Financial problems are the main reason why
poor people do not go to hospitals for treatment.

“I had to pay up to VND18 million ($900) for 13 days in
hospital, just because of dengue fever. This is a huge amount of money. It is
true that the poor should not be ill,” said Mrs. Lien, 40, from Ha Nam, a northern province
in Vietnam.

Lien’s four-member family is very poor. Her husband has to
leave his family to work as seasonal worker. Lien stays at home to plant rice
on a small land plot. They have to save every penny to take care of their two
children.

Lien recently caught dengue fever. As the disease had
side-effects, she was moved to Hanoi’s
Bach Mai hospital. Lien didn’t have a health insurance card so she had to
borrow money to cover the hospital fees.

“My family has been exhausted after my illness,” Lien said.

There are many people like Lien. Sickness has pushed them
into poverty and even hunger.

According to a survey carried out in Hanoi in 2008, 33 percent of interviewed
families said that illness reduces their living standards and prevents it from
improving.

“Vietnam
has many achievements in healthcare but there is still an inequality in
benefiting from the healthcare system. The rates of inborn death are highest in
the country’s two poorest region (northern mountainous region and the Central Highlands), which are 21-23 out of 1000 inborn
babies. The rate is only 8 per 1000 in the northern delta,” said Dr. Duong Huy
Lieu, Chairman of the Vietnam Health Economic Science Association.

Dr. Ly Ngoc Kinh, former chief of the Ministry of Health’s
Health Treatment and Examination Department, said that the poor have higher
need for healthcare but their access to health services is more limited than
other groups.

The quality of health services for poor people is also lower
than those for the rich. The poor mainly use services at grassroots clinics
while the rich go to central-level clinics.

“Though they use health services and grassroots clinics,
where the service fee is lower, but for the poor, the burden of healthcare
spending is still too large,” said. Dr. Kinh.

On average, the well-off and rich people see doctors 4.7
times annually, compared to 2.9 times for the poor. As a result, once the poor
have to go to hospitals, their hospitalization time is longer.

“Even for the poor who have health insurance or those who
are exempted or entitled to reduced fees, hospital fee is still a big burden,
which is on average equivalent to around ten months of spending. A research
revealed that nearly 60 percent of poor families incur debts due to illness,”
Dr. Kinh said.

Experts said that spending on medicines accounts for a large
part in the total healthcare expenditures due to poor control of medicine
prices. The prices for the same medicine may be very different at different
drug stores.

PV