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Within the last twenty years a large-scale bottom-up privatization has taken place in Vietnam, changing and dismantling the public health care system. This process has led to severe tensions inherent in the transitional society of Vietnam between equity and access to health care support - especially for the poor, elderly, migrants, and ethnic minorities - on the one hand, and its efficiency on the other hand. The book traces the reform efforts to modernize the health care system by the Communist Party of Vietnam and the Vietnamese government. The author bases her findings on little known primary literature and interviews with key stakeholders of the policy network involved in the reform of the health care system, thereby painting an authentic atmospheric picture of the profound changes in the health care system in Vietnam.
Thirty years of Ä?ổi Má»›i (economic renovation) reforms have catapulted Vietnam from the ranks of the world’s poorest countries to one of its great development success stories. Critical ingredients have been visionary leaders, a sense of shared societal purpose, and a focus on the future. Starting in the late 1980s, these elements were successfully fused with the embrace of markets and the global economy. Economic growth since then has been rapid, stable, and inclusive, translating into strong welfare gains for the vast majority of the population. But three decades of success from reforms raises expectations for the future, as aptly captured in the Vietnamese constitution, which sets the goal of “a prosperous people and a strong, democratic, equitable, and civilized country.†? There is a firm aspiration that by 2035, Vietnam will be a modern and industrialized nation moving toward becoming a prosperous, creative, equitable, and democratic society. The Vietnam 2035 report, a joint undertaking of the Government of Vietnam and the World Bank Group, seeks to better comprehend the challenges and opportunities that lie ahead. It shows that the country’s aspirations and the supporting policy and institutional agenda stand on three pillars: balancing economic prosperity with environmental sustainability; promoting equity and social inclusion to develop a harmonious middle- class society; and enhancing the capacity and accountability of the state to establish a rule of law state and a democratic society. Vietnam 2035 further argues that the rapid growth needed to achieve the bold aspirations will be sustained only if it stands on faster productivity growth and reflects the costs of environmental degradation. Productivity growth, in turn, will benefit from measures to enhance the competitiveness of domestic enterprises, scale up the benefits of urban agglomeration, and build national technological and innovative capacity. Maintaining the record on equity and social inclusion will require lifting marginalized groups and delivering services to an aging and urbanizing middle-class society. And to fulfill the country’s aspirations, the institutions of governance will need to become modern, transparent, and fully rooted in the rule of law.
Over the past two decades Vietnam has made enormous progress to expand health insurance coverage to its population. Further progress will require significant additional public financing, as well as efforts improve efficiency and strengthen insurance organization and management. It contains recommendations and next steps for Vietnam to follow.