Those theoretical contributions, on the one hand, fill in the shortcomings to improve research activities on issues related to the thesis topic, and on the other hand, suggest a new rese
Trang 1VIETNAM ACADEMY OF SOCIAL SCIENCES GRADUATE ACADEMY OF SOCIAL SCIENCES
DANG QUANG MANH
THE LAW ON PRIVATE HEALTHCARE IN
Trang 2The project was completed at:
ACADEMY OF SOCIAL SCIENCES
Scientific instructor:
1 Associate Professor Dr Nguyen Thi Viet Huong
2 Associate Professor Dr Nguyen Van Long
Reviewer 1: Associate Professor Dr Vu Thu
Reviewer 2: Professor Dr Thai Vinh Thang
Reviewer 3: Associate Professor Dr Dang Minh Tuan
The thesis will be defended before the Academy-level Thesis Examining Council at: Academy of Social Sciences
At hour, day month 2024
The thesis can be found at:
- Vietnam National Library
- Library of Academy of Social Sciences
Trang 3INTRODUCTION
1 Urgency of the topic
Implementing the policy of socializing social activities in the spirit of the Resolution of the 8th National Congress of the Party, the Government issued Resolution No 90/CP dated August 21, 1997, on the direction and the policy of socializing educational, medical, and cultural activities and Decree No 73/1999/ND-
CP dated August 19, 1999, on policies to encourage socialization of activities in the field education, health, culture, sports Implementing socialization aims at two major goals: first, to promote the intellectual and material potential of the people, and second,
to mobilize the entire society to take care of education, health care, culture, physical training, and sports The second is to create conditions for society, especially policy beneficiaries and the poor, to enjoy the results of education, healthcare, culture, physical training, and sports at an increasingly high level
After a period of implementation, the socialization of educational, medical, cultural, and sports activities has achieved important results: the great potential and resources of society have initially been promoted; The non-public sector develops with new, diverse, and rich types and methods of operation; The public sector has had many innovations under the socialist-oriented market mechanism To unify awareness, correct deviations, and continue to attract social resources to invest in development, in
2005, the Government issued Resolution No 05/2005/NQ-CP on promoting the socialization of educational, medical, cultural, and sports activities; In 2008, issued Decree No 69/2008/ND-CP dated May 30, 2008 on policies to encourage socialization
of activities in the fields of education, vocational training, health, culture, sports and environment
Policies to encourage and create conditions of the Party and State in socialization have contributed to the formation of a network of private medical facilities, many of which have applied high technology in medical examination, treatment, and medical care, providing quality health care services, creating opportunities for people to access medical examination and treatment services, contributing to reducing overload in public hospitals According to current statistics, the country has 157 private hospitals, including 6 foreign-invested hospitals; more than 30,000 private clinics, and medical service facilities (including 30 general clinics, 87 maternity homes, and 30 foreign-invested clinics) Thousands of doctors, medical staff, and medical practitioners each year perform medical
Trang 4examinations and treatment for millions of patients; contributing to the cause of people's health care Private healthcare currently accounts for about 8% of the health system, expected to increase to 15% in 2030 and 30% in 2045
However, reality shows that the private economic sector's activities are facing many barriers making development difficult Specifically: (1) the legal system of private healthcare has not been centralized and codified specifically, regularly, and scientifically, so it has not created a good legal corridor for the establishment and operation of healthcare facilities Private healthcare; (2) state management entities in private healthcare have not been independently and professionally regulated by law, so there is no uniformity in management; (3) The contents of state management of private healthcare are not separate from public healthcare, so there are no specific legal regulations specifically for this field; (4) Law provisions relating to conditions for establishment and operation of private healthcare such as investment law, health insurance law, civil law, registration law Business registration there are still many regulations that hinder and cause difficulties for the private healthcare sector; (5) legal regulations on inspection, examination, and handling of administrative violations in the private healthcare sector still have many problems; (6) Types of private healthcare activities are not separate from public healthcare in general, causing obstacles in creating new private healthcare service delivery models The above limitations of the law have directly impacted the establishment and operation of private medical organizations, and have not created mechanisms and policies to develop this field in Vietnam recently Therefore, if the private healthcare sector wants to develop, it inevitably requires investment in research to improve the law and strengthen the implementation of the law on private healthcare
From a scientific perspective, the law on private healthcare has not been reviewed, evaluated, and proposed by many domestic studies, especially research on the scale of a doctoral thesis Therefore, this also creates an urgent need for research to fill that "gap"
Based on that practical and scientific basis, the graduate student decided to
choose the topic " The Law on Private Healthcare in Contemporary Vietnam " to
conduct research on the scale of a doctoral thesis in jurisprudence
2 Research purposes and tasks
2.1 Research purpose
Trang 5The purpose of the thesis is to build a scientific argument, thereby proposing solutions to improve the law and strengthen the implementation of the law on private healthcare in Vietnam today
2.2 Research mission
The research tasks of the project include:
- Collect and systematize typical research works related to private health law; Analyze and evaluate these documents according to specific contents and provide comments on recent trends in legal research on private healthcare
- Analyze and clarify theoretical awareness of private healthcare law, identify concepts, characteristics, necessity, regulatory content, and factors affecting private healthcare law
- Survey and evaluate the current state of the law on private healthcare and the current status of implementing the law on private healthcare in Vietnam today Clearly point out the advantages, successes, limitations, problems, and causes of that situation
- Identify the context of improving the law and strengthening the implementation
of the law on private healthcare in Vietnam
- Determine viewpoints and propose solutions to improve the law, improve capacity, and effectively implement the law on private healthcare in Vietnam
3 Subjects and scope of research
- Spatial scope: The thesis studies the legal status of private healthcare in Vietnam During the research process, comparisons were made to learn about experiences in a number of other countries
- Time scope: The thesis researches the law on private healthcare in Vietnam during the country's reform period and is based on actual reported data over the past
10 years Specifically, the research focuses on the period from 2010, when the 2019
Trang 6Law on Medical Examination and Treatment takes effect, until the end of 2023 when the thesis begins to complete research results
4 Research methods
During the process of carrying out the thesis, the PhD student used a combination
of many different research methods, including the document research method; Comparison method; Historical method; Proof method; Sociological investigation methods; and methods of analysis and synthesis
5 New contributions of the thesis
The research results of the thesis bring new contributions as follows:
- Proving the inevitability of adjustment legal regulation of private healthcare
- Establish the 5 adjustment main and most important regulatory contents of the law for private healthcare
- Reflect, analyze, and evaluate the legal status and implementation of the law
on private healthcare in Vietnam from 2010 to the end of 2023
- Propose solutions suitable to practical requirements to improve the law and strengthen the implementation of the law on private healthcare in Vietnam in the coming time
6 Theoretical and practical significance of the thesis
6.1 Theoretical meaning
The thesis contributes to enriching the theoretical values of the law on private healthcare in the new context Those theoretical contributions, on the one hand, fill in the shortcomings to improve research activities on issues related to the thesis topic, and
on the other hand, suggest a new research direction on private healthcare from the perspective of majoring in Law and State Administration
6.2 Practical significance
The practical research content of the topic provides academics and managers with an overall picture of the current state of the law and implementation of the law on private healthcare in Vietnam over the past period The contexts, perspectives, and solutions proposed in the thesis, if approved by lawmakers and managers, can also become valuable reference documents and solution suggestions in future work on improving legal practice and implementing the law on private healthcare in Vietnam
in the coming time
Besides, the research results of the thesis can also become reference and teaching materials in university programs of Law and State Management in Vietnam today
Trang 77 Structure of the thesis
In addition to the Introduction, Conclusion, List of References, and Appendices, the thesis is structured into 04 Chapters, 14 sections, and subsections Specifically as follows:
Chapter 1 Overview of the research situation and raised issues that need to be studied for the thesis topic
Chapter 2 Theoretical issues of private healthcare and the law on private healthcare
Chapter 3 Current status of law and implementation of law on private healthcare
in Vietnam today
Chapter 4 Perspectives and solutions to improve the law and strengthen the implementation of the law on private healthcare in Vietnam
Chapter 1 OVERVIEW OF THE RESEARCH SITUATION AND PROBLEMS THAT
NEED TO BE RESEARCHED THESIS TOPIC
1.1 Overview of the thesis research situation
1.1.1 Research status of theoretical aspects related to the thesis topic
a On a foreign scale
Many works have been carried out very early on theoretical issues related to private healthcare law on a world scale This comes from reality when private medical services appeared and played an important role in the lives of many countries very early, especially developed countries Theoretical issues about private healthcare and the law on private healthcare are basically consistent throughout the history of research
on a world scale This is due to the worldview about the existence and role of private healthcare alongside public healthcare in the academic world, especially in highly unified private countries Therefore, analyzing the research situation of theoretical aspects related to the thesis topic in the last country, the PhD student only selected a few outstanding recent studies for analysis
b On a domestic scale
At the domestic scale, along with the innovation in national development thinking, the private economy recognized in the Constitution has paved the way for private participation in service provision activities that were previously only
Trang 8monopolized by the state, including health services Along with that practice, research
is also born and increasingly expands and perfects research content on private healthcare However, the longevity, quantity, and diversity of research topics on private health at the domestic scale are also fewer and less comprehensive than outside the country due to the above practical circumstances
1.1.2 Research situation of practical aspects related to the thesis topic
a On a foreign scale
The conditions for the establishment and operation of private healthcare in developing countries are also analyzed and clarified by the above studies In general, the legal systems of all countries have strict regulations on establishment conditions, foreign investment conditions, minimum physical facility conditions, minimum quantity, and qualifications of personnel These regulations are not uniform across countries, but there are very comprehensive core issues to ensure the role and nature of private medical services
b On a domestic scale
Aspects clarified by the author revolve around the 2009 Law on Medical Examination and Treatment such as subjects of regulation; conditions for establishment and practice; legal liability; Compensation liability when conflicts occur in the provision of private medical services; State management of private healthcare Evaluations of the law on private healthcare at the time of the study showed relatively comprehensive aspects of this issue It can be seen that author Dinh Thi Thanh Thuy and her research play an important role and fully demonstrate all aspects of the practical implementation of law and state management of private healthcare in Vietnam
1.1.3 Research situation and proposed solutions related to thesis topic
a On a foreign scale
The main solutions proposed by three prominent studies include: (1) ensuring the effectiveness of laws on the organization and operation of private healthcare to ensure a healthy medical system and private economy is stable and orderly; (2) enhancing the application and enabling research and organization of new, modern forms of private medical service provision, based on artificial intelligence and digital, network-connected platforms; (3) there are agreements to provide professional and technical support and technology transfer between countries and transnational organizations in private healthcare; (4) proactively source social capital for private
Trang 9healthcare development In addition, the studies also propose a number of solutions related to overcoming limitations in practice in each research area
b On a domestic scale
Studies have built and proposed a relatively synchronous system of solutions for private healthcare development such as: (1) perfecting legal regulations on private healthcare such as: building a legal system specialized law for private healthcare; supplementing shortcomings in the conditions and scope of private healthcare operations; there are different standards in legal conditions between different regions for private medical activities; develop a private healthcare development strategy; (2) solutions to improve the efficiency of state management of private healthcare such as: investing in professional development for management officials and civil servants; strengthen inspection and examination; applying technology to management activities; Strengthen measures to handle administrative violations; (3) solutions to promote private healthcare development in Vietnam such as: attracting foreign investment in private healthcare into Vietnam; Strengthen international cooperation and private medical technology transfer; There are preferential policies on taxes, fees and charges for private medical organizations
1.2 Comment on the research situation related to the thesis topic
1.2.1 General comments
The results of an overview of the research situation related to the topic of Law
on private healthcare in Vietnam today show that:
The number of research works on the topic of private healthcare is relatively large, rich, and diverse, approached from many directions with different levels of relevance to the topic "Legislation on private healthcare in Vietnam" This is an advantage and also a big challenge for implementing thesis research
The research results have clarified many theoretical aspects of private healthcare, private healthcare law, and state management of private healthcare in Vietnam Many research projects have deeply evaluated the legal status and practice
of private medical activities in some specific spaces On that basis, a number of research projects have paid attention to proposing solutions, including legal solutions
to improve the law and improve the efficiency of private medical activities in Vietnam Meanwhile, a number of research projects have allowed us to identify the theoretical framework of legal policy and the development and implementation of legal policy in
Trang 10some specific fields These are results that can be inherited and developed in researching the thesis topic
1.2.2 Issues related to the thesis topic have been researched clearly, have reached consistent conclusions and are inherited and developed by the thesis in researching the topic
First, on theoretical research issues Previous research works related to the thesis topic have been clearly researched and have reached consistent conclusions on the following contents:
- Regarding the content of private healthcare, the works have clarified and reached a consensus on the concept of private healthcare, the role of private healthcare
in social life, and the limits for its existence and development of private medical services
- Regarding the law on private healthcare and state management of private healthcare, the works have also agreed on the concept, characteristics, impact factors, and content of the law on private healthcare and state management of private healthcare
Second, about practical research issues Works through many different time and space limits have also conducted research to clarify the current situation of the problem Specifically:
- The history of birth, existence, and development of private healthcare in the social life of countries and territories selected for research have been clarified, thereby showing the roles and impacts of private healthcare Negative effects of private health services and point out the causes leading to those negative impacts in practice
- Practical provisions of the law on private healthcare and state management of private healthcare have been reviewed and reflected by research projects, thereby pointing out results and limitations of the activities of these two contents are associated with a certain territory and time In addition, the works have also pointed out the causes
of limitations when studying current situations
Third, about research problems and solutions Based on research on the current situation of the problem, the works have proposed solutions to improve the law and develop private medical services in many different areas Basic solutions in projects are divided into two groups: solutions to perfect the law and technical solutions to improve implementation efficiency In particular, the group of legal improvement solutions focuses on creating clear legal corridors for the existence of private
Trang 11healthcare On the other hand, the group of technical improvement solutions focuses
on proposals to improve the quality and competitiveness of private medical services and the staff and state organizations participating in the management of private medical services
1.2.3 The issues raised need to be further researched by the thesis
Starting from the analysis of the current state of research related to the thesis topic, it can be seen that the research space for the thesis is still relatively spacious, including the following issues:
First, research scientific perspectives on private health law associated with new thinking about the nature, position, and role of legal policy, about people's right to health care, and about The State's responsibility in ensuring social issues and freedom
of business etc On that basis, continue to research to unify the concept and clearly define the characteristics and roles of private health law Research results must present the concept in the form of a definition based on convincing scientific arguments
Second, research the content, construction, and implementation process, requirements, conditions, and factors affecting the law on private healthcare From this perspective, the research results need to identify the theoretical model of law on private healthcare in Vietnam
Third, the study identifies the need and theoretical framework for legal regulation of private medical activities in Vietnam On that basis, use the theoretical framework to analyze and comprehensively evaluate the current state of legal regulation of private medical activities in Vietnam Research results need to lead to an overall comment on the limitations and inadequacies of the law and find the causes of limitations in the development and implementation of legal policies on private healthcare in Vietnam
Fourth, research the current status of the content and process of developing and applying the law in the process of legislating and implementing the law on private health in Vietnam Overcoming the gap in research activities in recent times, the thesis aims to comprehensively evaluate the entire cycle and manifestation of the law in all aspects of legal life on private healthcare in order to clearly identify advantages and limitations in the law on private healthcare in Vietnam today, identifying causes and lessons learned
Fifth, the study forecasts the new context affecting private healthcare activities and the need to improve the law on private healthcare Research to identify viewpoints
Trang 12and propose a system of solutions to innovate the content as well as the process of developing and applying the law on private healthcare in Vietnam today The research results must ensure a more convincing argument about related solutions that have been mentioned and demonstrated by other research works, and at the same time recommend
a comprehensive system of strategic solutions for the process of strengthening the capacity of the law on private healthcare in Vietnam today
1.2.4 Research questions and research hypotheses
The thesis identifies the following 3 research questions:
Question 1: What is private healthcare? What issues are covered by the law on private
healthcare?
Question 2: What is the current practice of legal regulations and implementation of
laws on private healthcare in Vietnam?
Question 3: What solutions are there to enhance the capacity and effectiveness of
building and implementing the law on private healthcare in Vietnam in the current period?
Based on the above 3 research questions, the thesis determines the research hypothesis as follows:
Laws on private healthcare are the legislative perspectives and regulations of current practical law on private healthcare The law on private healthcare includes contents such as determining the role of private healthcare in national social life, development orientation according to timelines, and strategies for developing the contents of healthcare private healthcare: people, techniques, frequency , prohibited activities of private healthcare, and sanctions for those acts all of the above content does not go into detail but is subjective Ideological, directional, and comprehensive nature aims to macro-limit the contents that will be specified in laws and regulatory documents on private healthcare Laws on private healthcare are influenced by many different factors, including political institutions - the ruling Party's viewpoint on the role of the private economy in social life, awareness of society about the role and quality of private healthcare, thereby establishing their beliefs about the position of these services in social life, international integration factors, economic factors, and economic factors, natural elements…
The current law on private healthcare in Vietnam has many limitations and inadequacies and does not reflect the correct guidelines and policies of our Party and State on private healthcare development One of the important reasons is that the legal
Trang 13policy on private healthcare is not appropriate and there are many obstacles in the process of applying it to legislative activities and law implementation Therefore, the actual implementation of the law on private healthcare is still limited, and many obstacles appear, hindering the operation of private healthcare as well as state management of private healthcare
To improve the effectiveness of promulgating and implementing laws on private healthcare in Vietnam, the focus is on changing thinking and awareness of the role of legal policies in the promulgation and implementation cycle of private health law In addition, improving the planning and policy implementation capacity of officials and civil servants, and social awareness are also measures to improve the effectiveness
of legal and policy planning on private health care in Vietnam effectively Regarding the need to improve the implementation of laws on private healthcare in Vietnam, the focus is still on the capacity of the implementer and openness in political institutions about the role of the private economy key solution to the problem
Chapter 2 THEORETICAL ISSUES OF PRIVATE HEALTHCARE AND LAW ON
PRIVATE HEALTHCARE
2.1 Theoretical issues about private healthcare
2.1.1 Private healthcare concept
Private healthcare is the field of providing medical examination and treatment services and other healthcare and protection activities provided by individuals and private organizations with expertise and meeting practice standards according to the provisions of law and under the management of the state
2.1.2 Characteristics of private healthcare
First, private healthcare provides special services Healthcare in general has a central focus on examining and treating people
Second, private healthcare provides services in a position of information asymmetry Information asymmetry and inequality in information capture
Third, participating in the private healthcare sector requires certain conditions Healthcare is a field with great depth
Fourth, private healthcare is organized in many different forms and purposes, but most commonly for profit Private healthcare can exist under three models: (1)