SITUATION OF

IMPLEMENTING
HEALTH
INSURANCE
POLICIES FOR
ETHNIC
MINORITIES IN
VIETNAM
 01. INTRODUCTION
Background, needs and
urgency

TABLE OF
CONTENT 02. FINDING

S Analyze and explain policy

options

03. CONCLUSION
Forecasting
01.
BACKGROUN
D
Background, needs and
urgency
Health
Health insurance
insurance isis aa form of insurance
type of insurance organized
applied in
the
andfield of health
managed by thecare, notinfor
State profit,
order organizedthe
to mobilize by
the State and the
contributions participants collectives
of individuals, are responsible for
and social
participating
communities in foraccordance
health care,with the provisions
medical of
examination
this
and Law.
treatment for the people.
 IN RECENT
- YEARS
Help Health Insurance card holders access to the most advanced
medical technical services
- Most of the drugs and technical services are covered by the
Health Insurance Fund when providing medical care at the right
level
- Health insurance participants will receive thoughtful medical
examination and treatment, regardless of rich or poor
- Health insurance card holders, when going to the right medical
examination and treatment, are covered by the Health Insurance
Fund for 80%, 95% or 100% of medical examination and
treatment costs, depending on the target group.
 “Carrying out medical examination and treatment
with the Health Insurance card to help the poor,
near-poor, and people in difficulty reduce the
burden of spending on their families when they are
sick”.
02.
DESIGN AND
DEVELOP
POLICY
OPTIONS
AFFECTED FACTORS
01
There is no clear division of
the target groups to receive
support
02
Some regulations are not
specific, making it difficult to
guide implementation
03
The current organizational model of
the health insurance system
(unprofessional, scattered, and
overlapping) limits the organization
and performance of the state
management function on health
insurance.
PROBLEM TREE
OBJECTIVE
TREE
OBJECTIVE
TREE
OBJECTIVE
TREE
 THE
DESIGN
POLICY
OPTIONS
THE 1st POLICY
PACKAGE

OVERALL SPECIFIC GOALS

OBJECTIVES
Improving the quality of medical 85% of people participating in
examination and treatment health insurance are satisfied
services with health insurance with the quality of service

Solution 1: Standardize the attitude
and working style of medical staff in
medical examination and treatment
facilities
Issue clear and detailed regulations on
TOOL the attitude and working style, medical
1 examination and treatment of medical
staff.
Establish an inspection committee to
supervise medical examination and
TOOL treatment activities and the quality of
2 medical examination and treatment of
establishments accepting health
insurance
Solution 2: Simplify and eliminate
unnecessary processes that obstruct
the hospital referral process for
participants with health insurance.
Promulgating a decision on cutting
unnecessary processes that hinder
hospitals and health insurance users
during the referral process to serve
medical examination and treatment in
cases where lower-level hospitals are
not eligible for medical examination
and treatment.
Solution 3: Set standards for equipment at
each level of medical examination and
treatment facilities in order to establish a
common ground for medical examination
and treatment facilities and equipment for
participants of health insurance.
Issue a Resolution on infrastructure
investment for the Health Station and set
clear standards on essential equipment and
facilities that all facilities accept medical
examination and treatment with compulsory
health insurance
Set up a fund to use the budget from the
central to local levels to support medical
facilities that accept health insurance in terms
of modern facilities and machines for medical
examination and treatment for patients in
order to establish standard facilities
THE 2nd POLICY PACKAGE

OVERALL SPECIFIC GOALS

OBJECTIVES
Promoting PPP in investment in 90% of establishments accept
medical examination and health insurance coverage
treatment services using health
insurance
 Solution: Offer preferential policies for
private enterprises when investing in
medical examination and treatment
services using health insurance

Promulgating decisions on tax exemption

and reduction for private medical
TOOL 1
THE 2nd examination and treatment enterprises that
accept payment and use of health insurance

POLICY Issuing mandatory decisions for private

hospitals, introducing mandatory data on
PACKAGE TOOL 2 the percentage of private hospitals that must
accept health insurance in payment for
medical services at that hospital facility
THE 3rd POLICY PACKAGE

OVERALL SPECIFIC GOALS

OBJECTIVES
Unify the payment process for 85% of establishments apply the
medical examination and rate payment until 2025
treatment costs at facilities that
accept health insurance
 Solution: Implement the capitation
payment method on all health
insurance-accepting facilities
nationwide

Promulgating a circular guiding payment

THE 3rd along with the most specific and
minimalistic payment process, which is
TOOL 1
POLICY mandatory to apply at all medical
examination and treatment facilities using
health insurance.
PACKAGE
Make decisions and training plans for
TOOL 2 facilities accepting health insurance
03.
ANALYSIS OF
POLICY
OPTIONS
QUANTITATTIVE MEASUREMENT OF THE
PROPOSED POLICY OPTIONS
04.
THE ANALYSIS
OF POLICY
STAKEHOLDER
S
STATE ACTOR

Government Ministry of Health

Ministries and People's Committees

ministerial-level of all levels
agencies
STATE
ACTOR
SOCIAL ACTORS

BENEFICIARIES INTERMEDIARIES

Health insurance users, health Health insurance service

insurance holders providers: commune health
stations, wards, central and local
hospitals, clinics under the
Ministry of Health,...
05.
POLICY
FORECAST
FORECASTING POLICY OUTCOMES

95%
Health insurance participation rate by 2025

18.000
Medical technical services to serve patients are used
by health insurance medical examination and
treatment facilities

12-14 million
Number of people for medical examination and
treatment by health insurance
FORECASTING POLICY IMPACT
- Accelerate the implementation of universal health insurance, affirm the
correctness, an important pillar of the health insurance policy in the
social security system, contribute to social progress and justice, and
ensure socio-political stability.
- Promote communication about policies and laws of health insurance so
that people, businesses, organizations, agencies and units understand
about benefits, responsibilities and rights to actively participate in
health insurance.
06.
POLICY
DECISION
SERVICES

MERCURY MARS
Mercury is the closest planet to Despite being red, Mars is
the Sun and the smallest one actually a cold place. It's full of
iron oxide dust

VENUS NEPTUNE
Venus has a beautiful name and Neptune is the farthest planet
is the second planet from the from the Sun. It's also the
Sun fourth-largest
Based on 2 above analyses it is
clear that the 3rd policy
package is the best way to deal
with the problem of low
quality of health insurance
provided
07.
POLICY
CLOSURE
 Issuing a new circular by using the
2008 Health Insurance Law as a basic
will be selected as the agenda for
adoption and policy announcement.
Beside media channel via National
Assembly meeting will be also one of
the agenda for adoption and policy
announcement.
 RESOURCES
● http://baolamdong.vn/toasoan-bandoc/202111/bao-hiem-xa-hoi-bao-hiem-y-te-nhung-van-de-con-bat-cap-3
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●
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● https://tapchitaichinh.vn/bao-hiem/giai-phap-phat-trien-bao-hiem-y-te-ben-vung-tien-toi-bao-hiem-y-te-toa
n-dan-331643.html
● https://baohiemxahoi.gov.vn/tintuc/Pages/linh-vuc-bao-hiem-y-te.aspx?ItemID=17426&CateID=169
● https://syt.quangbinh.gov.vn/3cms/trien-khai-thi-diem-phuong-thuc-thanh-toan-chi-phi-kham-chua-benh-ba
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THANKS
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