TOPIC 1 – HEALTHCARE
HANDOUT – 1
➢ English – Vietnamese.
VIETNAM’S HEALTHCARE SYSTEM
In 1986, Vietnam did away with three decades of socialism and embraced market ideologies. The Sixth Party Congress proclaimed the Doi moi policy, which set off a powerful set of interactions between economic reform and the health sector in the country. Vietnam did not receive any financial support from the IMF or World Bank, only technical assistance and policy advice during its economic reform process.
Despite the fact that, under socialism, Vietnam’s health care coverage was extensive, commune health centers were poorly funded and poorly equipped, and utilization was very low. Consumers became dissatisfied with this system, and they began to lobby for change. Partly in response, the Vietnamese government announced four new health policies under the Doi moi. First, it legalized private medicine practice, which had been hitherto forbidden; second, it privatized the production and sale of drugs; third, the government imposed user charges in public medical facilities; and finally, it created a voluntary health insurance plan. In 1992, the government also mandated, by decree, compulsory payroll-based social health insurance for all government employees, and for workers of state and private enterprises with ten workers or more. This decree also made provision for a system of voluntary insurance for the majority of workers in small businesses and agriculture.
These new policies led to an explosive growth of private medicine and pharmaceutical market. Vietnam’s post-reform health system is complex. On the surface, the country appears to have a two-tier private sector. The first tier consists of a handful of well-established private hospitals located in the big cities, and a second tier is made up of private providers in the urban and rural areas. These private clinics often serve as ambulatory health...
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