Amongst the Vietnamese population, medical professionals and paraprofessionals are traditionally regarded as caring individuals, a belief captured in the age-old expression, “thay thuoc nhu me hien” (“medical doctors are like gentle mothers”). These medical providers, whether in an office, clinical, or hospital setting, are expected to wholeheartedly diagnose, treat, and prevent disease, illness, injury, and other physical and mental impairments. Unfortunately, this caring doctor-patient relationship has progressively morphed into a businesslike doctor-client transaction, which in turn has led to wealthier individuals receiving more care and higher rates of bribery at all levels.
According to a recent survey by Vietnam News, “bribery at leading hospitals is an unfortunate consequence of high demand and insufficient resources.” Public hospitals are often overcrowded, while patients’ doubts about quality of services by rural providers are increasing. By slipping money-filled envelopes to doctors as well as other staff members, patients are able to skip in front of long lines, receive test results quicker, be scheduled for early surgery, or simply obtain medical advice from the health staff. This has become such an expected norm that patients do not feel comfortable that they are receiving the utmost care unless they pass envelopes to all providers involved. For instance, in the same Vietnam News survey, one of the respondents recounted the story of her friend as follows:
A friend of mine tried to bribe a doctor just to feel safe about her treatment. When the doctor refused the money, she thought that the money might be not enough and tried to give him more. After getting a second refusal from the doctor, she felt so insecure about the treatment that she decided to switch to another hospital.
While the doctor in this story should be given credit for not accepting bribes, notice that it is the patient in the story who is propagating this unofficial practice. This could suggest that the general population may not be aware of the significance of what they are propagating. However, current data shows otherwise. According to the Vietnam Youth Integrity Survey, “although young people say they understand integrity and the negative impact of corruption, when faced with corruption in their daily lives a significant number are ready to compromise their values […] 45% consider it acceptable to bribe their way to better hospital treatment.” It seems as though bribery has been ingrained into patients’ minds. This can be seen especially amongst Vietnamese who have recently immigrated to the United States. These new immigrants often attempt to slip envelopes to receptionists and medical assistants in the hopes of being scheduled at desired times or being able to skip the process of obtaining prior authorizations from insurance companies. (The author of this article is stating this based on its occurrence in her clinics.)
Clearly, bribery in healthcare settings should be looked down upon and deterred. Are there steps being taken? The good news is yes.
Bribery in hospitals has became such a significant issue that the Vietnamese government has began to implement a new regulation where those who bribe and those who receive bribes will be fined $730-$970 per incident. Nonetheless, there are no laws specifying the difference between bribing and showing gratitude, so patients are still presenting “thank you” envelopes to medical staff.
Another method that may be more effective and lasting would be to increase the number of hospitals and qualified medical providers in rural areas. This would alleviate the current trend of overcrowded hospitals and hence the need for patients to bribe in order to jump in front of long lines. Paired with this solution must also be long-term efforts to rebuild the trust of patients in rural doctors and in receiving quality care without feeling the need to bribe.
I enjoyed reading this post. I would like to thank you Jenny for doing tremendous job in this article. Whatever you shared about Vietnam health care is very instructive. Very appreciative work! Keep it up.
Hi Steve, thank you very much. Are there any issues that you are interested in reading about perhaps?
I’ll let you know if I need to know anything else. Thanks buddy.
That’s because the commie bastards have been taking everything for themselves for so long– the only thing for anyone to do now is to be out for themselves, because there is no such thing as “fair.” You’re going to lose it all anyway– might as well hoard and spend as much as you can from other people before the government gets to it. Of course public hospitals are overcrowded– everything is under the government’s control so everything is broken. These doctors are taking bribes because they’re not making enough to live on, and this is the way they get paid– as long as “Charlie” doesn’t find out and get to it first.
Hi Tom, thank you for sharing your thoughts. It is depressing that this is currently the way things are. However, many individuals claim that the country is changing towards a more positive state. Unfortunately, the process is slow and could take decades before a more heartwarming norm becomes a reality. Until then, one could hold on to hope and optimism.
Perhaps a contrast between market-based healthcare and government healthcare in Vietnam is in order, i.e., which system patients prefer.
/geo@MalariaSurvivor™
Hi MalariaSurvivor, thank you for reading and commenting. A study of market-based versus government-backed healthcare in Vietnam is definitely something to look into. It is interesting that there is a similar debate occurring in the United States between private health insurance companies versus what have came to be known as Obamacare. No doubt, there are arguments that support both sides, and finding a system that patients and healthcare providers can agree on is no easy task.
Unfortunately, I think the problem is much deeper. Patients bribe because they know that there are plenty of doctors who are willing to take the bribe. Can you blame them? My aunt works as an ear,nose and throat doctor for one of the largest public hospitals in Saigon, and her official on paper salary is 8 million VND a month or about $400 USD a month. I don’t know if she takes bribes or not, but put yourself in that situation. I know I would be tempted. Also, everyone knows in Vietnam the very politicians who run these “anti-corruption” campaigns are often the very ones who are corrupt themselves who use these campaigns are a cover for their own corruption. But great story….Teachers receiving bribes for grades is also a big problem in Vietnam these days too. I think that would be a great story for someone to cover as well.