J Korean Med Sci.  2014 Jul;29(7):919-925. 10.3346/jkms.2014.29.7.919.

Moving toward Universal Coverage of Health Insurance in Vietnam: Barriers, Facilitating Factors, and Lessons from Korea

Affiliations
  • 1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. phealth@snu.ac.kr
  • 2JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 3Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea.

Abstract

Vietnam has pursued universal health insurance coverage for two decades but has yet to fully achieve this goal. This paper investigates the barriers to achieve universal coverage and examines the validity of facilitating factors to shorten the transitional period in Vietnam. A comparative study of facilitating factors toward universal coverage of Vietnam and Korea reveals significant internal forces for Vietnam to further develop the National Health Insurance Program. Korea in 1977 and Vietnam in 2009 have common characteristics to be favorable of achieving universal coverage with similarities of level of income, highly qualified administrative ability, tradition of solidarity, and strong political leadership although there are differences in distribution of population and structure of the economy. From a comparative perspective, Vietnam can consider the experience of Korea in implementing the mandatory enrollment approach, household unit of eligibility, design of contribution and benefit scheme, and resource allocation to health insurance for sustainable government subsidy to achieve and sustain the universal coverage of health insurance.

Keyword

Universal Coverage; Insurance, Health; Facilitating Factors; Korea, Vietnam

MeSH Terms

Eligibility Determination
Humans
Income
National Health Programs/*economics
Republic of Korea
Socioeconomic Factors
Universal Coverage/*economics
Vietnam

Reference

1. Ministry of Health. National health account. Hanoi: Ministry of Health;2010.
2. Ha D. Social Health Insurance as a means to achieving universal coverage and more equitable health outcomes. Hanoi: UNICEF;2011.
3. Knaul FM, Wong R, Arreola-Ornelas H, Méndez O. Network on Health Financing and Social Protection in Latin America and the Caribbean (LANET). Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean Countries. Salud Publica Mex. 2011; 53:s85–s95.
4. O'Donnell O, van Doorslaer E, Rannan-Eliya RP, Somanathan A, Gard CC, Hanvoravongchai P, Hug MN, Karan A, Leung GM, Tin K, et al. Explaining the incidence of catastrophic expenditures on health care: comparative evidence from Asia. 2005. accessed on December 2012. Available at http://www.equitap.org/publications/docs/EquitapWP5.pdf.
5. Van Doorslaer E, O'Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, Harbianto D, Herrin AN, Huq MN, Ibragimova S, et al. Catastrophic payments for health care in Asia. Health Econ. 2007; 16:1159–1184.
6. Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a multicountry analysis. Lancet. 2003; 362:111–117.
7. Vietnam National Assembly. Charter of health insurance. Hanoi: Vietnam National Assembly;1992.
8. Ministry of Health. Roadmap to achieve universal coverage of health insurance in Vietnam: 2012-2015. Hanoi: Ministry of Health;2012.
9. Prime Minister. Decree 63 on healthcare examination and treatment for the poor. Hanoi: Prime Minister;2003.
10. Wagstaff A, Sarah B. The impacts of public hospital autonomization: evidence from a Quasi-natural experiment. World Bank. 2012.
11. Jowett M. Do informal risk sharing networks crowd out public voluntary health insurance? evidence from Vietnam. Appl Econ. 2003; 35:1153–1161.
12. Tien TV, Phuong HT, Mathauer I, Phuong NTK. A health financing review of Vietnam with a focus on social health insurance. Hanoi: World Health Organization;2011.
13. Ekman B, Liem NT, Duc HA, Axelson H. Health insurance reform in Vietnam: a review of recent developments and future challenges. Health Policy Plan. 2008; 23:252–263.
14. Cuong V. The impact of voluntary health insurance on health care utilization and out-of-pocket payments: new evidence for Vietnam. Health Economics. 2011.
15. Jowett M. Voluntary health insurance in Vietnam: an evaluation. Health Popul. 2001; 24:29–44.
16. Vietnam Social Security. Report on two year implementation of the Law of Health Insurance. Vietnam: Vietnam Social Security;2011.
17. Thanh NX, Curt L, Chuc NTK, Niklas R, Anders E, Lars L. People's preferences for health care financing options: a choice experiement in rural Vietnam. Umeå: Umeå University;2005.
18. Ministry of Health and Ministry of Finance. Joint enforcement decree of health insurance law. Hanoi: Ministry of Health and Ministry of Finance;2009.
19. Carrin G. Social health insurance in developing countries: a continuing challenge. Int Soc Secur Rev. 2002; 55:57–69.
20. World Health Organization. Reaching universal coverage via social health insurance: key design features in the transition period. Geneva: WHO;2004.
21. Deutsche Technische Zusammenarbiet (GTZ). Social health insurance: a contribution to the international development policy debate on universal systems of social protection. 2005.
22. Yu SH, Anderson GF. Achieving universal health insurance in Korea: a model for other developing countries? Health Policy. 1992; 20:289–299.
23. Rockefeller-Foundation. Catalyzing change: the system reform costs of universal health coverage. New York: Rockefeller-Foundation;2010.
24. Lu JR, Kwon S, Bayarsaikhan D. Comparative desk-review of social health insurance experiences in Japan, Korea, Taiwan, and Mongolia. EQUITAP Working Paper. 2005. accessed on December 2012. Available at http://www.equitap.org/publications/docs/EquitapWP20.pdf.
25. Moon O. The Korean health insurance program. In : Nitayarumphong S, Mills A, editors. Achieving universal coverage of health care. Thailand Ministry of Public Health;1998.
26. Huber E. Options for social policy in Latin America: neoliberal versus social democratic models. In : Anderson GE, editor. Welfare states in transition. SAGE Public;1996. doi: 10.4135/9781446216941.
27. Vietnam General Statistics Office. Demographic statistics 2010. accessed on January 2013. Available at http://www.gso.gov.vn/default_en.aspx?tabid=467.
28. International Labour Organization. Vietnam employment trends report 2010. accessed on January 2013. Available at http://www.un.org.vn/vi/publications/doc_details/185-vietnam-employment-trends-report-2010.html.
29. Korea National Health Insurance Cooperation. Health Insurance Statistics Yearbook. Seoul: Korea National Health Insurance Cooperation;2010.
30. Nguyen CV. The impact of voluntary health insurance on health care utilization and out-of-pocket payments: new evidence for Vietnam. Health Econ. 2012; 21:946–966.
31. Republic of Korea. National Health Insurance Act. 2012.
32. Jeong HS. Korea's National Health Insurance: lessons from the past three decades. Health Aff (Millwood). 2011; 30:136–144.
33. Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009; 24:63–71.
34. Bayarsaikhan D, Kwon S, Ron A. Development of social health insurance in Mongolia: success, challenges and lessons. Int Soc Secur Rev. 2005; 58:27–44.
35. Mathauer I, Xu K, Carrin G, Evans DB. An analysis of the health financing system of the Republic of Korea and options to strengthen health financing performance. WHO;2009. accessed on January 2013. Available at http://www.who.int/health_financing/documents/hsfr_e_09-korea.pdf.
36. Lee JC. Health care reform in South Korea: success or failure? Am J Public Health. 2003; 93:48–51.
37. Soe SR, Choi ID, Moon SW, Kim JS, Hwang RI. Satisfaction survey of national healh insurance 2008. National Health Insurance Cooperation;2008.
38. Kang MS, Jang HS, Lee M, Park EC. Sustainability of Korean National Health Insurance. J Korean Med Sci. 2012; 27:S21–S24.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr