English - CEDAW Southeast Asia

CEDAW and the Law:
Indicator 86
Are there measures in place to provide financial assistance on
health care for poor women and other disadvantaged groups, such
as women with disabilities and ethnic minority women
Health care in Viet Nam is financed by: (a) government budget allocation; (b) out-ofpocket
payments; and (c) prepayment schemes or health insurance. 574 On government
budget allocation, in addition to discussions in Indicator 85, in Viet Nam, the percentage of
public/private health expenditure is 20 percent and 80 percent respectively of total health care
expenditure. 575 This is low compared to other countries in the region. 576 Out-of-pocket
payments are by far the most important source of financing, which includes formal user
fees. 577 These are fees paid directly by patients when they seek treatment including
consultations and medicines. User fees remain a major source of health-care financing; and,
in many ways, they undermine equality of access to health care, most especially those who
cannot afford them. 578 The prepayment schemes include compulsory insurance coverage of
active and retired workers in the public sector and salaried workers in the private sector.
Coverage of the private sector is low, with only 13 percent of private sector employees
covered in 1997. Voluntary health insurance, like health insurance for schoolchildren and
farmers, also exists. 579 The Resolution on Socialization targets by 2010 the universalization of
medical insurance.
To reduce the inequalities caused by user fees, the Government introduced a policy of
exempting certain individuals from treatment fees, including war veterans, people with
disabilities, orphans, ethnic minorities, the poor, children aged less than six years, and
individuals with particular illnesses. 580 This policy may be found in relevant legal documents,
such the: (a) Decision No.139/2002/QD-TTG of October 15, 2002 on the Purchase of Health
Insurance Care Funds for the Poor (Decision on Health Insurance) on the purchase of health
insurance cards or direct payment for medical examination and treatment and establishment
of the Health Care Fund for the Poor, which covers the poor, residents of communities with
difficult socio-economic circumstances, and ethnic minorities in disadvantaged provinces;
(b)Ordinance on Elderly People, which states that elderly people who do not have any support
or are without any income sources are entitled to free medical examination and treatment. 581
Elderly people who are aged 100 years or older will be granted health insurance cards free of
charge; (c) Ordinance on Disabled Persons, which provides that persons with serious
disabilities and with no income or support or are poor are entitled to free medical examination
and treatment. 582 Persons with disabilities who are poor are also entitled to be supplied freeof-charge,
or part of the costs, ordinary aids for functional rehabilitation; 583 (d) Law on Children,
260
574
United Nations Development Programme, ‘Health Care Financing for Viet Nam. Ha Noi’, Discussion Paper No. 2, United
Nations Development Programme, Ha Noi, June 2003 (UN Discussion Paper No. 2), p. i
575
Ibid., p. 7
576
Ibid.
577
Ibid.
578
Ibid., pp. 6 and 8
579
Ibid., pp. 6-9
580
United Nations Country Team Viet Nam, ‘User Fees, Financial Autonomy and Access to Social Services in Viet Nam’.
Discussion Paper No. 6., Ha Noi, August 2005 (UN Discussion Paper No. 6), pp. 13-14
581
Ordinance on Elderly People, Article 12
582
Ordinance on Disabled Persons, Article 10
583
Ibid., Article 11
Review of key legal documents and compliance with CEDAW