Vietnam Health Cover "Fragmentary"

Vietnam's health insurance system remains loose and fragmentary, giving rise to disparities in implementation, reports the Vietnam Courier.

Introduced in August 1992, the health insurance services comprise 59 bureaux in all 53 Vietnamese provinces and cities. Cover is compulsory for state employees (including retirees) and employees of enterprises. The premium is 3% of wages, of which 2% is paid by the government. Premiums for voluntary insurance are 40,000-100,000 dong ($3.6-$9.00) a year.

The Vietnam Insurance Company issued over 7 million insurance cards, worth over 400 billion dong ($36.3 million) in 1995, and the estimate for 1996 is 10 million cards worth 500 billion dong. However, a recent survey by the State Inspector of 42 out of the 53 health insurance offices revealed financial deficits of 11% of total revenues. For many offices, it is not clear how premiums have been spent, but only 50.2% of health insurance revenues have been used to pay medical bills, instead of the 90% set by the government. Also, voluntary insurance premiums differ according to location. For example, a child in the mountain provinces pays only 7,000 dong a year, while the amount in Hanoi or Ho Chi Minh City is 40,000 dong.