Speaking at the National Assembly hall about the draft Resolution on protecting, caring for, and improving public health, and the National Target Program on Health, Population, and Development for the 2026–2035 period, National Assembly Delegate Nguyen Anh Tri from Hanoi said the hospital fee exemption is an important condition to create breakthroughs in medical examination and treatment.

Tri said the fee exemption should focus on four core issues and be implemented under a reasonable roadmap, aiming toward nationwide exemption by 2030. However, he noted that patients with severe conditions, chronic illnesses, or high treatment costs should receive earlier support to reduce their financial burden.

“Because there is a roadmap, I propose implementing early fee exemption for those undergoing treatment for difficult-to-cure diseases, chronic conditions, patients on hemodialysis, and cancer patients receiving very expensive targeted therapies. They are struggling greatly and need immediate support; we should not wait until 2030,” Tri said.

This opinion has drawn significant public attention, especially as medical costs continue to rise while many families still face financial burdens in long-term treatment of critical illnesses.

The Ministry of Health said the issue of hospital fee exemption has been studied and integrated into the “plan on gradually implementing hospital fee exemption” nationwide.

According to the expected roadmap, the plan will be divided into three phases: 2026–2027; 2028–2030; and after 2030. After 2030, MOH will aim to provide full hospital fee exemption for the basic service package for the entire population.

Revenue sources for health insurance fund

Statistics show the total number of medical examination and treatment visits nationwide in 2024 reached 183.6 million, an increase of 9.7 million visits (5.6 percent) compared to 2023. 

National health insurance–covered medical expenses in 2024 exceeded VND139,000 billion, up more than VND18,000 billion from the previous year.

Many experts warn that the proposal for hospital fee exemption, although a humanitarian action, would entail enormous costs. The pressing question is whether the Health Insurance Fund and the state budget can sustain it.

Dr Nguyen Khanh Phuong noted that if by 2027 the health insurance reimbursement rate increases to 100 percent for near-poor households and people aged 75 and older, the Health Insurance Fund would have to pay an additional VND2,700 billion per year on average.

By 2030, if basic service packages are fully exempted for the entire population, costs could reach VND21,500 billion annually, equivalent to the amount people paid out of pocket for medical services in 2024.

To guarantee stable financing for this scheme, Phuong said it is necessary to diversify resources and expand revenue sources. In addition to raising the health insurance contribution rate from 4.5 percent to a maximum of 6 percent, a portion of the luxury tax on products harmful to health such as tobacco and alcohol, could be allocated to the fund to implement the plan.

Regarding the suggestion of early fee exemption for severely ill patient groups such as cancer or dialysis patients, Phuong told VietNamNet that “although very humane, it is not feasible.”

“This must be calculated by specialized agencies with reference to the Health Insurance Fund. No country has been able to do this,” Phuong said.

Others voiced support for a proposal by Nguyen Anh Tri. The biggest issue is not “whether we should do it,” but “where the money will come from”, he said. 

Potential resources include the Health Insurance Fund, the State budget, taxes, national target programs, or special health support funds.

The Ministry of Health’s proposed roadmap for hospital fee exemption is as follows:

Phase 2026–2027:

Citizens receive free annual health checkups or screenings.

The entire population has electronic health records.

Near-poor households and people aged 75 and older receive 100 percent coverage for medical services under health insurance.

Phase 2028–2030:

Reduce out-of-pocket expenses to below 30 percent.

Expand screening for common diseases.

Increase health insurance coverage to more than 95 percent.

After 2030:

Move toward nationwide hospital fee exemption within the basic service package.

Expand services further when resources allow and operate an intelligent, multi-layered health insurance payment system.

N. Huyen