Brookings Institution, a non-profit public policy organization based in Washington DC, said that UHC is measured by the World Health Organization (WHO) along three dimensions: population coverage (who’s covered); service coverage (which services are covered); and financial coverage (what proportion of health service expenses are covered).
The institution’s article cited a recent research as saying that Vietnam provided a generous benefit package which is more equitable for all.
It held that the takeaway lessons for other developing countries that want to achieve UHC through health insurance include strong political commitment with financial resources and an incremental approach that is attuned to their population.
When designing health insurance systems, keeping tabs on all three UHC dimensions, ensuring consistent service coverage for essential health services, and government subsidies for vulnerable populations are needed.
Vietnam established health insurance for employees in the 1990s, but it was not until 2003 that the Vietnamese government began taking more financial responsibility for the poor. That was when it increased coverage, though incrementally, the article noted.
It said that Vietnam made impressive increases in population coverage over the span of 13 years through the critical policies, laws and decrees the country enacted.
Vietnam’s pro-poor design focused on stabilizing the most vulnerable populations, so those uninsured are assumed to have some form of financial capacity.
However, the article noted that Vietnam still faces great challenges, including aging population and shifting disease burdens are putting a lot of pressure on the financial sustainability of their health insurance systems.
Cross subsidization, provider payment reform, and cost-effective benefit packages have to be carefully designed and implemented to improve the efficiency, equity, and affordability of health insurance systems.
Though the future is uncertain, Vietnam’s prospects look promising as they continue to customize their designs to their realities, the article stressed.