Enhanced direction could spur advancements in healthcare budgeting
In a bid to make healthcare more affordable and accessible for all, Vietnam is focusing on strategies that aim to reduce out-of-pocket (OOP) expenses and work towards achieving universal health coverage (UHC).
One key approach is expanding and refining targeted public health financing programs. The Health Care Fund for the Poor (HCFP), which uses government revenues to finance healthcare for vulnerable groups, has increased healthcare utilization, particularly inpatient care, and reduced catastrophic spending risks. However, further improvements in targeting mechanisms and program design are critical to enhance efficiency and equity.
Another strategy is increasing government subsidies and financial protection measures. Lessons from East Asian models like Taiwan and Hong Kong demonstrate the value of inclusive models with generous benefits and lenient eligibility criteria, which minimize OOP spending and increase coverage generosity.
Strengthening health insurance schemes is also crucial. Vietnam has nearly achieved universal health insurance coverage, but ongoing reforms should focus on enhancing the comprehensiveness of coverage, reducing copayments, and improving financial sustainability.
Improving healthcare financial governance is another essential aspect. Reform efforts that promote greater transparency, autonomy, and accountability in financial management of public healthcare resources can improve operational efficiency and resource allocation.
Diversifying financing sources is another strategy. Incorporating various mechanisms such as compulsory savings accounts and government safety nets can mobilize more sustainable resources for health services and reduce reliance on OOP payments.
Dr. Angela Pratt, the representative in Vietnam for the World Health Organisation, emphasizes the importance of moving from a system designed to respond to acute episodes of ill health to a system that focuses on keeping people in good health. This transition can improve the efficiency of health financing.
The government's commitment to achieve free healthcare by 2035 is a significant step towards UHC. However, addressing high OOP spending and boosting service coverage are key challenges. Appropriate service delivery arrangements are important to ensure the right service is given at the appropriate time and level of care.
Utilizing digital technologies can save the time of health workers and facilitate diagnosis. Rules, regulations, and monitoring are needed to ensure funds are used in equitable and efficient ways. Clearer guidance on when and how OOP payments are collected is also necessary.
Focusing on innovation, such as utilizing digital technologies, can improve the efficiency of health financing. The focus is on improving Vietnam's health financing mechanisms while expanding access to services. A bold strategy is required for effective health financing, which is essential for UHC and sustainable health systems.
The transition away from donor funding, an ageing population, rising non-communicable diseases, and strengthening the commune health system increase fiscal pressures. Linking at least some component of the remuneration of health workers to performance and to the health needs of the people they serve can improve efficiency.
Focusing on quality primary healthcare and the commune health system is the most cost-effective and effective way of providing most of the health services that people need. Out-of-pocket expenditure in Vietnam is currently above 40% of total current health expenditure, highlighting the need for these strategies.
In conclusion, by implementing these strategies, Vietnam can reduce the financial burden on individuals, especially vulnerable populations, thus advancing its goal of UHC while enhancing health financing efficiency.
Science and health-and-wellness are closely intertwined as Vietnam explores innovative digital technology solutions to improve health financing efficiency. These technologies, such as those facilitating diagnosis, can help save health workers' time and contribute to the transition of the healthcare system from acute care to preventative care, as emphasized by Dr. Angela Pratt from the World Health Organisation.
