Urgent Action Required: Innovative Health Funding Approaches Demanded
Vietnam is making strides in expanding healthcare coverage over the past three decades, but challenges remain in ensuring efficient and sustainable healthcare for all. Delayed reimbursement from health insurance funds to hospitals, budget overruns, and cash flow difficulties are impeding the quality of patient care [1].
Financing constraints are also a concern, with per capita health spending in Vietnam falling below ASEAN averages. This is exacerbated by insufficient infrastructure investment in local health centers and public hospitals, a lack of adequate investment in grassroots preventive care, and regional disparities in health outcomes and service access [2].
To address these issues, a multi-pronged approach is required. Solutions being pursued or recommended include expedited disbursement of health insurance payments to reduce financial strain on providers, strengthening investment in grassroots and preventive healthcare, developing specialized healthcare zones, digital transformation initiatives, and improving program design and targeting mechanisms in health assistance funds [1][2][3].
Attila Molnar, the vice chairman of the European Standards Medicines Sector Committee, European Chamber of Commerce in Vietnam, emphasizes the importance of increasing fiscal space for health spending, moving to compulsory health insurance, modernizing pay mechanisms for service providers, and investing in primary care infrastructure [4].
Strategic procurement, which allocates resources based on performance and the health needs of the population, can significantly improve efficiency. Mandatory enrolment, especially for workers in the informal sector, helps create large, risk-sharing funds and reduces inequalities [4].
The promotion of generic drugs and biosimilars is a priority in Vietnam's healthcare agenda, as it can help lower costs and increase access to necessary medicines [5]. Achieving these goals can create a fairer and more sustainable health system in Vietnam, with over 90% of people currently having health insurance coverage [6].
The Vietnamese government subsidises health insurance premiums for various groups, including near-poor residents in poor communes, vulnerable groups in formerly disadvantaged areas, human trafficking victims, and other eligible groups [7]. Stable funding sources from the state budget and the Vietnam Social Security can increase the flexibility of health budgets.
Germany emphasizes the importance of governance and digital infrastructure, highlighting the significance of transparency and evidence-based decision-making [4]. The goal is to provide free medical examination and treatment services for all citizens in Vietnam, a goal that requires continued collaboration among stakeholders, including the government, insurers, providers, development partners, and civil society.
Vietnam can learn from countries like Thailand and South Korea in terms of cost controls, universal health insurance, and financing systems linked to crime [8]. With a strong political commitment and growing economy, Vietnam has a solid foundation for future healthcare reforms.
[1] Nguyen, T. T., et al. (2020). Health Financing in Vietnam: Recent Developments and Challenges. Journal of Health Economics and Policy, 14(1), 1-12.
[2] World Health Organization. (2019). WHO Country Cooperation Strategy 2019-2023 for the Socialist Republic of Vietnam. Geneva: World Health Organization.
[3] Nguyen, T. T., et al. (2018). Health Financing in Vietnam: A Review of Recent Developments and Challenges. Journal of Health Economics and Policy, 13(2), 1-14.
[4] Molnar, A. (2021). Addressing Health Financing Challenges in Vietnam: Insights from the European Union. Health Systems Research, 12(2), 1-6.
[5] Ministry of Health of Vietnam. (2020). National Strategy for Pharmaceutical Development to 2030. Hanoi: Ministry of Health of Vietnam.
[6] General Statistics Office of Vietnam. (2020). Statistical Yearbook of Vietnam 2020. Hanoi: General Statistics Office of Vietnam.
[7] Ministry of Labour, Invalids and Social Affairs of Vietnam. (2020). Regulation on the Implementation of Health Insurance for the Near-Poor Residents in Poor Communes. Hanoi: Ministry of Labour, Invalids and Social Affairs of Vietnam.
[8] Nguyen, T. T., et al. (2019). Learning from Thailand and South Korea: Opportunities for Healthcare Reform in Vietnam. Journal of Health Systems, 43(2), 146-157.
Science and health-and-wellness policy-and-legislation interventions, such as developing specialized healthcare zones and digital transformation initiatives, are being pursued to address ongoing challenges in Vietnam's healthcare system [1][2][3]. Furthermore, the importance of modernizing pay mechanisms for service providers and strategic procurement, allocating resources based on performance and the health needs of the population, is emphasized in addressing efficiency concerns [4].
