Comprehensive orientation for implementing public health insurance
The Secretariat has issued Directive No. 52-CT/TW, a comprehensive orientation for the implementation of public health insurance in the new period, with the goal of taking care of the health of the entire population, leaving no one behind.
Currently, more than 92 million Vietnamese people participate in health insurance, contributing to ensuring fairness and sharing risks in health care. The application of information technology and digital transformation in the health insurance sector has been invested in, initially promoting efficiency in management, appraisal, payment and control of medical examination and treatment costs. The quality of health services is increasingly improved, the health index of the people has improved significantly.
However, the implementation of health insurance still has some limitations: The mechanism and policies are not synchronous and lack of strategy; the health insurance coverage rate is not sustainable; the work of appraisal and payment of health insurance examination and treatment costs is still stuck; the method of health insurance payment is not complete according to regulations. The quality of medical examination and treatment at grassroots health facilities, remote areas, and areas with special difficulties has not met requirements, while investment in information technology infrastructure to serve health insurance data connectivity is still slow.
In this context, the Secretariat requested Party committees, Party organizations, and authorities at all levels to strengthen leadership and direction in effectively implementing policies, plans, and strategies on health insurance. The focus is on developing health insurance participants, especially households, while the State continues to increase the level of health insurance payment support for policy beneficiaries, the poor, near-poor, people with disabilities and vulnerable groups. The goal is that by 2026, the health insurance coverage rate will reach over 95% of the population and by 2030, it will reach the national health insurance.
The Secretariat also directs the research, amendment, supplementation and completion of the system of policies and laws on health insurance, raising the contribution level in accordance with the expansion of benefits. Piloting and diversifying additional health insurance and health insurance packages according to people's needs, while strengthening linkages with business health insurance to avoid overlapping medical costs.
Notably, from 2026, the Secretariat requires increasing the rate and level of expenditure for disease prevention, early diagnosis and treatment of a number of diseases and priority subjects, in line with the roadmap for increasing health insurance contributions and the ability to balance the Health Insurance Fund. The scope of payment is expanded for health insurance services for disease prevention, nutrition, chronic disease management, periodic health check-ups and screening according to professional requirements.
Propaganda work, raising awareness and responsibility of all levels, sectors, unions, organizations and people about health insurance has also been strongly innovated, in order to create a change in health insurance participation, identifying this as the right and responsibility of all people.
Synchronizing solutions from direction to action
Deputy Director of Vietnam Social Insurance Nguyen Duc Hoa affirmed: " ki hieu No. 52-CT/TW is an important milestone, creating a comprehensive breakthrough in implementing universal health insurance, demonstrating the Party's political determination in caring for people's health - the pillar of sustainable social security".
Accordingly, Vietnam Social Insurance and localities have issued specific action programs. Provincial and municipal Social Insurance coordinates with People's Committees and People's Councils to include social insurance and health insurance targets in the annual socio-economic development resolution, and at the same time propose funding to support additional health insurance contribution levels to quickly increase the number of participants. The consolidation of the Steering Committee for Social Insurance and Health Insurance at the provincial and commune levels is also being implemented to improve the effectiveness of direction and implementation.
Propaganda and dissemination of the amended Law on Health Insurance and guiding documents for implementation continue to be promoted, especially for the new target group, so that people and businesses clearly understand their rights and obligations when participating in health insurance. The list of increases, decreases, and issuance of social insurance books and health insurance cards is also strictly guided, ensuring the rights of people, especially when the new two-level local government apparatus comes into operation.
At the same time, Vietnam Social Security promotes digital transformation, modernizes business processes, improves management and service efficiency. The work of assessing health insurance examination and treatment costs has been strengthened, ensuring transparency, using the fund for the right purpose, and at the same time checking and controlling electronic data to help detect and prevent cases of abuse and profiteering of the health insurance fund.
