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ACCESS AND PAYMENT FOR HEALTH CARE: THE POOR OF NORTHERN VIETNAM
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1996
Year
Family MedicineHealthcare ProvisionDevelopment EconomicsEconomic DevelopmentHealth PoliticsFinancial ProtectionHealth Care FinanceHealth FinancingPovertyUser FeesCash TransferPublic HealthHealth Services ResearchUniversal Health CareHealth Insurance ReformEconomicsPublic PolicyHealth PolicyHealth InsuranceNew SystemHealth EquityNational Health InsuranceNorth VietnamHealthcare AccessHealth EconomicsRural HealthBusinessLow Income Developing CountryHealth Care CostSocial Policy
In common with many developing countries, Vietnam has begun to introduce user fees at community and district level. This is part response to the transformation of the economy, economic recession, and the growing acceptability of alternative forms of health finance. This article examines the impact of these charges on the rural poor. Results from a 1995 survey in North Vietnam suggest that the poor generally delay treatment, make less use of government health facilities, and pay more for each episode of illness than the rich. There is evidence that the poor are forced to reduce consumption of essential goods or to borrow to meet these charges. A significant minority are deterred from using facilities. The current system of exemptions fails to provide adequate protection to the poor and a completely new system is required. The results suggest that it is the poor in poorer communes that are most affected by high user fees and it is to these areas that any assistance from government or donors should be targeted.