Vietnam Aims for Free Hospital Care by 2045 in Major Healthcare Push

By Tim Warrick, South East Asia Correspondent

Vietnam has unveiled an ambitious plan to provide free hospital care for all citizens by 2045, a landmark policy championed by Party General Secretary Tô Lâm to transform the nation’s healthcare system. Announced by Deputy Minister of Health Trần Văn Thuấn, the directive targets 90% access to comprehensive health services by 2030, including annual check-ups, vaccinations, and chronic disease management. With costs estimated at VND 25 trillion (~$963 million) annually for check-ups alone, the state aims to fully fund health insurance, slashing out-of-pocket costs. While hailed as a humane leap, the plan faces funding and logistical hurdles, testing Vietnam’s socialist welfare ambitions.

The policy, detailed at a government press conference on 6 May, seeks to ensure universal access to healthcare, from grassroots clinics to urban hospitals. “The General Secretary’s directive is not only a strategic goal but a policy that touches millions and reflects the people’s aspirations,” Thuấn said (Vietnam News, 7 May 2025). By 2045, citizens will face no additional costs for insured services, positioning Vietnam as a global leader in healthcare equity. The initiative builds on the CPV’s vision of a “people-centric” system, prioritizing vulnerable groups like ethnic minorities and the elderly.

A Transformative Healthcare Vision

The plan’s cornerstone is universal health coverage, starting with 90% of Vietnam’s 100 million citizens accessing disease prevention, vaccinations, maternal care, mental health, and annual check-ups by 2030. Each citizen will receive electronic health records for lifelong management, supported by a “green, clean” environment with improved nutrition. “This is a profoundly humane policy that reflects the superiority of our system,” Thuấn said, emphasizing benefits like early diagnosis, reduced poverty, and enhanced labor productivity (Vietnamnet.vn, 6 May 2025).

Funding will rely on state budgets, targeting 100% health insurance coverage. Out-of-pocket spending, currently 40–45% of healthcare costs, will drop below 20%, with co-payments for insured treatments under 10%. Annual check-ups, costing VND 250,000 (~$9.6) per person, will total VND 25 trillion yearly (Thanh Nien, 7 May 2025). If successful, the policy may boost GDP by improving workforce health, though economic gains remain speculative without detailed projections.

The policy prioritizes equity, with pilots from 2026–2030 expanding services for ethnic minorities, the poor, and remote communities. By 2035, a revised Law on Health Insurance will ensure sustainability, with sub-funds for critical illnesses and contingencies to prevent waste. Measures to curb overuse, such as strict monitoring, aim to avoid overloading facilities like Hanoi’s Bach Mai Hospital.

Policy Roadmap and Implementation

The Ministry of Health is drafting a resolution for the Politburo, proposing healthcare breakthroughs, including free care. A decree, effective 1 July 2025, will detail state-supported insurance premiums and expanded benefits, covering screening and early treatment (VietnamPlus, 6 May 2025). Circulars will specify reimbursement rates for medicines and devices, prioritizing vulnerable groups.

From 2026–2030, pilots will expand basic healthcare packages to 20–30% of base salary (up from 15%), fund check-ups, and screen at-risk groups by age or occupation. Health insurance coverage will rise to 100% for those at 95%, with incremental increases for others. By 2030–2035, comprehensive legal revisions will solidify free care, integrating with the 2026–2035 national health program for efficiency.

If implemented effectively, the policy may reduce financial burdens, as seen in Thailand’s universal coverage scheme, which cut out-of-pocket costs by 30% since 2002. However, Vietnam’s larger population and rural disparities pose unique challenges, requiring robust infrastructure and funding.

Opportunities and Challenges

The policy promises transformative gains. Improved healthcare access could lower poverty, with 5.4 million near-poor households in 2024 potentially benefiting (Tuoi Tre News, 6 May 2025). Early diagnosis may reduce chronic disease costs, while a healthier workforce could drive Vietnam’s 6.5% GDP growth. Social equity will improve if ethnic minorities in regions like the Central Highlands gain better services, narrowing wealth gaps.

Yet, challenges are significant. The VND 25 trillion annual check-up cost, equivalent to 2% of 2024’s state budget, strains finances, especially with southern flooding recovery demands (Vietnamnet.vn, 6 May 2025). Overuse risks overwhelming hospitals, as seen in Ho Chi Minh City’s 120% bed occupancy rates. “If not managed, free care could lead to waste,” warned a Ministry of Health official. Public support is strong—X posts praise the policy’s ambition—but rural residents like farmer Lê Văn Tâm fear long waits at distant clinics.

Regional and Political Context

Vietnam’s healthcare push aligns with ASEAN’s 2025 welfare goals but stands out for its scope. Malaysia’s hospital upgrades focus on urban centers, while Thailand’s border healthcare strains under security costs. Within Vietnam, the CPV’s anti-corruption drive, convicting 1,200 officials in 2024, supports fiscal discipline for healthcare funding. The policy, tied to Tô Lâm’s leadership, leverages momentum before the 2026 Party Congress, aiming to cement his legacy.

If successful, Vietnam could model universal healthcare for ASEAN, surpassing regional peers. Failure risks public distrust if costs spiral or services lag. “These goals are achievable with strong political will and a clear roadmap,” Thuấn said (Vietnam News, 7 May 2025). As Vietnam balances growth and welfare, the policy tests its socialist vision on a global stage.