How Can Vietnam Reform Its Health Insurance for Better Access?

October 25, 2024

The Vietnamese National Assembly deputies are considering a proposal to amend and enhance health insurance regulations, targeting the elimination of referral procedures and exploring other reforms to improve the convenience and effectiveness of the health insurance system. This proposal comes amid recent deliberations on the Draft Law suggesting amendments to the Law on Health Insurance. Implemented for 15 years and currently covering 93.35 percent of the population, the existing system has been identified to have several shortcomings, with referral procedures being a primary focus of criticism.

A significant theme in the proposed revisions is the elimination of referral procedures, particularly for rare and severe diseases. This change aims to simplify the patient process by allowing direct access to specialized care without needing prior referrals. Minister of Health Dao Hong Lan emphasizes that this proposal would reduce administrative burdens, improve patient convenience, lower out-of-pocket costs, and save resources for the Health Insurance Fund.

However, Deputy Nguyen Tri Thuc of Ho Chi Minh City suggests a more selective approach. He proposes eliminating referral procedures between primary and secondary care levels at district and provincial hospitals while maintaining them for specialized care. His rationale is to prevent an overwhelming influx of patients to larger hospitals and specialized centers, which could undermine the primary healthcare system. This system is fundamental to the government’s grassroots healthcare development policy. Thuc underscores the necessity of removing administrative hurdles while allowing people to choose appropriate medical facilities regardless of location.

Deputy Nguyen Tri Thuc from Hanoi also advocates for expanding health insurance coverage to include cancer screenings. This measure would enable early detection and timely treatment, thus reducing long-term healthcare costs. Supporting this, Deputy Nguyen Anh Tri points out that the current system is burdened by numerous issues and risks bankrupting the Health Insurance Fund if operational methods remain unchanged. He criticizes the current strategy of categorizing insurance lines by levels, viewing it as a temporary and insufficient measure. Instead, he calls for a comprehensive reorganization of the health system to ensure equitable access to quality health services across all locations.

Deputy Pham Khanh Phong Lan from Ho Chi Minh City echoes these concerns, identifying complex payment and referral processes as significant barriers to effective health insurance utilization. She advocates for simplifying these procedures to enhance the system’s efficacy and reduce patient dissatisfaction. Additionally, she stresses the need for rigorous technical oversight of health insurance examinations and treatments and suggests reviewing the financial framework and regulations. This review aims to ensure access to high-quality health services while also supporting the primary health care system.

In summary, there is a clear call among the deputies for reforming the health insurance system to enhance convenience, accessibility, and quality of care. The consensus revolves around simplifying procedures, eliminating unnecessary administrative burdens, and ensuring equitable access to health services. The deputies understand that the current system requires significant restructuring to address its inefficiencies and better serve the population’s health needs. This cohesive perspective underscores the necessity of health insurance reforms in Vietnam, aiming to balance patient convenience with systemic sustainability.

The article concluded by acknowledging the varied yet coherent viewpoints of the deputies, all emphasizing the importance of systemic reforms to improve the health insurance system. Through objectivity, the summary captured the multi-faceted nature of the proposed changes while maintaining a clear and logical structure to outline the key points discussed.

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