1. Health Financing and Delivery in Vietnam Kevin Arts April 25, 2012

3. Background Vietnam has excellent health outcomes… Life expectancy U5 mortality rate Maternal mortality rate Public health *Communicable disease …given its development status and spending.

4. History of Health System Independence (1954 – 1975) Unification (1975 – 1985) Doi Moi (1986 – Present)

5. Economic Effects of Doi Moi

6. Health Sector Reforms Market Mechanisms Policy Adjustments 1991: National Target Programs 1993: Social Health Insurance 1994: Salary Support 1995: Fee Schedule + Supply-Side Subsidies

7. Recent Reforms 2003: Decision 139 2005: Benefit reform* 2000s: Autonomization*

8. Challenges and Solutions Breadth of Coverage Few Low-Hanging Fruit Inequities Source: Lieberman and Wagstaff 2009

9. Challenges and Solutions Depth of Coverage Out-of-Pocket Catastrophic Health Costs Source: Lieberman and Wagstaff 2009

10. Challenges and Solutions Rising Cost of Care Throughput Case mix Unexplained Source: Lieberman and Wagstaff 2009

11. Conclusion Vietnam has high health outcomes on relative and per dollar bases… Due to economic growth and policy interventions… But problems remain with respect to breadth and depth of coverage + cost of care + inequities

12. Sources International Labor Organization (2006), Vietnam Social Health Insurance: Current Issues and Policy Recommendations. Lieberman, Samuel and Adam Wagstaff (2009), Health Financing and Delivery in Vietnam: Looking Forward, The World Bank. Trinh Kuu, Duke (1998), Vietnamese Health Care, Stanford Medical Review. The World Bank (2012), World Development Indicators: Vietnam. World Health Organization (2011), Viet Nam: Health Profile.