School health insurance in VN

By VSS, Vietnam School Health Insurance in Vietnam Page 1 1 2 Background Features Future Plans ASSA’s Good Practices on Customer – focused Service Delivery B A C K G R O U N D B B A A C C K K G G R R O O U U N N D D Vietnam started Doimoi (economic reform) in 1986, changing from a centrally planned to a socialist-oriented market economy. In the late 1980’s and the early 1990’s there were many changes which had both positive and negative influences on the people’s life. The health care system was not an exception. Before Doimoi, the health services had been entirely subsidized by the State. People now had to pay partially for the health care. During this period, the health care providers at the grassroots level (commune health station, school health clinic, and factory health clinic) were deteriorating due to the shortage of fund for operation. This problem limited people’s access to health care especially for the poor. Having realized that, the Government decided to use health insurance as a health financing mechanism. Therefore, Vietnam Health Insurance (VHI) was established in 1992 to manage health insurance activities throughout the country with two health insurance schemes: compulsory and voluntary health insurance schemes. Having evaluating the needs for health care services and the potential participation of the school children and university students, the Ministry of Health and the Ministry of Education and Training issued an Inter-ministerial Circular on School Health Insurance (SHI) in 1995. It is a form of voluntary health insurance aiming at strengthening school health system and protecting school children from consequences of bad health. F E A T U R E S F F E E A A T T U U R R E E S S  The target groups of this scheme are school children and university students. The coverage has increased steadfastly from around 300,000 in 1995 to 4.9 million in 2002 (accounting for 26% of total school - aged children and students in Vietnam).  Premium amount is quite low ranging from 10,000VND to 45,000VND/student/year depending on the local socio-economic conditions. (1USD is equivalent to about 15,000VND, July 2003)  Benefit package: Emergency out-patient care, in-patient care, death benefit. Co-payment is not applicable for SHI. Besides, all the students in the school are eligible to health-promoting programs. ASSA’s Good Practices on Customer – focused Service Delivery S p e c i a l F e a t u r e s : S S p p e e c c i i a a l l F F e e a a t t u u r r e e s s : :  30% of the collected revenues are transferred back to the school. The school will utilize that fund to:  Set up new health clinic (if there was no health clinic existing before);  Pay for the salary of the school’s health clinic worker(s);  Organize health-promoting programs at school such as “sound teeth program”, myopia prevention program, helminthes prevention program, safe water program and annual medical check-ups. All the children in the school benefit from these programs;  Purchase drugs for emergency cases;  Provide first aid for accidents occurring at school; In the school year 2002-2003, 35 billion VND was transferred back to the schools.  61% of the collected revenues, which are allocated for the health care fund, pay for out-patient care (emergency only), in-patient care and death benefit. The major difference between VSS’s SHI and other types of commercial health insurance is that VSS will pay according to the medical needs and there is no cap for the benefits. At the end of the fiscal year, if there is a surplus, then 80% of that is transferred to the health care reserve fund of the following year. The remaining 20% of the surplus is used to provide free health insurance cards for the poor children of the school with good education results. Over the past years, part of the accumulated surplus has been utilized to buy water filters, medical beds, drugs, essential medical instruments for examination and dental chairs for the schools. In 2002 only, 7.2 billion VND was spent for this purpose. F U T U R E P L A N S F F U U T T U U R R E E P P L L A A N N S S SHI has been proved to be effective and it is a good way to better access health care services. SHI has a good social impact and has been welcomed by the students’ parents. It has contributed to the success of comprehensive education. However, SHI scheme still has some limitations. For example, the coverage rate is still low, the benefit package is not comprehensive. Therefore, in the near future a more proper benefit package will be designed. At the same time, VSS will work closely with Ministry of Education and Training to promote SHI and to manage this scheme more effectively. Successful SHI is a significant stage for Vietnam to reach universal health insurance. This article is contributed by the Vietnam Social Security, Vietnam. Readers who have enquiries may send them to vss@hn.vnn.vn . on School Health Insurance (SHI) in 1995. It is a form of voluntary health insurance aiming at strengthening school health system and protecting school children from consequences of bad health. . established in 1992 to manage health insurance activities throughout the country with two health insurance schemes: compulsory and voluntary health insurance schemes. Having evaluating the needs. people’s access to health care especially for the poor. Having realized that, the Government decided to use health insurance as a health financing mechanism. Therefore, Vietnam Health Insurance (VHI)