Pham Luong Son, Director, Department of Health Insurance Policy, speaks to Nong thon Ngay Nay (Countryside Today) about Viet Nam's healthcare coverage expansion plans
According to Viet Nam Social Insurance, the number of people with health insurance fell by 1.2 million in the first quarter of this year. What do you think the main reason for this is?
The first quarter of 2015 saw an increase of 2.7 million people paying health insurance premiums over the same period last year. However, compared to the whole of 2014, the overall figure dropped by more than 1.2 million.
There were two main factors for this. Firstly, the number of workers in industrial parks dropped considerably, and secondly, 500,000 near poor people who enjoy up to 70 per cent subsidies from the Government dropped out of the scheme.
Many people also said that administrative procedures were an issue. However, in reality, the number of family members participated in the health insurance scheme in the first three months of 2015 saw an increase of 300,000 people – from 7.5 million to 7.8 million people. This represented an increase of 3 per cent compared to the same period last year.
Can you explain why almost 30 per cent of the Vietnamese population have not signed up for health insurance?
There are various reasons for the low rate, including poor law enforcement on the side of employers.
According to initial reports, up to 49 per cent of enterprises nationwide have avoided paying health insurance or have only paid a part of health insurance premiums for their employees. Viet Nam Social Security has recommended elevating the act of avoiding paying health insurance or social insurance to a criminal level.
The other group that has failed to take up health insurance is students.
Viet Nam Social Insurance has asked the Ministry of Education and Training to step up its communication campaign to encourage students to buy health insurance.
The VSS is also working with the Ministry of Finance to develop a loan scheme for this group.
Under the current policy, the government subsidises up to 70 per cent of health insurance costs for near poor people, but only 45 per cent of them participate in the scheme.
Living conditions between the poor and near poor are not very different. For people who are classified as poor, they receive free health insurance cards, but the group of near poor has to pay up to 30 per cent for their health insurance cards. That's why the central Government has asked local governments to find ways to offer financial support to the near poor so that they access health insurance.
In 2012, the Government decided to subsidise farmers, forest workers, fishermen and salt workers on medium incomes to help them take out health insurance. Why has that decision not been executed?
In May 2014, the Prime Minister signed Decision 32 on the criteria for middle income households involved in the agro-forestry-fishery and salt making sectors for 2014 – 15.
Under the decision, households in rural areas wanting to be classified as middle income families should have an income from VND 521,000 – 900,000 (US$24-41) per month. For those living in urban areas, their monthly income should be from VND 651,000 – 900,000 ($30-41).
The decision came into effect on July 15, 2014. Ironically enough, the Ministry of Labour, Invalids and Social Affairs has not come up with procedures to classify which households are entitled to receive Government subsidies for health insurance.
Many people have complained about the administrative procedures for families that want to join the health insurance scheme as a group. In your opinion, what are the barriers?
Viet Nam Social Insurance has worked with the Ministry of Health to review the current administrative procedures and decided to simplify them.
I hope the new procedures will enable more people to get health insurance.
Viet Nam Social Insurance has agreed to create a wide network of sales points for health insurance cards, including at communal healthcare centres and post offices. — VNS