Experts suggest including infertility treatment in health insurance coverage. — VNA/VNS Photo

HÀ NỘI — Experts have called for the health insurance system to begin covering infertility treatment, aiming to reduce the financial burden on couples trying to conceive.

This proposal comes as the rate of infertility in Việt Nam continues to rise, with many couples unable to afford the high costs of treatment.

The Ministry of Health (MoH) estimates that more than one million couples face infertility each year, representing 7.7 per cent of the population.

Of this number, 3.9 per cent are classified as primary infertility, while 3.8 per cent suffer from secondary infertility.

Around 50 per cent of these couples are under the age of 30.

Secondary infertility, which occurs after a previous pregnancy, has been rising by 15-20 per cent annually and now accounts for over half of all infertility cases.

The World Health Organization (WHO) has identified infertility as the third most serious health issue of the 21st century, ranking it behind only cancer and cardiovascular diseases.

WHO statistics also place Việt Nam among the countries in the Asia-Pacific region with the lowest fertility rates and the highest infertility rates globally.

Professor Nguyễn Viết Tiến, former Deputy Minister of Health, President of Việt Nam Association of Gynecology and Obstetrics (VAGO) attributed the rise in infertility to factors such as late marriages and delayed childbirth.

He also pointed out societal pressures, with many couples waiting to achieve financial stability, such as securing a house or car, before deciding to have children. By that time, the woman's fertility may have diminished, impacting the country's population replacement rate.

To maintain replacement-level fertility, each couple must have at least two children. However, in major cities like HCM City and Hà Nội, the birth rate has dropped below two, signalling a potential population decline.

This issue has already been observed in other countries, such as South Korea and Japan. Tiến said that without immediate action to address infertility and population replacement issues, Việt Nam could face severe consequences as the population ages.

Calling for health insurance reform, the president of VAGO said that the country’s infertility treatment capabilities were now on par with other nations in the region, with rapid technological advancements.

Việt Nam is internationally recognised for its progress in assisted reproduction, with more than 50 IVF centres now operating nationwide, according to Tiến.

The country’s IVF success rates are notably high, with up to 60 per cent of clinical pregnancy cycles proving successful.

However, the cost of such services remains prohibitive for many couples.

Numerous couples who desperately want children are unable to proceed with treatment due to financial constraints.

Tiến urged reforms to the health insurance system to gradually cover infertility treatment.

He argued that such reforms would not only relieve financial stress for families but also contribute to population stability.

International comparisons show that countries like France allow for up to four IVF cycles to be covered by health insurance, with patients only having to pay for subsequent treatments.

In 2022, China added 16 reproductive health services to its health insurance coverage.

Meanwhile, in Việt Nam, couples still bear the full cost of infertility treatments.

Given Việt Nam’s current health insurance premiums, it was not yet possible to cover treatments like IVF, he said.

However, the system could at least begin by covering cases of infertility linked to medical conditions.

Professor Tiến suggested that as the health insurance system strengthens, expanding coverage for infertility treatments should be considered.

He emphasised that implementing the right policies could greatly support couples and contribute to stabilising the nation's population.

The draft 2024 Health Insurance Law, currently under review and set to be discussed in the National Assembly this October, proposes significant changes to enhance health insurance benefits.

Key revisions include expanding coverage to include infertility treatments, which experts argue are financially burdensome for many Vietnamese families.

According to Trần Thị Trang, director of the Health Insurance Department at the MoH, the draft law aims to update policies to align insurance criteria with legal standards, adjust benefits based on contributions and fund balance, and improve coverage efficiency.

Under the proposed changes, employees will need only one month of employment to qualify for health insurance, a reduction from three months. This is expected to increase coverage rates towards the Government's target of 95 per cent.

The draft also seeks to streamline patient care by allowing direct treatment for severe conditions at higher-level facilities without prior referrals. Additionally, it proposes full coverage for certain high-cost diseases and high-tech procedures at district health centres.

The law will facilitate patient transfers between facilities when needed and support the transfer of medications and equipment. It also suggests full benefits for patients seeking care at primary healthcare facilities, regardless of their initial registration.

MoH is revising the coverage of transport costs for patient care, proposing that insurance should cover transfers and emergencies requiring specialised treatment.

For high-cost treatments like cancer, the draft notes that while the insurance list includes around 76 drugs, covering new, expensive treatments remains challenging. Early intervention for cancers such as breast and cervical cancer is expected to be more cost-effective. The ministry plans to update the medication list to improve benefits.

The draft also proposes direct payments to patients when hospitals cannot provide necessary drugs or supplies, aiming to resolve issues with the current tendering process and ensure patients' rights are protected. — VNS