Phased Health Insurance Fee Hike: Strategy to Realize Free Healthcare
MoH Proposes Raising HI Contribution Rate to 6% by 2032 to Consolidate Fund and Reduce Public Out-of-Pocket Spending
The Ministry of Health (MoH) is proposing a phased roadmap to increase the Health Insurance (HI) contribution rate, from the current 4.5% of the base salary to approximately 5.1% (2027), 5.4% (2030), and reaching 6% by 2032. This move is designed to solidify the HI Fund and establish a strong financial basis for the gradual implementation of a universal free healthcare policy for basic services.
Financial Pressure and Urgent Objectives
According to the MoH report, the HI Fund has faced substantial expenditure pressure: in 2024, total expenses for medical examinations and treatments exceeded VND 139 trillion. The HI contribution rate has remained unchanged for 10 years, despite the continuous expansion of benefits and a persistent rise in demand for costly chronic disease treatments.
The MoH affirmed that adjusting the contribution rate is mandatory to sustain and expand benefits. The ultimate goal is to maximally reduce the public’s out-of-pocket spending (which remains high) and ensure healthcare equity.
Three-Phase Roadmap for Benefit Expansion and Fee Increase
The proposal is structured in three specific phases, tied to the expansion of participant benefits:
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2026-2027 Phase: Priority is given to increasing HI payment levels and coverage. Free periodic health check-ups or screening for prioritized groups begin (from 2026). The contribution rate is projected to increase to approximately 5.1% starting in 2027.
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2028-2030 Phase: The goal is to reduce out-of-pocket spending to below 30%. HI coverage is expanded for drugs, equipment, and techniques, alongside piloting HI payment for preventive services. The contribution rate is projected to increase to 5.4% starting in 2030.
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Post-2030 Phase: Moving toward universal health insurance. The scope of free healthcare within the basic service package is expanded, accompanied by a contribution rate increase to 6% starting in 2032. This phase also focuses on perfecting grassroots healthcare and a smart payment system.
Commitment to Mitigate Impact and Control Waste
The MoH committed to implementing the fee hike roadmap appropriately, avoiding sudden “shock” for citizens and businesses (which contribute a significant portion of this cost). Policies supporting HI contributions for vulnerable groups will be maintained.
Experts also warned that parallel to the fee increase, clear measures are needed to control cost losses and prevent misuse of the HI fund. Steps such as reducing duplicate testing, minimizing unnecessary service indications, and economizing on medicine and material costs are considered essential to ensure the fund’s efficiency.
