Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options

To address the growth in resultant out-of-pocket (OOP) payments and associated problems of financial barriers to access, the government issued several policies aimed at expanding coverage throughout the 1990s and 2000s, particularly for the poor an...

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Main Authors:	Somanathan, Aparnaa, Tandon, Ajay, Dao, Huong Lan, Hurt, Kari L., Fuenzalida-Puelma, Hernan L.
Format:	Publication
Language:	English en_US
Published:	Washington, DC: World Bank 2014
Subjects:	ABILITY TO PAY ACCESS TO HEALTH SERVICES ACCESS TO SERVICES ADMINISTRATIVE COSTS ADMINISTRATIVE EFFICIENCY ADVERSE SELECTION AGED AGING AUDITORS BUDGETARY IMPACT BUDGETARY RESOURCES CAPITATION CAPITATION PAYMENTS CASE MANAGEMENT CATASTROPHIC HEALTH SPENDING CHILD HEALTH CITIES CLINICAL PRACTICE COMPETENCIES CONSULTATION PROCESS CONSUMERS CONTRIBUTION RATE CONTRIBUTORY INSURANCE COST EFFECTIVENESS COUNSELING DELIVERY SYSTEM DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DIAGNOSIS DIAGNOSTIC ASSESSMENT DRUGS EMPLOYMENT ENROLLEES ENTITLEMENT EPIDEMIOLOGICAL TRANSITION EXPANSION OF COVERAGE EXPENDITURES FAMILIES FEE SCHEDULES FEE-FOR-SERVICE FINANCIAL BARRIERS FINANCIAL CATASTROPHE FINANCIAL INCENTIVES FINANCIAL PROTECTION FINANCIAL RISK FLAT RATE GYNECOLOGY HARD TO REACH GROUPS HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE USE HEALTH CENTERS HEALTH COVERAGE HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INTERVENTIONS HEALTH ORGANIZATION HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROJECT HEALTH PURCHASERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE PROVIDERS HEALTH SERVICES HEALTH SHARE HEALTH SPENDING HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM FINANCING HEALTH SYSTEM GOALS HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH SYSTEMS STRENGTHENING HEALTH WORKERS HEALTHCARE HEALTHCARE SERVICES HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RESOURCES DEVELOPMENT ILLNESS IMMUNODEFICIENCY INCENTIVES FACING PROVIDERS INCOME INCOME COUNTRIES INCOME ELASTICITY INCOME GROUPS INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION SYSTEMS INPATIENT ADMISSION INSURANCE LAW INSURANCE POLICIES INSURANCE PREMIUM INSURANCE PREMIUMS LAWS LIBERALIZATION LIVING STANDARDS LOW-INCOME COUNTRIES MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL TRAINING MEDICINES MIGRANTS MIGRATION NATIONAL HEALTH NATIONAL HEALTH INSURANCE NEEDS ASSESSMENT NURSES NUTRITION PATIENTS PHARMACEUTICAL COSTS PHARMACEUTICAL SECTOR PHARMACEUTICAL SPENDING PHARMACISTS PHYSICIANS POCKET PAYMENTS POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PRIMARY HEALTH CARE PROBABILITY PROGRAMS PROVIDER PAYMENT PROVISION OF SERVICES PUBLIC HEALTH PUBLIC HEALTH SERVICES PUBLIC HOSPITAL PUBLIC SPENDING QUALITY OF CARE REIMBURSEMENT RATES RISK GROUPS SAVINGS SCREENING SOCIAL ASSISTANCE SOCIAL HEALTH INSURANCE SOCIAL MOBILIZATION SOCIAL SECURITY SOCIAL WORKERS SUSTAINABILITY TUBERCULOSIS VACCINATION WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2014/06/19776955/moving-toward-universal-coverage-social-health-insurance-vietnam-assessment-options http://hdl.handle.net/10986/18885

id	okr-10986-18885
recordtype	oai_dc
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ABILITY TO PAY ACCESS TO HEALTH SERVICES ACCESS TO SERVICES ADMINISTRATIVE COSTS ADMINISTRATIVE EFFICIENCY ADVERSE SELECTION AGED AGING AUDITORS BUDGETARY IMPACT BUDGETARY RESOURCES CAPITATION CAPITATION PAYMENTS CASE MANAGEMENT CATASTROPHIC HEALTH SPENDING CHILD HEALTH CITIES CLINICAL PRACTICE COMPETENCIES CONSULTATION PROCESS CONSUMERS CONTRIBUTION RATE CONTRIBUTORY INSURANCE COST EFFECTIVENESS COUNSELING DELIVERY SYSTEM DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DIAGNOSIS DIAGNOSTIC ASSESSMENT DRUGS EMPLOYMENT ENROLLEES ENTITLEMENT EPIDEMIOLOGICAL TRANSITION EXPANSION OF COVERAGE EXPENDITURES FAMILIES FEE SCHEDULES FEE-FOR-SERVICE FINANCIAL BARRIERS FINANCIAL CATASTROPHE FINANCIAL INCENTIVES FINANCIAL PROTECTION FINANCIAL RISK FLAT RATE GYNECOLOGY HARD TO REACH GROUPS HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE USE HEALTH CENTERS HEALTH COVERAGE HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INTERVENTIONS HEALTH ORGANIZATION HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROJECT HEALTH PURCHASERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE PROVIDERS HEALTH SERVICES HEALTH SHARE HEALTH SPENDING HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM FINANCING HEALTH SYSTEM GOALS HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH SYSTEMS STRENGTHENING HEALTH WORKERS HEALTHCARE HEALTHCARE SERVICES HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RESOURCES DEVELOPMENT ILLNESS IMMUNODEFICIENCY INCENTIVES FACING PROVIDERS INCOME INCOME COUNTRIES INCOME ELASTICITY INCOME GROUPS INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION SYSTEMS INPATIENT ADMISSION INSURANCE LAW INSURANCE POLICIES INSURANCE PREMIUM INSURANCE PREMIUMS LAWS LIBERALIZATION LIVING STANDARDS LOW-INCOME COUNTRIES MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL TRAINING MEDICINES MIGRANTS MIGRATION NATIONAL HEALTH NATIONAL HEALTH INSURANCE NEEDS ASSESSMENT NURSES NUTRITION PATIENTS PHARMACEUTICAL COSTS PHARMACEUTICAL SECTOR PHARMACEUTICAL SPENDING PHARMACISTS PHYSICIANS POCKET PAYMENTS POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PRIMARY HEALTH CARE PROBABILITY PROGRAMS PROVIDER PAYMENT PROVISION OF SERVICES PUBLIC HEALTH PUBLIC HEALTH SERVICES PUBLIC HOSPITAL PUBLIC SPENDING QUALITY OF CARE REIMBURSEMENT RATES RISK GROUPS SAVINGS SCREENING SOCIAL ASSISTANCE SOCIAL HEALTH INSURANCE SOCIAL MOBILIZATION SOCIAL SECURITY SOCIAL WORKERS SUSTAINABILITY TUBERCULOSIS VACCINATION WORKERS
spellingShingle	ABILITY TO PAY ACCESS TO HEALTH SERVICES ACCESS TO SERVICES ADMINISTRATIVE COSTS ADMINISTRATIVE EFFICIENCY ADVERSE SELECTION AGED AGING AUDITORS BUDGETARY IMPACT BUDGETARY RESOURCES CAPITATION CAPITATION PAYMENTS CASE MANAGEMENT CATASTROPHIC HEALTH SPENDING CHILD HEALTH CITIES CLINICAL PRACTICE COMPETENCIES CONSULTATION PROCESS CONSUMERS CONTRIBUTION RATE CONTRIBUTORY INSURANCE COST EFFECTIVENESS COUNSELING DELIVERY SYSTEM DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DIAGNOSIS DIAGNOSTIC ASSESSMENT DRUGS EMPLOYMENT ENROLLEES ENTITLEMENT EPIDEMIOLOGICAL TRANSITION EXPANSION OF COVERAGE EXPENDITURES FAMILIES FEE SCHEDULES FEE-FOR-SERVICE FINANCIAL BARRIERS FINANCIAL CATASTROPHE FINANCIAL INCENTIVES FINANCIAL PROTECTION FINANCIAL RISK FLAT RATE GYNECOLOGY HARD TO REACH GROUPS HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE USE HEALTH CENTERS HEALTH COVERAGE HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INTERVENTIONS HEALTH ORGANIZATION HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROJECT HEALTH PURCHASERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE PROVIDERS HEALTH SERVICES HEALTH SHARE HEALTH SPENDING HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM FINANCING HEALTH SYSTEM GOALS HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH SYSTEMS STRENGTHENING HEALTH WORKERS HEALTHCARE HEALTHCARE SERVICES HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RESOURCES DEVELOPMENT ILLNESS IMMUNODEFICIENCY INCENTIVES FACING PROVIDERS INCOME INCOME COUNTRIES INCOME ELASTICITY INCOME GROUPS INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION SYSTEMS INPATIENT ADMISSION INSURANCE LAW INSURANCE POLICIES INSURANCE PREMIUM INSURANCE PREMIUMS LAWS LIBERALIZATION LIVING STANDARDS LOW-INCOME COUNTRIES MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL TRAINING MEDICINES MIGRANTS MIGRATION NATIONAL HEALTH NATIONAL HEALTH INSURANCE NEEDS ASSESSMENT NURSES NUTRITION PATIENTS PHARMACEUTICAL COSTS PHARMACEUTICAL SECTOR PHARMACEUTICAL SPENDING PHARMACISTS PHYSICIANS POCKET PAYMENTS POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PRIMARY HEALTH CARE PROBABILITY PROGRAMS PROVIDER PAYMENT PROVISION OF SERVICES PUBLIC HEALTH PUBLIC HEALTH SERVICES PUBLIC HOSPITAL PUBLIC SPENDING QUALITY OF CARE REIMBURSEMENT RATES RISK GROUPS SAVINGS SCREENING SOCIAL ASSISTANCE SOCIAL HEALTH INSURANCE SOCIAL MOBILIZATION SOCIAL SECURITY SOCIAL WORKERS SUSTAINABILITY TUBERCULOSIS VACCINATION WORKERS Somanathan, Aparnaa Tandon, Ajay Dao, Huong Lan Hurt, Kari L. Fuenzalida-Puelma, Hernan L. Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
geographic_facet	East Asia and Pacific Vietnam
relation	Directions in Development--Human Development;
description	To address the growth in resultant out-of-pocket (OOP) payments and associated problems of financial barriers to access, the government issued several policies aimed at expanding coverage throughout the 1990s and 2000s, particularly for the poor and other vulnerable groups. Universal coverage (UC) can be an elusive concept and is about three objectives: (a) equity (linking care to need, and not to ability to pay); (b) financial protection (ensuring that health care use does not lead to impoverishment); (c) effective access to a comprehensive set of quality services (ensuring that providers make the right diagnosis and prescribe a treatment that is appropriate and affordable; and (d) to ensure that the financing needed to achieve UC is mobilized in a fiscally sustainable manner, and is used efficiently and equitably. The objective of this report is to assess the implementation of Vietnam social health insurance (SHI) and provide options for moving toward UC, with a view to contributing to the law revision process. It analyzes progress to date on the two major goals of the master plan. The report assesses Vietnam's readiness to meet these goals, the challenges it will face in achieving UC, and key reforms needed to overcome those challenges. It does so through a health financing lens, focusing on how resources are mobilized, pooled, and allocated, and how services are purchased. The report also examines the stewardship of financing that is, the organization, management, and governance of SHI as it has direct implications for achieving UC. The report ends by pulling together the recommendations in the form of an implementation road map.
format	Publications & Research :: Publication
author	Somanathan, Aparnaa Tandon, Ajay Dao, Huong Lan Hurt, Kari L. Fuenzalida-Puelma, Hernan L.
author_facet	Somanathan, Aparnaa Tandon, Ajay Dao, Huong Lan Hurt, Kari L. Fuenzalida-Puelma, Hernan L.
author_sort	Somanathan, Aparnaa
title	Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
title_short	Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
title_full	Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
title_fullStr	Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
title_full_unstemmed	Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options
title_sort	moving toward universal coverage of social health insurance in vietnam : assessment and options
publisher	Washington, DC: World Bank
publishDate	2014
url	http://documents.worldbank.org/curated/en/2014/06/19776955/moving-toward-universal-coverage-social-health-insurance-vietnam-assessment-options http://hdl.handle.net/10986/18885
_version_	1764443360013058048
spelling	okr-10986-188852021-04-23T14:03:51Z Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options Somanathan, Aparnaa Tandon, Ajay Dao, Huong Lan Hurt, Kari L. Fuenzalida-Puelma, Hernan L. ABILITY TO PAY ACCESS TO HEALTH SERVICES ACCESS TO SERVICES ADMINISTRATIVE COSTS ADMINISTRATIVE EFFICIENCY ADVERSE SELECTION AGED AGING AUDITORS BUDGETARY IMPACT BUDGETARY RESOURCES CAPITATION CAPITATION PAYMENTS CASE MANAGEMENT CATASTROPHIC HEALTH SPENDING CHILD HEALTH CITIES CLINICAL PRACTICE COMPETENCIES CONSULTATION PROCESS CONSUMERS CONTRIBUTION RATE CONTRIBUTORY INSURANCE COST EFFECTIVENESS COUNSELING DELIVERY SYSTEM DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DIAGNOSIS DIAGNOSTIC ASSESSMENT DRUGS EMPLOYMENT ENROLLEES ENTITLEMENT EPIDEMIOLOGICAL TRANSITION EXPANSION OF COVERAGE EXPENDITURES FAMILIES FEE SCHEDULES FEE-FOR-SERVICE FINANCIAL BARRIERS FINANCIAL CATASTROPHE FINANCIAL INCENTIVES FINANCIAL PROTECTION FINANCIAL RISK FLAT RATE GYNECOLOGY HARD TO REACH GROUPS HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE USE HEALTH CENTERS HEALTH COVERAGE HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INTERVENTIONS HEALTH ORGANIZATION HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROJECT HEALTH PURCHASERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE PROVIDERS HEALTH SERVICES HEALTH SHARE HEALTH SPENDING HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM FINANCING HEALTH SYSTEM GOALS HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH SYSTEMS STRENGTHENING HEALTH WORKERS HEALTHCARE HEALTHCARE SERVICES HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RESOURCES DEVELOPMENT ILLNESS IMMUNODEFICIENCY INCENTIVES FACING PROVIDERS INCOME INCOME COUNTRIES INCOME ELASTICITY INCOME GROUPS INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION SYSTEMS INPATIENT ADMISSION INSURANCE LAW INSURANCE POLICIES INSURANCE PREMIUM INSURANCE PREMIUMS LAWS LIBERALIZATION LIVING STANDARDS LOW-INCOME COUNTRIES MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL TRAINING MEDICINES MIGRANTS MIGRATION NATIONAL HEALTH NATIONAL HEALTH INSURANCE NEEDS ASSESSMENT NURSES NUTRITION PATIENTS PHARMACEUTICAL COSTS PHARMACEUTICAL SECTOR PHARMACEUTICAL SPENDING PHARMACISTS PHYSICIANS POCKET PAYMENTS POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PRIMARY HEALTH CARE PROBABILITY PROGRAMS PROVIDER PAYMENT PROVISION OF SERVICES PUBLIC HEALTH PUBLIC HEALTH SERVICES PUBLIC HOSPITAL PUBLIC SPENDING QUALITY OF CARE REIMBURSEMENT RATES RISK GROUPS SAVINGS SCREENING SOCIAL ASSISTANCE SOCIAL HEALTH INSURANCE SOCIAL MOBILIZATION SOCIAL SECURITY SOCIAL WORKERS SUSTAINABILITY TUBERCULOSIS VACCINATION WORKERS To address the growth in resultant out-of-pocket (OOP) payments and associated problems of financial barriers to access, the government issued several policies aimed at expanding coverage throughout the 1990s and 2000s, particularly for the poor and other vulnerable groups. Universal coverage (UC) can be an elusive concept and is about three objectives: (a) equity (linking care to need, and not to ability to pay); (b) financial protection (ensuring that health care use does not lead to impoverishment); (c) effective access to a comprehensive set of quality services (ensuring that providers make the right diagnosis and prescribe a treatment that is appropriate and affordable; and (d) to ensure that the financing needed to achieve UC is mobilized in a fiscally sustainable manner, and is used efficiently and equitably. The objective of this report is to assess the implementation of Vietnam social health insurance (SHI) and provide options for moving toward UC, with a view to contributing to the law revision process. It analyzes progress to date on the two major goals of the master plan. The report assesses Vietnam's readiness to meet these goals, the challenges it will face in achieving UC, and key reforms needed to overcome those challenges. It does so through a health financing lens, focusing on how resources are mobilized, pooled, and allocated, and how services are purchased. The report also examines the stewardship of financing that is, the organization, management, and governance of SHI as it has direct implications for achieving UC. The report ends by pulling together the recommendations in the form of an implementation road map. 2014-07-14T16:30:53Z 2014-07-14T16:30:53Z 2014-06-26 http://documents.worldbank.org/curated/en/2014/06/19776955/moving-toward-universal-coverage-social-health-insurance-vietnam-assessment-options 978-1-4648-0261-4 10.1596/978-1-4648-0261-4 http://hdl.handle.net/10986/18885 English en_US Directions in Development--Human Development; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ Washington, DC: World Bank Publications & Research :: Publication East Asia and Pacific Vietnam

Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options

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