Vietnam needs clearer policies for private healthcare

September 10, 2023 | 04:00 pm PT
Nguyen Lan Hieu Doctor
After his father passed away from colon cancer, an often curable cancer if detected early, Tuan quickly scheduled virtual colonoscopies and stomach scans for himself and his elderly mother.

He chose a private hospital for his mother. After years of queuing at public hospitals in Vietnam, he did not want his mother to have to suffer all the fuss. He himself went to a public hospital to save costs.

Upon getting the results, he happily informed me there were no signs of danger.

But he appeared to be very concerned about the discrepancy between private and public hospital costs.

While he only paid VND1 million (US$42) for the scans, a similar procedure for his mother at the private hospital cost four times. The doctors there also prescribed a handful of medicines, which cost another VND4 million ($170). Tuan was not even sure if his mother needed or wanted to take all those medicines.

This is a typical story in the Vietnamese healthcare sector.

Private healthcare institutions have been mushrooming across the country.

Firstly, demand for healthcare has been rising in recent years but public hospitals do not have the capacity to handle the demand. Secondly, the government has many policies to encourage investment in the healthcare sector, such as providing lands for hospital construction at discounted prices and loans at low interest rests.

Thirdly, healthcare is of increasing interest to investors looking to diversify their investments in a sustainable manner.

Finally, private healthcare institutions are thriving as a result of the public hospital crisis.

Public hospitals, despite large investments and government support, struggle to get enough facilities and equipment due to bureaucratic government procedures, and more and more talented doctors are opting for private hospitals.

Faith in public hospitals has been shaken. Recognizing this trend, many healthcare investors, instead of seeking stakes in and contracts from them, feel encouraged nowadays to set up independent private healthcare institutions.

This is an inevitable trend, one that I endorse.

Nevertheless, Vietnam needs proper policies to manage privatization in the healthcare sector. Not only do private hospitals need to ensure quality, but also need to ensure that the investments are properly managed to prevent squander of vital societal resources used to support them.

The first issue has been thoroughly discussed in the public domain in Vietnam. As a privately operated entity, private hospitals' first and foremost mission is to be financially profitable.

They also face many prejudices (which are not completely baseless) of only being able to handle common illnesses and simple medical procedures.

As a consequence, the skills of healthcare professionals at private hospitals do not improve, creating a vicious cycle of having no complicated medical cases, focusing on common illnesses, conducting simple procedures, and making no improvement.

It is therefore understandable why private healthcare institutions prescribe more medical tests and procedures than are actually necessary: to increase their revenues. The situation is not ideal, but somewhat understandable.

My chief concern about private hospitals is how they can maintain a high quality of care.

There should be strict policies to ensure that healthcare institutions, regardless of whether public or private, should prioritize patients over profitability.

This issue is not an easy one to tackle. Only institutions with a strong financial base can attempt stricter management of quality and consider investing in specialties. But the benefits can be long-term and promote sustainable growth.

Society should also be rational about medical mishaps occurring at private hospitals since they occur at a similar rate at public health facilities. I feel that we as a society are irrational in denouncing private hospitals every time a mishap occurs rather than objectively assess it.

This is another hurdle that systematically favors public hospitals over private hospitals.

Continuing education and training is also imperative in hospitals, both public and private.

Applying technologies to promote Internet-based healthcare services, such as online consultation, goes the extra mile in helping patients in remote places access better healthcare.

Private hospitals can be more flexible and potentially more innovative in this regard, which should be encouraged.

The second issue is the efficacy of investments in private hospitals. Many private hospitals are heavily and carefully invested in, but do not operate at full capacity due to certain reasons like lack of human resources and licenses and simply lack of faith among patients.

But overall, the issue lies in the lack of planning for the systematic organization of private hospitals.

The government should have an overarching policy regulating the role of private healthcare providers, which could go a long way in allocating appropriate societal resources.

The contribution of private healthcare providers is immense, and should be appropriately recognized.

As private providers play a growing role in the healthcare sector, the most vital step forward is to have a clear, concise and effective policy to assist and regulate private healthcare activities.

*Nguyen Lan Hieu is the director of the Hanoi Medical University Hospital and a National Assembly delegate.

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