Trần Thị Trang, Director of the Department of Health Insurance under the Ministry of Health. — Photo vov.vn

As Việt Nam moves towards universal health coverage, the Government is exploring a phased approach to hospital fee exemptions. Rather than offering completely free healthcare, the policy aims to reduce out-of-pocket spending and improve access through the national health insurance system.

The Voice of Vietnam spoke with Director of the Department of Health Insurance under the Ministry of Health, Trần Thị Trang, to clarify what the policy entails and how it will be implemented.

Many people believe that the hospital fee exemption policy means medical treatment will soon be free for everyone. Is that correct?

That’s a common misunderstanding. Fee exemption doesn’t mean people can access healthcare services at will without paying anything. The policy is based on the health insurance (HI) system. In other words, hospital fees will be waived within the coverage limits of HI and the financial capacity of the State.

The HI fund, together with the State budget, will pay for essential medical care. Services beyond that, such as high-tech procedures or treatment on demand, will still involve co-payment by patients. Support policies will also be in place for low-income individuals through social contributions and sponsorships.

How will the policy be implemented?

Health insurance will be required to fully cover basic medical costs. The State will also subsidise health insurance premiums for certain groups such as the elderly, children, the poor, near-poor, and those with average incomes to ensure sustainable participation. People with higher incomes will continue to contribute based on their financial capacity. This will all be carried out in a phased and systematic way.

Every citizen will receive an annual health check-up at their local commune health station. These check-ups will cover basic indicators to screen for early signs of disease. The cost will be covered by HI fund, with the State budget stepping in if necessary. We expect this regular check-up programme to begin as early as 2026.

People will be screened and managed for certain non-communicable diseases.

Finally, the State will fund essential preventive healthcare service packages.

We also plan to increase HI reimbursement rate and expand coverage for high-cost medicines and services. For example, cancer drugs currently reimbursed at 50–70 per cent may see a gradual increase in coverage, prioritised for vulnerable groups. Vaccine coverage will also expand, offering more free vaccines through the national immunisation programme.

Given the scale of this reform, where will the financial resources come from?

The health insurance fund will continue to be the main source of funding, with additional support from the State budget. People with stable incomes will still get basic healthcare benefits but will need to pay part of the cost for expensive treatments. This helps keep the system fair and sustainable, where those who can afford more help support those who cannot.

We’re also exploring mechanisms recommended by international experts, such as using taxes on tobacco and alcohol to fund healthcare. Over time, HI contribution rates may also be gradually increased to meet expanding needs.

Aside from funding, what changes are needed at the grassroots level to ensure the policy is effective?

Strengthening primary healthcare is critical. Commune health stations must have enough qualified staff and modern equipment. Ideally, each station should have at least three to five general practitioners capable of performing biochemical tests, basic diagnostics, and regular health screenings. The State must fund both day-to-day operations and infrastructure investment.

We also need a functioning network of family doctors at the grassroots level. Because salaries are low, especially in remote areas, the State must ensure income support for staff. Preventive healthcare, which doesn’t generate revenue, must also be funded directly by the State.

To provide essential general care, commune health stations should be equipped to the same level as district-level polyclinics, and human resources must be allocated accordingly.

How can we attract and retain healthcare workers at commune-level stations?

We need two key strategies. First, the Government should provide extra monthly income for doctors working at commune-level health stations, especially in remote or disadvantaged areas. This means giving them a regular financial allowance on top of their base salary to make the job more attractive.

Second, implement a rotation system that sends doctors from higher-level hospitals to grassroots units on a regular basis.

There also needs to be support for housing and other living conditions for staff posted to rural areas. Because commune health stations lack the income-generating capacity of large hospitals, they cannot operate under a self-financing model. The State must guarantee their funding to ensure long-term development. — VNS