, HEALTH INTERVENTIONS, HEALTH ORGANIZATION, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROJECT, HEALTH PURCHASERS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICES, HEALTH SHARE, HEALTH SPENDING, HEALTH STRATEGY, HEALTH SYSTEM, HEALTH SYSTEM FINANCING, HEALTH SYSTEM GOALS, HEALTH SYSTEM STRENGTHENING, HEALTH SYSTEMS, HEALTH SYSTEMS STRENGTHENING, HEALTH WORKERS, HEALTHCARE, HEALTHCARE SERVICES, HOSPITAL BEDS, HOSPITAL REVENUES, HOSPITAL SERVICES, HOSPITALS, HUMAN DEVELOPMENT, HUMAN RESOURCES, HUMAN RESOURCES DEVELOPMENT, ILLNESS, IMMUNODEFICIENCY, INCENTIVES FACING PROVIDERS, INCOME, INCOME COUNTRIES, INCOME ELASTICITY, INCOME GROUPS, INFORMAL SECTOR, INFORMAL SECTOR WORKERS, INFORMATION SYSTEMS, INPATIENT ADMISSION, INSURANCE LAW, INSURANCE POLICIES, INSURANCE PREMIUM, INSURANCE PREMIUMS, LAWS, LIBERALIZATION, LIVING STANDARDS, LOW-INCOME COUNTRIES, MEDICAL BENEFIT, MEDICAL DOCTORS, MEDICAL EDUCATION, MEDICAL TRAINING, MEDICINES, MIGRANTS, MIGRATION, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NEEDS ASSESSMENT, NURSES, NUTRITION, PATIENTS, PHARMACEUTICAL COSTS, PHARMACEUTICAL SECTOR, PHARMACEUTICAL SPENDING, PHARMACISTS, PHYSICIANS, POCKET PAYMENTS, POLICY DISCUSSIONS, POLICY RESEARCH, PRIMARY CARE, PRIMARY HEALTH CARE, PROBABILITY, PROGRAMS, PROVIDER PAYMENT, PROVISION OF SERVICES, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, PUBLIC HOSPITAL, PUBLIC SPENDING, QUALITY OF CARE, REIMBURSEMENT RATES, RISK GROUPS, SAVINGS, SCREENING, SOCIAL ASSISTANCE, SOCIAL HEALTH INSURANCE, SOCIAL MOBILIZATION, SOCIAL SECURITY, SOCIAL WORKERS, SUSTAINABILITY, TUBERCULOSIS, VACCINATION, WORKERS,
Online Access:	http://documents.worldbank.org/curated/en/2014/06/19776955/moving-toward-universal-coverage-social-health-insurance-vietnam-assessment-options http://hdl.handle.net/10986/18885
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