Health insurance thresholds and policy implications: a Vietnamese medical survey in 2015

In this research, we use a survey dataset from 900 Vietnamese patients, of which 605 have health insurance, to establish empirical relations between medical expenditures, actual insurance coverage rate, residency status, socioeconomic status of patients and their perceived dis/satisfaction toward the health insurance services/values. The results show that actual insurance coverage and medical expenditures contribute to higher probabilities of satisfaction, but with coverage rate having much higher influence. In addition, threshold insurance coverage and expenditures are estimated, showing that perceptions are immensely heterogeneous regarding values of benefits, following which the poor and non-resident patients being those most efficient for the healthcare system to target and demonstrate positive policy changes. This group's threshold coverage is only 63.4%, a little above the current mean 58%. Finally, as the universal insurance and full coverage is impossible, Vietnamese health insurance policy should switch to support the most vulnerable, with more flexible health insurance and financing options as the current system has proved too rigid to be of value to the poor.