Old women do morning exercises at Hoan Kiem Lake. As the Vietnamese population gets older, more money needs to be spent on health, experts said (Photo: VNA) Hanoi (VNS/VNA) - Global trends inhealth policies and practical access in the context of the rapidly agingpopulation were topics of discussion at a forum on health care on November 13in Hanoi.
The forum was titled “Paving the path for thefuture in healthcare: Driving efficiency and outcomes in a rapidly aging Asia”and was organised by the Vietnam Medical Association and Novartis Vietnam. Itdrew the participation of dozens of healthcare policymakers and academicleaders in the healthcare sector from across Asia.
According to Amos Garcia from Singapore’s MilkenInstitute, the challenges of ageing societies were enormous as older people areincreasing in number.
Research by the institute showed that Asia wasageing faster than it was gaining wealth.
The Healthcare sector’s share of GDP has beenrising in East Asia and the Pacific with income growth, he said.
Speaking at the forum, Nguyen Van Tien, former deputyhead of the National Assembly’s Committee for Social Affairs, said Vietnam isamong the countries with the fastest growing aging populations in Asia.
While developed countries like France takes 115years to transform from an ageing population into an old or aged population,the process only takes 18 years for Vietnam.
As the Vietnamese population ages, more moneywould be spent on healthcare, he said, adding that health expenditure accountedfor 5.7 percent of its GDP in 2015.
The number of dependent elderly people who needcare was increasing while the population of young labourers paying taxes wasreducing.
Tien said the burden on the health system wouldonly grow as the population gets older.
He proposed re-orienting the system to respondto an increase in non-communicable diseases and the ageing population.Universal healthcare coverage for people of all ages would be continued as willthe development of private health services.
To overcome the negative impacts of an ageingpopulation, Garcia said it was necessary to redefine traditional notions ofageing. This includes reinforcing the message that older adults are valuable tosociety. A top-down corporate culture that recognizes the wisdom, knowledge andopportunities of older workers should be emphasised.
Another solution was to provide opportunitiesfor meaningful and productive experiences and focus on long-term wellness anddisease prevention, he said.
He underlined the need to remove age-relatedinstitutional barriers to social participation.
Regarding challenges to universal healthcoverage, Le Van Kham, Director of the Health Insurance Department under theVietnamese Ministry of Health, said 13 percent of the population was uninsured.The rate of out-of-pocket spending was at 40 percent, but World HealthOrganisation recommendations saidit should be less than 30 percent.
He said "limited financial resources meanthat resources are not always used efficiently".
The capacity of health service provisions wasweak, especially at the provincial level, which limited benefits forbeneficiaries, increasing costs for patients, Kham said.
To solve these difficulties, he suggested adissemination campaign and making benefits more favourable for health insuranceholders.
Prastoeti Soewondo from office of the vicepresident of the Republic of Indonesia served as a member of the supervisoryboard of the National Social Health Insurance Agency until 2015 and now sits onthe country’s health working group. She said remarkable results had beenachieved since the integration of the health insurance scheme into single payer- JKN (Jaminan Kesehatan Nasional), a scheme operated by Badan Panyelenggara JaminanSosial Kesehatan (BPJS) in 2014.
Under JKN, a government-subsidised scheme, allcitizens are able to access a wide range of health services provided by publicfacilities, and services from a few private providers that opted to join thescheme.
Analysts have pointed out that from 2013 to2016, the utilisation of both outpatient and an inpatient services isconsistently higher among JKN members compared to uninsured people. From 2013to 2016, inpatient utilization for JKN member increased by 68.7 percent and in2016 was 1.6 more than that of the uninsured, she said.
Reforms in payment systems and the drug supplychain resulted in a comprehensive benefit package with almost all diseasescovered, Soewondo said.
“Universal coverage is ‘beyond treatment,’” shesaid. “It should be a holistic approach embedded in a strong health caresystem.”
Participants at the forum agreed that patientshould be the centre of the health sector and community. They said the publicand patients should be engaged in disease prevention and management.
Given the increasing challenges in the healthcare system, new technologies and digitalisation should be adopted to enhancethe quality of patient care and enable sustainable development, theysaid.-VNS/VNA
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