Will Millions Receive Health Care in Vietnam?

12.18.09 – Health Care in Vietnam: A Restless Problem

While millions of Americans are watching closely on every critical step taken by the White House in completing the healthcare reform process, Vietnam has already seen major problems with its new health insurance policy.  Effective October 1, 2009, the Vietnamese authority approved a significant adjustment to the insurance coverage provided by the National Healthcare Trust Fund for its contributory participants.  Compared to the current plan, the new plan would provide different coverage levels to different tiers of participants.  Patients in certain categories such as low income, minor ethnicity, or infancy, would receive higher coverage compared to other patients [B.?].  This is definitely a plausible improvement to the social welfare system of Vietnam.  Nevertheless, the law makers failed to foresee several serious problems before implementing the new laws.

Utilization is expected to increase due to the more favorable coverage that pertains to certain groups of people.  This increase in utilization has caused thousands of hospitals to face the overflow of patients since the first effective day of the new policy.  The waiting lines have stretched out longer than ever.  Doctors and other healthcare professionals have to work a lot more hours than before [Qu?c Tu?n].  This would most likely reduce the quality of care to the patients.  In addition, the lack of new technology to quickly identify the correct tier for patients has further slowed down the admission process.

Sadly, many patients still want to discontinue their care and get discharged early due to the high medical cost.  Despite the fact that low income patients are eligible to receive higher reimbursement of coverage, the maximum reimbursement per visit was capped at a much lower figure compared to the cost of many serious diseases [Thuy Hoa].  This continued to result in high out-of-pocket expenses to the patients who are very ill.

Radio Free Asia (RFA.org) also reported various frauds in the new healthcare system.  Without strict regulations and proper care guidelines in place, the standards for medical procedures and care quality do not truly exist.  Based on this flaw, many hospitals and clinics deny exam results from other hospitals, which in turn forcing the patients to repeat the same procedures or exam process.  Many hospital officers take advantage of the patients by taking under-the-table money from those who want to avoid the long waiting lines [Do Hieu].  VnExpress goes into more details to describe corruption in healthcare that takes place outside of the hospital settings.  Pharmacists from drug stores would try to sell the newest and most expensive types of drugs to the patients to receive larger commissions from pharmaceutical companies even though the equivalent generics were available at much cheaper price.  A handful of health professionals and officers manipulated patients to switch over to private clinics instead of public hospitals to avoid the long-waiting time [Hoang Khue].  Services provided from private practices would result in larger bills to the patients but lower quality due to less restrictive regulations by the government.

Healthcare corruption is the most dangerous social problem because it hits the people at the time between life and death, leaving them with no other alternatives to choose.  So, what can we do to help in solving this problem?

What Can We Do?

In order to solve a problem, we need to identify the causes and origins of the problem.  Let’s first start with three simple steps:

1. The law makers of Vietnam did not carefully estimate the costs and determine the risks that associated with the new laws.  In many countries, this important task would be assigned to a team of actuaries.  An actuary is a professional who deals with the financial impact of risk and uncertainty.  However, Vietnam does not have a strong society of actuaries yet, compared to many other Asian countries such as China, India, and Korea.  Vietnam often ranks top places in many international Mathematics competitions.  This proves that Vietnam has the most and brightest potential candidates for this type of profession.  A network is needed for these potential talents from Vietnam to build relationship with professional Vietnamese actuaries from oversea to learn more about this low-profile but highly respected career.
2. Failure in predicting the utilization increase has caused the uncontrollable overflows of patients.  Non-profit organizations from inside and outside of Vietnam can gather medical volunteers and medical professionals to provide free medical care in the hospitals of Vietnam.  Before we can reduce the inefficiency in the healthcare system of Vietnam, we must first reduce the inefficiency in our works.  To avoid duplicative efforts, these organizations must collaborate together.  Again, a strong network is needed to provide effective communications among the groups.  This would help to reduce the overflow problem temporarily until the Vietnamese government can generate a definite solution.
3. The lack of care guidelines and strict regulations had made ways for corruption.  By mixing a group of volunteers in each hospital, moral standards would increase due to the fact that medical volunteers are not working for money incentives.  The volunteer workers will be more likely to report corrupted behaviors because they are not under the pressure of losing their job.  For the long-term goal, we would need to have a group of professionals to draft a proposal for healthcare guidelines in Vietnam.  The big question would be: Where do we find these professionals that have the passion to do such thing?  I’m leaving this question for the readers to answer.

If you would like to contribute other solutions for the healthcare problems described above, please feel free to contact us.  We would love to hear from you.