Access to Health Services by the Poor and the Non-Poor: The Case of Vietnam

Abstract

This paper examines the access of the poor and the non-poor in Vietnam to health-care services and discusses the extent to which each group benefits from government health subsidies in that country. It shows that while the overall utilization of health services improved in Vietnam between 1993 and 1998-a period of rapid economic growth, the access of the poor to health care did not improve as much as that of the better-off. The evidence points to increasing polarization of public health services, with the upper income groups constituting the majority of users of public hospital-based services and the lower income quintiles being the primary users of commune health centers. This polarization is especially problematic in view of the fact that the government spends more than three-quarters of its entire recurrent health budget on public hospitals. What this means is that the Vietnamese elite captures a disproportionate share of the large public subsidies that go into public hospitals.