Young cancer patients receive treatment at the Oncology Centre of Việt Nam National Children's Hospital. VNA/VNS Photo Minh Quyết

HÀ NỘI — Việt Nam’s proposed track to provide universal free healthcare by 2035, starting with basic medical facilities, has been broadly welcomed by the public. Health experts, however, emphasise the need for careful and comprehensive planning.

This includes reforms in healthcare financing, organisational restructuring, capacity building at grassroot health centres and tighter control over the quality of public service delivery.

The policy initiative, introduced by Party General Secretary Tô Lâm during a meeting of the sub-committee in charge of drafting documents for the 14th National Party Congress on March 15, is being hailed as a breakthrough in the country’s healthcare strategy.

Deputy Minister of Health Trần Văn Thuấn described the plan as deeply humane. The ministry is currently drafting a proposal to submit to the Government and the Politburo, seeking the issuance of a resolution on advancing public healthcare in line with national development goals for the new era. Central to the proposal are solutions that prioritise the development of healthcare services and aim to gradually eliminate hospital fees for all citizens.

Simultaneously, the ministry is expediting the development of a decree detailing the implementation of the Law on Health Insurance and drafting circulars outlining reimbursement conditions for patients.

Consultations with the Government Party Committee and relevant ministries and agencies are expected soon.

According to the Ministry of Health, the policy rollout will follow a two-phase approach. From 2026 to 2030, efforts will focus on strengthening grassroots healthcare, ensuring that 90 per cent of the population receives preventive medical care and eliminating hospital fees for vulnerable groups.

From 2030 to 2035, the plan is to extend free hospital care to the entire population, in tandem with mandatory health insurance and reformed payment mechanisms.

Public reactions to the announcement have been overwhelmingly positive.

Nguyễn Văn Mạnh, aged 62, is currently undergoing dialysis at Hà Nội’s Bạch Mai Hospital. He told the Nhân dân (The People) newspaper that he had end-stage kidney disease and had been on dialysis for over eight years.

“I go to the hospital three times a week. Although health insurance covers most costs, there are still many out-of-pocket expenses. For chronic patients like me, the promise of universal free healthcare is a ray of hope. It would ease the financial burden on our families,” he said.

Nguyễn Thị Lan, 45, a breast cancer patient at K Hospital’s Tân Triều campus, said cancer treatment was extremely costly. Some essential drugs not covered by insurance could cost tens of millions of đồng per course.

“If hospital fees are waived or treatment costs fully supported, I can focus on recovery without worrying about my family. It will give me strength to keep fighting,” she said.

Trần Văn Dũng, a construction worker from Bắc Ninh Province who has lived with diabetes for over a decade, said: “Monthly medication and hospital bills add up. As a freelance labourer, I often have to tighten my belt. Hearing about this plan to eliminate hospital fees gives me hope. I wish it could be implemented soon, especially for those of us with chronic illnesses.”

Vũ Thị Hiền, 34, from Bắc Giang Province, is caring for her six-year-old son who has haemophilia. She said emotionally: “Since my son was diagnosed, our family has been overwhelmed by medical expenses. Some rounds of treatment cost tens of millions đồng, and health insurance only covers part of it.

“When I heard about the proposed universal hospital fee exemption, I felt a huge weight lifted. I sincerely hope the policy is implemented soon, starting with children suffering from life-threatening diseases. They deserve a chance to recover and our families need relief.”

Careful planning

While the universal free healthcare initiative carries undeniable humanitarian value and public appeal, it also poses significant challenges, especially in balancing the national budget and securing sustainable financial resources.

According to the World Bank, for Việt Nam to achieve universal health coverage, the country must increase its healthcare spending from the current 2.7 per cent of GDP to a level closer to that of developed nations with mature healthcare systems.

At present, public healthcare spending exceeds VNĐ175 trillion (US$6.74 billion) per year, with nearly VNĐ112 trillion ($4.31 billion) allocated solely for health insurance reimbursements.

Eliminating hospital fees would require tens of trillions more annually, creating considerable fiscal pressure amid competing demands for social welfare, education and national defence.

Capacity constraints also remain a critical concern. The Ministry of Health reports a shortage of approximately 23,800 preventive healthcare workers, including over 8,000 doctors.

Overcrowding continues to plague central hospitals, especially in oncology, intensive care and cardiology departments. Without strengthened grassroot health services and more equitable personnel distribution, universal free care could overload an already strained system.

The Director of Bạch Mai Hospital, Dr Đào Xuân Cơ, told Sức khỏe & Đời sống (Health & Life) newspaper that this would be a transformative policy that would ensure all citizens can access healthcare without financial fear.

But, he stressed, financial capacity would be the cornerstone of success. He identified three key solutions.

Việt Nam must expand universal health insurance coverage with diverse, inclusive participation models. Government investment would be crucial, particularly in underserved regions and for specialised medical services.

Community-driven funding would be essential, he said, Việt Nam should actively engage businesses, philanthropists, and social funds. In many developed countries, nonprofit hospitals thrive thanks to contributions from corporate welfare funds and civil society.

Cơ called on the Party, State and Government to establish mechanisms to robustly mobilise these resources.

“If we can effectively harness all three funding streams, maintain our current economic growth momentum and rally societal commitment, I truly believe the goal of universal free healthcare by 2030–2035 is within reach,” he said.

Addressing human resource concerns, Cơ proposed specific strategies. He recommended recruiting and training local residents who can return to serve in their hometowns.

He also stressed the need to redesign training for grassroot medical staff.

“Primary care doctors must be multi-skilled. They should be able to deliver babies, treat broken bones and heart attacks, administer vaccinations, provide basic dental care and manage common illnesses. They don’t need the depth of central hospital specialists, but they must be versatile to meet the community’s frontline needs.”

To attract and retain health workers at the grassroots level, he urged reforms in compensation, working conditions and resource availability. Essential equipment and medicines must be guaranteed.

On digital transformation, Cơ highlighted the need for a unified electronic health record system, linking patient data from local clinics to district, provincial and central hospitals. This would allow higher-level specialists to provide remote consultations, oversee treatment, and reduce hospital congestion while enabling people to receive quality care closer to home.

The Director of the Institute for Social Issues under the Việt Nam Union of Science and Technology Associations, Dr Đỗ Ngọc Văn, stated that universal free hospital care would only be viable if accompanied by sustainable economic growth and comprehensive healthcare financing reform.

"In the short term, we should prioritise free care for vulnerable populations and patients with chronic conditions to alleviate pressure on the healthcare system and the State budget,” he added. — VNS