Vietnam is running a healthcare system which looks hale and hearty but underneath the surface, shifting demographics and financial woes put the country's healthcare in serious problems.
Caring for elderly at National Geriatric Hospital. Photo: Tapchibenhvien
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As of the end of 2018, more than 10 million people or 13% of the population were uncovered by public health insurance scheme.
Seriously, about two million people fall into poverty every year because of unexpected healthcare costs, a problem affecting mainly those without insurance, according to the Vietnam Public Expenditure Review, an annual World Bank report.
As the majority of Vietnamese have access to state-subsidized national health insurance, the government aims to increase the health insurance coverage to 88% in 2019. But critics say it isn’t reaching those who need it fast enough.
Percentage of population aged over 60. Photo: United Nations
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In terms of demographics, Vietnam’s population is aging as the percentage of over 60s is set to jump to 21% of the population in 2040, up from 12% today. While Vietnam’s median age is currently a youthful 26, the nation is simultaneously aging at one of Asia’s fastest rates.
An International Monetary Fund (IMF) report in 2018 argued that “Vietnam is at risk of growing old before it grows rich.” Indeed, when Vietnam’s working age population, or the number of people aged 15 to 64, reached its demographic peak in 2013, annual gross domestic product (GDP) per capita was just over US$5,000, compared to US$32,000 in South Korea and US$31,000 in Japan, respectively when those countries reached the demographic peak.
In the context of rising public debt, state expenditure on healthcare has fallen over the past three years. In 2018, the government’s budget allocated US$137 million to hospitals, a smaller amount than in 2017.
Solutions
In an attempt to ensure a better healthcare system, the government has pushed a policy of financial independence for the sector, for which, public hospitals are responsible for increasing their revenues.
Although the policy was first launched in 2002, when a government decree provided healthcare facilities with greater autonomy, analysts say it has been more intensely promoted in recent years.
Nguyen Nam Lien, director of the Planning and Finance Department under the Ministry of Health, said that 160 public hospitals completely controlled their own expenditures and revenue as of the end of 2018, while another 1,364 hospitals control about 90% of their finances.
The move aims at less bureaucracy and greater control by doctors and practitioners and improving the ability of public hospitals to meet their patients’ demands.
Shortcomings
The policy, however, has resulted in some shortcomings. Recent inspections by the Ministry of Health found that doctors were prescribing unnecessary treatments or urging patients to stay excessive amounts of time in hospitals.
The ministry’s solution to the problem, it seems, is to improve administrative processes at hospitals, engage in more inspections to deter malpractice and better educate patients.
Minh Thi Hai Vo, a PhD graduate in public policy at Victoria University in Wellington, New Zealand, wrote in recent paper that the government should start to think that healthcare services and their contributions to economic growth must be regarded as an investment for greater development, not as an economic burden, Asia Times has reported.
