Contents -- Foreword -- Acknowledgments -- Overview -- 1 Vietnam's Health System Since DOI MOI -- The Evolution of Vietnam's Health System -- Recent Health Policy Agenda -- Vietnam's Health System Now -- Overview of the Chapter -- 2 Recent Trends in Vietnam's Health Sector Performance -- Health Outcomes -- Health Inequalities -- Financial Protection -- 3 Health Insurance -- Schemes and Target Groups -- Contribution Rules, Benefit Packages, Provider Arrangements -- Coverage -- Insurance, Access to Health Services, and Financial Protection -- VSS Revenues and Expenditures-Recent Trends -- Adverse Selection and Factors Affecting Coverage -- Moral Hazard and the Impacts of Health Insurance -- 4 Reforming Health Insurance -- Expanding Coverage -- Deepening Coverage to Further Reduce Out-of-Pocket Payments -- Reforms to Contain Health Insurance Program Costs -- 5 Service Delivery -- Institutional Background and Policy Makers' Concerns -- Provider Performance -- Prices and Provider Payment -- Autonomy -- 6 Reforming Service Delivery -- Delivery Reform Depends on Insurance Reform -- Improving the Quality of Care -- Provider Payment Reform -- Autonomy Reform -- 7 Decentralization and Government Stewardship -- Current Health Responsibilities of Government in Vietnam -- The Future Horizontal Division of Responsibilities -- The Future Vertical Division of Responsibilities -- Notes -- References -- Index -- Figures -- 1 Revenue Sources in Vietnam's Health System, 1998, 2000, and 2005 -- 2 Out-of-Pocket Health Spending, Vietnam 2006 -- 3 Who Benefits from Government Health Spending in Vietnam? -- 4 Trends in Age-Adjusted Mortality- Vietnam Compared to Malaysia and Thailand -- 5 Catastrophic Household Health Expenses, Vietnam and Other East Asian Countries -- 6 Trends in Insurance Coverage through VSS, Vietnam 1993-2006.

7 Enrollment Numbers by Target Group, 2006 -- 8 Trends in Inpatient Admissions and Outpatient Visits -- 9 Source of Hospital Revenues, Vietnam 1998-2005 -- 1.1 Vietnam's Total Health Spending in Context -- 1.2 Revenue Sources in Vietnam's Health System, 1998, 2000, and 2005 -- 1.3 Out-of-Pocket Health Spending, Vietnam 2006 -- 1.4 Vietnam's Government Health Spending in Context -- 1.5 Government Health Spending as a Share of Government Spending vs. Total Government Spending as a Share of GDP -- 1.6 Inter-regional Inequalities in Government Health Spending, 2002 and 2006 -- 1.7 Who Benefits from Government Health Spending in Vietnam? -- 2.1 Vietnam's Under-Five Mortality Trends in Historical and International Context -- 2.2 Trends in Childhood Health Indicators, 1997-98 to 2002-03 -- 2.3 Trends in TB Mortality and Prevalence -- 2.4 Trends in Age-Adjusted Mortality-Vietnam Compared to Malaysia and Thailand -- 2.5 Faster Infant Mortality Reduction in Vietnam's Richer South -- 2.6 Trends in Inequality in Infant and Under-Five Mortality, Vietnam, Philippines, and Indonesia -- 2.7 Catastrophic Household Health Expenses, Vietnam and Other East Asian Countries -- 2.8 Spending Breakdown among Households with Catastrophic Health Spending -- 2.9 Trends in Catastrophic Household Health Spending, Vietnam 1993-2006 -- 3.1 Trends in Insurance Coverage through VSS, Vietnam 1993-2006 -- 3.2 Enrollment Numbers by Target Group, 2006 -- 3.3 Enrollment of Formal Sector Workers, by Sector, 2006 -- 3.4 VSS's Changing Financial Fortunes, 2003-2006 -- 3.5 Costs and Revenues of Vietnam's Insurance Scheme, 2005 -- 3.6 Rising Unit Costs and Rising Utilization Rates as Causes of VSS's Financial Problems, 2004-2006 -- 3.7 Have VSS Inpatient and Outpatient Costs Risen Faster Than Those in the Health System as a Whole?.

3.8 Utilization Rates over Time for VSS Members and Vietnam's Population as a Whole -- 3.9 Reasons Given for Noncoverage, 2006 -- 3.10 Effect of Illness on Probability of Coverage, 2006 -- 4.1 Insurance Coverage by Scheme -- 4.2 Current Financing Mix in Vietnam -- 4.3 Financial Flows in Current System -- 5.1 Trends in Inpatient Admissions and Outpatient Visits -- 5.2 Quality of Care to Children with Diarrhea, Late 1990s -- 5.3 Quality of Care to Children with Pneumonia, Late 1990s -- 5.4 Hospital Cost Inflation -- 5.5 Breaking Down Hospital Cost Inflation -- 5.6 Source of Hospital Revenues, Vietnam 1998-2005 -- 5.7 Variations in Speed of Adoption of Decree 10 by Type of Hospital -- 5.8 Variations in Speed of Adoption of Decree 10 by Type of Region -- Tables -- 1 Simulating the Costs of Universal Insurance -- 2.1 Actual and Expected Annual Rates of Change of Infant and Under-Five Mortality, 1980-2005, by Subperiod -- 2.2 Percentage Changes in Childhood Health Indicators, Vietnam 1997-2002, by Wealth Quintile -- 3.1 Finance and Benefit Rules for Health Insurance Programs -- 3.2 Effects of Insurance on Utilization and Out-of-Pocket Spending, 2006 -- 3.3 VSS Revenues and Outlays per Person -- 4.1 Simulating the Costs of Universal Insurance -- 5.1 Vietnam Inpatient and Outpatient Statistics in Context -- 5.2 Changes in Service Delivery, 1997-2002 from DHS -- 5.3 An Accounting Breakdown of Cost Increases, 1999-2000 -- 5.4 Decrees 10 and 43 Compared.