How to achieve sustainable development of universal health insurance?

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From 2015 to 2019, there was an increase of about 15 million people participating in health insurance nationwide. The quality of medical examination and treatment of health insurance has been improved and many new drugs, modern medical techniques and services imported into Vietnam have been quickly paid for by the health insurance fund,creating conditions for patients to access conveniently, ensuring principles of risk sharing among participants. The health insurance policy has contributed to reducing direct spending of household budget on health services. By 2018, this percentage decreased to 37 percent, contributing to the equity in health care, especially for group of the poor, near poor and children under six years old.

According to Phan Van Toan, Deputy Director of Department of Health Insurance (Ministry of Health), Resolution No. 68/2013/QH13 of the National Assembly assigned some targets to the Government to ensure that by 2015, at least 75 percent of the population would participate in health insuranceand by 2020, at least 80 percent of the population would participate in health insurance. Accordingly, in 2018, the country had more than 83.5 million people in health insurance, reaching the percentage of health insurance coverage of 88.5 percent of the population, exceeding the target assigned by the Prime Minister in Decision No. 1167/QD-TTg of 3.3 percent(exceeding the target set by Resolution No. 68/2013/QH13, reaching at least 80 percent of the population participating in health insurance by 2020), of which subjects participating in household health insurance reached 15.7 million, increasing nearly 1 million people compared to 2017 (an increase of 6.3 percent).

In 2019, the country is estimated to have some 85.2 million people participating in health insurance, reaching the health insurance coverage rate of 89.8 percent of the population, exceeding the target assigned by the Prime Minister in Decision No. 1167/QD-TTg of 1.7. percent (exceeding the target assigned by Resolution No. 68/2013/QH13, by 2020, at least 80 percent of the population will participate in health insurance).

Remarkably, according to Bui Sy Loi, Deputy Chairman of the National Assembly's Social Affairs Committee, through monitoring, they found about 5-10 years ago, this proportion was very different among locations. Even in localities near Hanoi, such as Nam Dinh was just over 40 percent, less than 50 percent in 2012. But so far, it is very happy news that this percentage is spread evenly throughout the country, which means a large area of coverage.

It must cover all people, also known as universal health insurance, so no one has to go for medical examination and treatment without health insurance. Photo: Internet.

Must ensure two requirements

Also according to Bui Sy Loi, the sustainable development of health insurance must satisfy two basic requirements. Firstly, it must cover all people, also known as universal health insurance, so no one has to go for medical examination and treatment without health insurance. Secondly, finance issues must be ensured sustainably. This is a very important issue, it is seen the coverage is large, but the risk of "insolvency" is high, because the current situation is “pay less, enjoy more”, and general sharing is low, even not sharing. This does not make health insurance sustainable. These two factors need special attention.

The important issue is the remaining coverage of 10 percent, we need to focus on advocacy and propaganda for this object to participate in the national health insurance system, which will help our fund increase. Next, our current contribution rate is 4.5 percent; but the law allows for 6 percent, we have good room. But if collection amount increases rapidly, it will also put pressure on people and enterprises, so there is a need for a roadmap and cannot be increased immediately. Importantly; this capital must be used effectively.

Therefore, to have a balance between achieving the goal of health insurance coverage and ensuring rights of participants and ensuring the safety of funds, Deputy Chairman of the Committee on issues Congress of the National Assembly Bui Sy Loi said the most important sustainability of health insurance is to ensure the best health and the best satisfaction of the people, and also create opportunities for those who have not participated in health insurance would join the system. This means it is necessary to implement a fair and effective health financing mechanism, which helps our health insurance system be more sustainable.