The Vietnamese healthcare system

Overview of Vietnam's health industry and workforce

Vietnam's economy has undergone rampant gentrification. With a GDP per capita of roughly 3,000 USD, Vietnam now ranks as a lower-middle-income nation. Experts from The World Bank have made some exciting forecasts about Vietnam's middle and upper classes. Predictions say these affluent communities will account for a staggering 26% of the population by as early as 2026. A few key statistics for Vietnamese healthcare are as follows:

• Vietnam maintains a world healthcare score of 65/195.
• The average life expectancy in this country is 75.77 years old.
• Roughly 7% of Vietnamese citizens have private health insurance.
• 89.3% of the population is following the Universal Health Coverage (UHC).

In addition to this, AmCham Vietnam has projected that healthcare expenditure will increase to 26 billion USD by 2025. This boils down to 262 USD per capita. A balance of numerous variables dictates the state of Vietnam's growing healthcare sector. These include the government's continued investments in healthcare infrastructure. This is combined with Universal Healthcare Coverage (UHC) and the nation's unwavering demand for high-quality services.

The challenges of Vietnam's healthcare system

The Vietnamese Ministry of Health is swamped with challenges. Although a majority of the population benefits from access to Universal Healthcare Coverage, an imbalance of supply and demand is visible on a physical scale. This is partially because state-run Vietnamese hospitals are outdated, and chronic overcrowding is a prevailing issue. At present, the state-run medical institutions in Hanoi and Ho Chi Minh City alone cater for 60% of the country's healthcare workload. The result is that these hospitals are operating at double the recommended capacity. In short, there aren't enough hospital beds to accommodate the overwhelming influx of traffic.

Surgery is another rising issue in state-run hospitals. As a large amount of the equipment is now obsolete, complex procedures are becoming either more difficult or simply impossible to implement. This lack of sufficient equipment for intensive care is mainly accredited to their healthcare sector's reliance on governmental funding. This state budget is a dominant factor in terms of applying upgrades to services, equipment, and facilities. And while this budget has seen increases over the last decade, it, unfortunately, remains too low to sustain the demand.

Qualified medical staff in the public health sector are in short supply, too. Stressful conditions and relatively low wages for such demanding work are mostly to thank for this. With many factors like improving education, the majority of medical graduates are either working in the private sector or heading overseas.

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Medical equipment and pharmaceuticals in Vietnam

Healthcare service providers are being driven by numerous key factors. Firstly, the demand of Vietnam's rising middle and upper classes. Secondly, the continued successful growth of Vietnam's economy in general. These healthcare providers are instigating numerous investments in order to better equip local, state-run hospitals.

Vietnam's policy on the importation of advanced medical devices is encouraging. At present, local production is incapable of sustaining the demand. Therefore, in accordance with the EU-Vietnam-Free-Trade Agreement (EVFTA), this rapidly developing nation enjoys a smooth influx of sophisticated medical equipment. No quote restrictions are applied whatsoever, and these imported necessities are subject to low duties.

Ownership of the healthcare industry in Vietnam

Vietnam's healthcare sector is divided into two discernable systems. The first is public healthcare, which is responsible for the majority of the citizens in the country. The public healthcare sector can be separated into four distinct levels - commune, district, provincial, and central. The private sector accounts for the other aspect of Vietnam's healthcare system. It is a combination of investments from foreign and domestic entities.

Nowadays, there are fewer restrictions in regard to foreign ownership, meaning that collateral from abroad has a significant impact on private healthcare facilities in Vietnam. These same healthcare systems have also benefited massively from a number of governmental incentives. Over the last few years, policies designed to increase welfare in the public and private sectors have resulted in auspicious improvements. For example, in a little under 10 years, the number of hospital beds per 10,000 people increased from 23.56 to 29. The latest statistic as of 2023 is promising, with 31.7 patients per 10,000 beds with goals to reach 37 by the year's end.

Although the healthcare system in this country used to rely exclusively on tax contributions, a number of adjustments to the revenue stream have been implemented. Government revenue plays the biggest role in funding the public healthcare system. However, out-of-pocket payments and social health insurance contributions are also playing a part nowadays.

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What does Vietnam's public healthcare system cover?

Considering that Vietnam is still a developing nation, public healthcare facilities are becoming increasingly promising in terms of their sophistication. Locals and foreigners using these public facilities can expect the following to be covered:

• Inborn diseases and birth defects;
• Sexually transmitted infections (STIs);
• Self-inflicted injuries and treatment in the case of suicide;
• Eyesight treatment for all children under the age of six;
• Transportation support for anyone who is considered a vulnerable person;
• Pregnancy check-ups;
• Any fees associated with consultations;
• Medications;
• Pathology;
• Inpatient and outpatient care;
• Dermatology.

Vietnam Social Security (VSS) is responsible for the management of the two primary types of healthcare coverage in this country. These types of healthcare are in place to ensure all foreign and local citizens can afford to access public medical facilities. These types of healthcare coverage are:

• Voluntary health insurance - This system is in place for anyone who is not protected under the mandatory scheme. This may include self-employed workers, informal workers and freelancers from overseas.
• Compulsory social security cover - Any worker on a permanent contract stretching to over three months is legally required to arrange this category of healthcare cover. Additionally, this type of cover is a legal requirement for children under six, students, people over 90, war veterans, and financially unstable citizens. The contribution rate is 4.5%. Should you be employed by a local Vietnamese company, you will be responsible for 1.5% of this, while your employer will be responsible for the remainder.

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The cost of healthcare in Vietnam

At present, some citizens of Vietnam are expected to cough up themselves when the need for healthcare arises. These medical expenses can surface at both private and public institutions. At the moment, around 80% of Vietnamese citizens qualify for reduced rates in healthcare. This includes:

• Anyone benefiting from social assistance programs, such as farmers and fishermen.
• Social insurance pensioners (This is normally paid by present or previous employers).
• Financially unstable people (subsidized 100%).
• Children under the age of six (subsidized 100%).
• Citizens under the poverty line (subsidized 70%)
• Full-time students (subsidized 30%)
• Any workers in the formal sectors.

Should you fall outside of any of these categories, you will be required to pay the entirety of healthcare fees in Vietnam. This applies to the majority of foreign citizens. On a brighter note, the cost of hospital care in Vietnam is significantly lower than in nearby countries, not to mention Western states. For example, a quick visit to the doctor or a hospital check-up will typically cost USD 5. Should the need to be examined by a specialist arise, the standard fee is around USD 30.

The average total costs for hospitalization care in Vietnam amount to USD 270 when paid out-of-pocket by patients. To break this down a little further, surgery accounts for almost 25% of these fees, while examinations and diagnostic tests contribute to another 24%. The costs of pharmaceuticals amount to roughly 23% of the overall cost of hospitalization. Naturally, these fees fluctuate depending on the nature and complexity of the surgery. For example, treatment for burns is at the top end of the spectrum, at an average of USD 321. Generally, patients who are the recipients of health insurance will be subject to slightly lower fees than patients without such protection.

Health insurance in Vietnam

Whether traveling or migrating to Vietnam, it is critical to be covered by health insurance. Your embassy or consulate can help you choose the appropriate plan, which will be calculated based on factors such as your age, destination(s), and duration of travel. Ensure that your health insurance includes coverage for repatriation.

There are many insurance companies to choose from, according to your needs and budget. Some of the leading international health insurance providers are:

• Allianz Care
• Regency for expats
• Cigna

Consider having a look at their offers according to your needs and get a free quote on Expat.com's Health Insurance for expatriates in Vietnam page.

The quality of healthcare in Vietnam

The Lancet has awarded Vietnam's healthcare system a total of 60 points out of a maximum of 100. Although this does leave plenty to be desired, this score is still reasonable when viewing it from an optimistic perspective. If you're moving to Vietnam from a Western European country or the US, you may feel disappointed with the healthcare in Vietnam.

Typically, Western standards are much higher, but surprisingly, Vietnam's waiting times are often less. In the UK, for example, hospital waiting times can be upwards of four or five hours. It is possible to be seen and treated by a Vietnamese doctor within a few hours. This is despite the public hospitals often being overcrowded.

It must be stressed that medical facilities in rural areas are highly underfunded and extremely basic. Should the need for surgery arise, it would be strongly advised to return to one of the major cities immediately.

Another point to note is that staff at public hospitals in Vietnam aren't the most competent of English speakers. In fact, it is likely that only the doctors will be able to converse effectively in English. Nursing staff typically speak Vietnamese only. This unfortunate fact only becomes even more apparent as you venture further away from major cities. If you need to visit a hospital, it is highly recommended that you do so with the aid of a local Vietnamese person.

Expats in Vietnam are entitled to use the same medical facilities as Vietnamese citizens. However, if they are tax residents, they are expected to contribute to compulsory health insurance. Unfortunately, these mandatory payments aren't always enough to protect people from the more expensive types of healthcare, such as surgery for broken bones. It is for this reason that many expats choose private health insurance instead.

Private healthcare insurance can provide the beneficiary with a number of things that Vietnam's public system is currently unable to do. Granted, this would significantly increase your cost of living in Vietnam. However, the peace of mind incurred would pay for itself. The benefits of private health insurance in Vietnam include:

• Better facilities;
• Fewer language barriers;
• Shorter waiting times;
• Cover for ongoing expenses;
• A network of private medical facilities.

The future outlook for Vietnam's healthcare sector

In spite of Vietnam's lower standards than many Western countries, the government is striving to implement positive changes to improve facilities. These upgrades aren't merely in the pipeline. The recent Covid pandemic is evidence enough that they are already in action.

Over the past few years, a staggering number of new and advanced hospitals have been erected in smaller cities. These include Nha Trang, Phu Quoc and Vung Tau. Furthermore, the capital city of Hanoi and the southern metropolis of Ho Chi Minh City are now home to internationally accredited general hospitals. According to the 2022 Statisca, Vietnam's GDP equaled 255.7 trillion Vietnamese dong, spent on healthcare, which is 2.69 percent of the country's total. There is speculation that this funding may see an increase in years to come. However, there is nothing to confirm this yet.

Useful link:

Vietnam's Evolving Healthcare System: Notable Successes and Significant Challenges - PMC

Information about Vietnam's health system

International Insurance Vietnam