Social Health Insurance, SHI (non-contributory component)
Basic Information
Country
Geographic area
Population group
Children, Ethnic groups
Programme Details
Programme objectives
Achieving universal health coverage.
World Bank. 2017. Moving toward UHC: Vietnam - national initiatives, key challenges, and the role of collaborative activities (English). Moving toward UHC. Washington, D.C.: World Bank Group. http://documents.worldbank.org/curated/en/464111513160157867/Moving-toward-UHC-Vietnam-national-initiatives-key-challenges-and-the-role-of-collaborative-activities
Programme components
The programme has different enrolment modalities for different groups:
• Workers in formal sectors;
• Pensioners;
• People on working capacity loss allowance;
• The poor, minorities, and children under 6 years of age;
• The near-poor;
• Pupils and students;
• Workers in informal sectors;
• Other members of households.
The poor, minorities, and children under 6 years of age have their premiums covered by the government; the near-poor, pupils and students have 7- per cent of their premiums subsidised.
Nguyen LH and Hoang ATD (2017) Willingness to Pay for Social Health
Insurance in Central Vietnam. Front. Public Health 5:89. doi: 10.3389/fpubh.2017.00089
Start date
1992
The Social Health Insurance (SHI) was created in 1992 and has expanded its coverage over time, with universal coverage being enshrined in the country’s 2013 Constitution. The Health Care Fund for the Poor (HCFP) was created in 2003 and from 2009 onwards it was merged with SHI.
Nguyen LH and Hoang ATD (2017) Willingness to Pay for Social Health
Insurance in Central Vietnam. Front. Public Health 5:89. doi: 10.3389/fpubh.2017.00089
World Bank. 2017. Moving toward UHC: Vietnam - national initiatives, key challenges, and the role of collaborative activities (English). Moving toward UHC. Washington, D.C.: World Bank Group. http://documents.worldbank.org/curated/en/464111513160157867/Moving-toward-UHC-Vietnam-national-initiatives-key-challenges-and-the-role-of-collaborative-activities
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
Coverage
By 2020, the government aims to reach 90 per cent of the population and, by 2025, 95 per cent.2 In 2017 the programme covered 83.8 per cent of the population (78.2 million people).
UN Viet Nam 2017. Viet Nam 2017 One UN Results Report. <http://www.un.org.vn/en/publications/un-wide-publications/doc_details/566-viet-nam-one-un-results-report-2017.html > Accessed 22 August 2018.
Programme expenditure
The social health insurance fund had an expenditure of VND 101,201 billion (VND 100,891 for mandatory insurances) in 2015.
Khoa, N.D. 2015. Aging Population and Expanding Social Insurance in Vietnam. Presentation at the Capacity Building Seminar on Enhancing
SS S f G Social Spending in Support of Inclusive Growth in Asia July 14-15, 2015, Colombo, Sri Lanka. <https://www.imf.org/external/np/seminars/eng/2016/srilanka/pdf/0715_2-3.pdf > Accessed 22 August 2018.
Targeting and eligiblity
Targeting methods
Proxy Means Test
Categorical Targeting
Cuong, N.V. and Duc, L.T. 2016. Testing Proxy Means Tests in the Field: Evidence from Vietnam. < https://mpra.ub.uni-muenchen.de/80002/1/MPRA_paper_80002.pdf >(accessed 22 May 2018).
Targeted areas
Nationwide
Target groups
Poor, near-poor, children, ethnic groups, other social assistance beneficiaries.
Eligibility criteria
The poor, near-poor, children under six, school children, ethnic minorities in disadvantaged regions, lower income farmers and social assistance beneficiaries are entitled to receive subsidised health insurance.
The poverty line is centrally determined, but reflects regional specificities. The poor and the near poor reach 100 and 150 per cent respectively of this line, which in rural areas is around VND 400,000 to 520,000 per month (USD 20 to 25) for rural areas and around VND 500,000 to 650,000 per month (USD 25 to 37) for urban areas.
World Bank. 2017. Moving toward UHC: Vietnam - national initiatives, key challenges, and the role of collaborative activities (English). Moving toward UHC. Washington, D.C.: World Bank Group. http://documents.worldbank.org/curated/en/464111513160157867/Moving-toward-UHC-Vietnam-national-initiatives-key-challenges-and-the-role-of-collaborative-activities
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
Eligibility reassessment (if any)
Though households’ income status is to be recertified yearly, households transitioning out of poverty can retain their health benefits for up to three years.
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
Coverage and other information
Type of benefits
Health care services.
Amount of benefits
Poor, minorities and children under 6:
Premium: 4.5 per cent of monthly minimum wage
Subsidy rate: 100 per cent by government
Near poor:
Premium: 4.5 per cent of monthly minimum wage
Subsidy rate: 70 per cent subsidy by the government
Pupils and students:
Premium: 3 per cent of monthly minimum wage
Subsidy rate: 30 per cent subsidy by the government.
The benefit package includes ambulatory care, rehabilitation, advanced diagnostics, and curative services.
Nguyen LH and Hoang ATD (2017) Willingness to Pay for Social Health
Insurance in Central Vietnam. Front. Public Health 5:89. doi: 10.3389/fpubh.2017.00089
World Bank. 2017. Moving toward UHC: Vietnam - national initiatives, key challenges, and the role of collaborative activities (English). Moving toward UHC. Washington, D.C.: World Bank Group.
Payment/delivery frequency
Upon demand.
Benefit delivery mechanism
The poor are registered by Provincial Social Security and their cards are printed and sent to the District Social Security (DSS) which delivers them to the beneficiaries. The near-poor go through a similar process, tough they must pay their premium contribution to DSS before receiving their cards; they can also register in-person at VSS offices.
Services are delivered at health facilities selected by the government.
Nguyen LH and Hoang ATD (2017) Willingness to Pay for Social Health
Insurance in Central Vietnam. Front. Public Health 5:89. doi: 10.3389/fpubh.2017.00089
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
Benefit recipients
Patients.
Minimum and maximum duration of benefits (if any)
Households transitioning out of poverty can retain their health benefits for up to three years.
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
Monitoring and evaluation mechanisms and frequency
The Ministry of Health is in charge of monitoring and evaluating SHI as well as reporting on the scheme’s performance to the National Assembly of Vietnam. However, in-depth reporting on equity and efficiency is not conducted.
Vietnam: Approaches to covering poor, vulnerable, and informal populations to achieve universal health coverage < http://www.jointlearningnetwork.org/resources/download/get_file/ZW50cnlfaWQ6MzUzOHxmaWVsZF9uYW1lOnJlc291cmNlX2ZpbGV8dHlwZTpmaWxl > Accessed 23 August 2018.
