Roadmap to Develop and Implement the Basic Health Service Package Paid by Health Insurance in Vietnam

The Government of Vietnam has prioritized the implementation of health insurance for the entire population, with a focus on controlling healthcare costs, ensuring service quality, and responding to health policy priorities. The Law on Health Insurance, adopted in 2009, aims to develop a national health insurance program. To achieve universal health coverage, the Ministry of Health and Vietnam Social Security have been actively addressing issues such as stable and sustainable funding, reducing out-of-pocket payments, and extending government subsidies to the poor and near-poor. Despite a 71% enrollment rate in health insurance in 2014, the number remains low in compulsory groups, and out-of-pocket payments account for approximately 47% of healthcare costs. The Resolution No. 68/2013/QH13, passed by the 13th National Assembly of the Socialist Republic of Vietnam, emphasizes the need to develop a basic health service package paid by health insurance. The resolution requires the completion of the definition of basic health services package by 2018, taking into account various premiums and socio-economic conditions. The Law No. 46/2014/QH13, which came into effect on January 1, 2015, regulates that the basic health service package paid by health insurance includes essential health services suitable to the liability of the health insurance fund. The development of a basic health service package paid by health insurance is a complex process that requires a roadmap to guide the designing process, identify stakeholders' participation, and establish coordinating mechanisms. The objectives of the roadmap include developing a prioritized list of health services to be included in the basic health service package, forecasting stable and sustainable financial resources needed to deploy the package, and proposing options for delivering the list of prioritized health services. The World Health Organization defines essential health services as a collection of health services considered essential and should be guaranteed for everyone. The full list of health services includes treatment, specialist treatment, and medication, preventive and primary health care, irrespective of who provides them and of their source of financing. The prioritized health services are a subset of the full list of health services, offered by providers contracted by the Social Health Insurance of Vietnam, but paid through different financial sources, including patients' copayments. The basic health service package is a minimum set of basic health services to serve all the needs of the people and ensure that all people have access to essential health services, especially the most disadvantaged groups. The package is currently being implemented in several developing countries, including Afghanistan, Liberia, Iraq, Rwanda, and others. The development of a basic health service package paid by health insurance in Vietnam is a critical step towards achieving universal health coverage and ensuring equity and efficiency in healthcare.