Public Health Insurance in Vietnam towards Universal Coverage: Identifying the challenges, issues, and problems in its design and organizational practices

Vietnam is attempting to achieve universal health insurance coverage by 2014. Despite great progress, the country faces some challenges, issues and problems. This paper reviewed official documents, existing reports, and related literature to address: (1) grand design for achieving universal health coverage, (2) current insurance coverage, (3) health insurance premium and subsidies by the government, (4) benefit package and payment rule, and (5) organizational practices. From the review, it became apparent that the insurance system is broadly speaking complex and there are huge ambiguities, which seems hindering universal coverage of health insurance. Also, hidden distorted incentives and lack of financial stability are the main challenges in the current public health insurance system in the country.