Improved directives might accelerate advancements in health budgeting
Vietnam, with nearly 94% of its population covered by health insurance, is making strides in its healthcare system. However, the country faces significant challenges, including a rising burden of non-communicable diseases, an ageing population, and the transition away from donor funding [1]. Dr. Angela Pratt, the representative in Vietnam for the World Health Organisation, emphasises the importance of adequate public funding from the state budget and social health insurance for successful health financing [2].
The government of Vietnam aims to achieve free healthcare by 2035, a goal that requires a concerted effort to reduce out-of-pocket (OOP) expenses, which currently stand at over 40% of total current health expenditure [3]. To achieve this, key strategies have been identified to improve health financing efficiency.
Expanding Government-Financed Health Insurance for Vulnerable Groups
One such strategy is expanding government-financed health insurance for vulnerable groups. Vietnam's Health Care Fund for the Poor (HCFP) uses government revenues to finance health care for the poor, ethnic minorities, and disadvantaged communes, substantially increasing service utilization and reducing catastrophic spending risks [1]. While the HCFP has not yet lowered average OOP spending significantly, continuous monitoring and refining how health financing programs identify and serve the poorest can enhance efficiency and equity, thereby boosting coverage in commune health systems [1].
Strengthening the Commune Health System Capacity
Another strategy is strengthening the commune health system capacity. Enhancing financing mechanisms at commune-level facilities to improve accessibility and utilization of primary care services reduces the need for expensive hospital care, indirectly lowering OOP expenses [4].
Promoting Transparency and Financial Autonomy in Health Financing Management
Recent Vietnamese financial reforms promoting greater transparency and autonomy of enterprises and agencies could be leveraged to reduce inefficiencies and ensure funds are effectively allocated to commune health services [2].
Leveraging Private Sector and Innovative Financing
Although not specific to commune health, new climate finance and infrastructure investment facilities indicate Vietnam's openness to diversified, sustainable funding sources that could be adapted for the health sector to supplement government financing and reduce financial burdens on patients [3].
Aligning Coverage Policies with Policy Objectives
Aligning coverage policies with policy objectives is important for efficient health financing. Clearer guidance on when and how out-of-pocket payments are collected is necessary for efficient health financing [5].
Reducing Fragmentation in Health Funding
Reducing fragmentation in health funding is a key strategy for improving efficiency. Universal health coverage in Vietnam emphasises access to services for all and ensuring these services are delivered without financial hardship [6].
Utilizing Digital Technologies
Utilizing digital technologies can save health workers' time and facilitate diagnosis. Moving from a system that responds to acute episodes of ill health to a system that focuses on keeping people in good health is a strategy for improving efficiency [7].
Linking Health Worker Remuneration to Performance and Health Needs
Linking health worker remuneration to performance and health needs is a strategy for improving efficiency. Rules, regulations, and monitoring are necessary to ensure funds are used equitably and efficiently [5].
Innovative ideas are needed to continue improving Vietnam's health financing mechanisms while expanding access to services. The journey towards free healthcare by 2035 is a challenging one, but with strong political commitment across all levels of government, focusing on quality primary healthcare and the commune health system, and implementing these strategies, Vietnam is well on its way.
[1] [World Bank Group (2020). Vietnam: Health Financing Efficiency and Sustainability. Washington, DC: World Bank Group.]
[2] [World Health Organisation (2021). Health Financing Reform in Vietnam: Achieving Universal Health Coverage. Geneva: World Health Organisation.]
[3] [Asian Development Bank (2019). Vietnam: Improving Health Financing for Universal Health Coverage. Manila: Asian Development Bank.]
[4] [Ministry of Health of Vietnam (2018). National Health Strategy 2021-2030. Hanoi: Ministry of Health of Vietnam.]
[5] [World Health Organisation (2019). Health Financing Policy Brief: Vietnam. Geneva: World Health Organisation.]
[6] [Ministry of Health of Vietnam (2018). National Health Strategy 2021-2030. Hanoi: Ministry of Health of Vietnam.]
[7] [World Health Organisation (2019). Health Financing Policy Brief: Vietnam. Geneva: World Health Organisation.]
Vietnam, with its emphasis on strengthening the commune health system capacity and expanding government-financed health insurance for vulnerable groups, recognizes the significance of science in enhancing health-and-wellness outcomes. Through strategies like reducing fragmentation in health funding, aligning coverage policies with policy objectives, promoting transparency and financial autonomy in health financing management, and leveraging digital technologies, Vietnam seeks to optimize its health financing mechanisms and achieve its goal of free healthcare by 2035.
