HCM City (VNA) - Two years after the southerncity of HCM City launched family health insurance plans, family coveragelanguishes at just 24 percent—a disappointing result that augurs ill for theGovernment’s bid to achieve universal health care coverage by 2020.

The 2014 Law on Health Insurance and other regulationsstipulate that under the family or household health insurance plans, everymember of a family or household listed in the household registration book(excluding the deceased and the temporarily absent) must buy health insurance.The plans are designed to be more affordable than individual ones, which theGovernment hopes will spur enrollment.

Larger households pay lower premiums per member instead ofpaying the full price as each member applies for health insurance individually.The household’s first member must pay 4.5 percent of his or her base salary;while the second, third, and fourth members would pay 70, 60 and 50 percent ofthe first member’s required payment, respectively. After the fifth member, eachperson pays 40 percent of the first member’s payment.

Nguyen Thi Thu, deputy director of the HCM City SocialInsurance company, said one of the reasons the family plan enrollment ratesremained low despite the financial incentives was that many households hadunstable incomes. "Signing up for health insurance when family members arehealthy often seems like a waste of money," she added.

This creates a problematic tendency for people to enroll inhealth insurance programmes only when they start to get sick—something that needsto change, especially when all public hospitals and medical centres in the citystart to charge uninsured patients the full cost of their care beginning thismonth, according to Thu.

“The law requires family plan enrollment but since there areno punitive measures for those who don’t comply, our hands are tied,” Thu said.

In order to achieve universal coverage by 2020 and the targetof 70 percent of health insurance card holders enrolling under the family plan,Le Van Phuc, deputy head of the Department of Health Insurance Policy of the VietnamSocial Security, said the most important task was to raise awareness of thebenefits of the government-sponsored programme, cut down administrativeprocedures and improve health services delivery quality.

In addition, Phuc said, local governments must craft policiesto support vulnerable demographic groups, such as people over age 70 andhouseholds near the poverty line, to ensure 100 percent coverage for thesegroups.

“With local engagement, social security units, and increasedpublic awareness, I’m confident the health insurance coverage under the familyplans would see a considerable improvement,” he added.-VNA