Government policies of assistance in health care - from the beneficiaries' point of view

Hoang Van Minh, Nguyen Khanh Phuong

National health survey report, Medicine publisher, 2002

Objectives: To evaluate the equity and effectiveness in thegovernment policies of assistance in health care services, to analyze factors affecting equity and effectiveness, then propose recommendations for improving and enabling those policies.

Methods: Analysis of the data of the National health survey 2001-2002 and overview of the available documents.

Results: Local health level brings the most benefit for poor people; Preventive services and reproductive health care are the most "pro-poor", out-patient health services and rehabilitation are the areas of the highest inequity; Poor patients when coming to health care services (both inpatient and outpatient) are assisted mainly through the fee reduction or exemption, the proportion of payment covered by health insurance is still small, and the assistance for outpatient examination and treatment is lower than for inpatient examination and treatmen; Health expenses burden is mainly o­n hospital fee and is higher for poor patients than for the rich; The near-poor group has the highest proportion of self-payments for inpatient treatment; The policies of assisting poor people are being actively implemented, but the "uncovered" proportion is still fairly high.

Conclusion: On the whole, rich people are still getting more benefit than the government assistancefor health care services for poor patients. However, compared to a few years ago, the government assisting policies for health care for the poor are now more "pro-poor"; The policy to reinforce local health level has been appropriate. Decision 139/QD-TTg of the Prime Minister about the Fund for health care for poor people will be the important basis for the solution of the remained problems of previous assisting policies for poor people.