In addition to the basic periodic health check-up package covering these specialties, it will include blood, biochemistry, ultrasound, X-ray, and electrocardiogram tests, depending on the age group and risk factors. The average check-up cost is estimated to be VND300,000/visit.

Tran Thi Trang, Director of the Health Insurance Department under the Ministry of Health (MOH), said this free checkup package is based on current regulations and will have results updated to electronic health records for unified management. Technical indications will be carried out according to doctors’ professional evaluations.

Regarding screening services, especially high-risk diseases such as cancer and cardiovascular diseases, Trang said MOH has issued Circular 30 on the basic health service package at commune health stations. However, it is reviewing options to select services that are suitable, cost-effective, and capable of early disease prevention. 

Initially, priority will be given to screening common diseases that are easy to detect early and that respond well to interventions. More advanced techniques will be deployed gradually, depending on the financial capacity of the fund.

“The average cost per checkup is estimated at VND300,000 per person. With more than 80 million people outside the labor group (whose healthcare is paid by employers under the law), total funding will be around VND25,000 billion. The state budget will not cover all costs in 2026 but allocate them in phases, prioritizing policy beneficiaries, children, the elderly, people with disabilities, and ethnic minorities. Those with health insurance cards may be covered by the health insurance fund,” Trang said.

For 2026–2027: citizens will receive one free health checkup or screening per year; all residents will have electronic health records. Near-poor households and people aged 75 and above will have 100 percent of medical examination and treatment costs covered within the scope of health insurance.

For 2028–2030: out-of-pocket spending will drop below 30 percent; screening lists for common diseases will expand; and health insurance coverage will exceed 95 percent.

After 2030: Vietnam will move toward free hospital fees for all within the basic service package.

Free hospital fees: realistic option

The major question is: where will the resources come from to sustain such a humane and high-cost policy? Hoang Van Minh, Rector of the University of Public Health, said free hospital fees are not unrealistic if Vietnam has a suitable roadmap, learns from international experience, and optimizes the existing healthcare system.

Sweden is considered a model of free and equitable healthcare. Most healthcare costs are funded by tax revenue. Citizens almost never pay for basic medical services, except for small co-payments to prevent overuse.

According to Minh, the core factor is social consensus: citizens pay high taxes but trust the quality and transparency of the healthcare system. This model is sustainable only when paired with good governance and proper resource allocation.

The UK operates the National Health Service (NHS), fully funded by public budgets. Citizens receive medical examinations, emergency care, and inpatient treatment almost free of charge. The salary-based payment mechanism for healthcare workers helps control costs, though the system sometimes faces overload and long waiting times, which is an important lesson for countries expanding free services.

Thailand, a country with many similarities to Vietnam, is successfully implementing universal health insurance, starting with a “30 baht” co-payment and later making it completely free. From this, Minh believes Vietnam should also start with a suitable benefits package, prioritize primary healthcare, and ensure stable financing.

Minh emphasized that Vietnam needs to carefully evaluate the payment capacity of the health insurance fund and the state budget, while looking into new revenue streams such as health taxes on sugary drinks, tobacco, and alcohol, measures widely adopted by many countries to increase funding and improve public health.

Vietnam in 2024 achieved a health insurance coverage rate of up to 94.2 percent. The medical examination and treatment network has expanded to every commune, and professional capacity at both basic and specialized levels has made clear progress.

However, out-of-pocket costs from the public still account for over 40 percent of the total health expenditure, a high level that leads to the fragility of household welfare. Therefore, the policy of providing free hospital fees is an urgent requirement to be implemented.

The implementation of free hospital fees will significantly increase the expenditure of the Health Insurance Fund according to the roadmap, by about VND2,700 billion per year.

Vo Thu