INVESTIGATION OF POSSIBLE ORGANIZATIONAL CHANGES TO THE HEALTH INSURANCE SYSTEM IN VIETNAM

M. Doan, Sergey I. Dukhno
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Abstract

Purpose – to identify the prerequisites for organizational changes of the emerging health insurance system in Vietnam. Research methodology - comparative analysis, statistical analysis, case study. Findings – the obligatory health insurance in Vietnam performs its functions only partially. There is still high level of out-of-pocket spending on medical services. First we identified one of the most important challenges to the health insurance system in Vietnam, namely, the population aging. Secondly, we identified and analyzed and the prerequisites (the pre-existing conditions), which can become the basis for the reorganization of the existing health insurance system without major reforms: (1) the cultural values of Asian society, which allow to build a community-based type model of living for the elderly on the basis of “equal with equal”; (2) technological advances in medicine that extend the healthy life of the elderly, (3) trust in traditional medicine, which allows widen the coverage of the poorest “elderly households”. Practical implications - the results of the study require attention from the government and insurance providers when rethinking of organizing process for mandatory medical insurance. Originality/Value – we have identified the ways of possible organizational changes for the health insurance system, making the most of the existing prerequisites. This can help to get closer to the goal of full coverage with health insurance services while achieving a positive social effect. The identified internal reserves make it possible to imple- ment organizational changes without major reforms of the established health insurance system. No studies have been conducted in this perspective.
对越南医疗保险制度可能发生的组织变化的调查
目的-确定越南新兴医疗保险系统组织变革的先决条件。研究方法:比较分析、统计分析、个案研究。调查结果-越南的强制性健康保险只发挥了部分作用。医疗服务的自付费用仍然很高。首先,我们确定了越南医疗保险系统面临的最重要的挑战之一,即人口老龄化。其次,我们识别和分析了在不进行重大改革的前提条件(既存条件),这些前提条件可以成为重组现有医疗保险制度的基础:(1)亚洲社会的文化价值观,它允许在“平等与平等”的基础上建立社区式的老年人生活模式;(2)延长老年人健康寿命的医学技术进步;(3)对传统医学的信任,使最贫穷的“老年家庭”得以扩大覆盖范围。实际影响——研究结果需要政府和保险公司在重新思考强制性医疗保险的组织过程时予以关注。原创性/价值-我们已经确定了健康保险系统可能的组织变革方式,充分利用现有的先决条件。这有助于更接近医疗保险服务全面覆盖的目标,同时产生积极的社会影响。确定的内部储备金使在不对现有健康保险制度进行重大改革的情况下实施组织变革成为可能。目前还没有这方面的研究。
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