Social insurance and health insurance in general nationwide. Of the 258 surveyed households, 24 households participated in social insurance, accounting for 9.3% and 63 households participated in health insurance, accounting for 28.8%.
Second, the results of participation in social insurance and health insurance for farmers from the surveyed localities.
- Regarding social insurance for farmers , when grouping participants by type of district, we see that in the delta districts, the number of farming households with the longest period of participation in social insurance and also the most people participating in the social insurance system; while in coastal districts, farming households have only accessed the social insurance system in the last 1-2 years (see Appendix 3.1).
While in the delta and midland districts in the past two years, there have been additional registrations to join the social insurance system, in the coastal districts in the past four years, no households have been seen participating in the social insurance system according to the survey sample.
According to the communes, the communes in the good category have the largest number of households participating in the social insurance system (22/24 households) and the longest period of participation, while the communes in the average category have not many households participating (2/24 households). The poor communes have almost no households participating in the social insurance system (see Appendix 3.2).
Analyzing the household groups from rich to poor according to the survey, we see that not all rich households participate in social insurance. However, there is a trend that the lower the living standard, the lower the ability of people to participate in the social insurance system according to the contribution-benefit principle. In other words, according to the survey results from the topic, the rate of rich households participating in social insurance is the highest (44.44%) followed by well-off households (25.87%). Households with average incomes have hardly participated in the contribution-benefit system to receive social security (see Appendix 3.3).
- Regarding health insurance for farmers . The survey results show that farmers highly appreciate the benefits of participating in the health insurance system. Therefore, compared to the participation of farmers in the social insurance system, the participation of farmers in the health insurance system is always better in all aspects, such as the number of years of participation, the number of participants and the maintenance of the annual participation of people in the health insurance system.
In terms of quantity, coastal districts have the highest proportion of participating households (34.78%), but most of them have only participated in recent years; the plain districts
The district has an average rate of participation in health insurance (28.34%); the midland and mountainous districts have a participation rate of about 17.59% (see Appendix 3.4).
Similar to the status of participation in the social insurance system, the status of participation in the health insurance system of the people varies depending on the economic conditions of each commune. The rate of participation in the health insurance system of the well-off communes (32.8%) is higher than that of the average communes (19.5%); while the poor communes have the lowest number of participants in the health insurance system (10.86%) (see Appendix 3.5).
When looking at the types of households surveyed, similar to the case of social insurance, not all rich people buy health insurance cards and not all rich people are the pioneers in buying health insurance cards (see Appendix 3.6).
Third, comments on the participation and impact of social insurance according to the contribution principle
- benefits for farmers.
1) According to the research results, in terms of social security according to the contribution-benefit principle, by 2012, only 0.38% of the country participated in social insurance and 10.3% participated in health insurance. In the surveyed provinces, in 2011, the rate was higher but only 9.3% of farmers participated in social insurance and 28.8% of farmers participated in health insurance. This result is low. The implementation of the Party and State's policies on social security for farmers into practice is still slow.
2) The subjects participating in the Social Insurance for Unemployment Insurance are mainly those who have participated in the Social Insurance for Unemployment Insurance and switched to paying Social Insurance for Unemployment Insurance, those who are past retirement age but have not worked long enough to receive pension benefits, and farming households with incomes from moderate to high... The level of Social Insurance for Unemployment Insurance is still low, mainly choosing a salary higher than the minimum wage.
3) According to a survey in some localities, so far only a few people have received social insurance pensions. However, in general, the pension rate is low, about 725,000 VND to 1,300,000 VND/person/month. With pensions lower than the minimum wage or not much higher than the minimum wage, ensuring the lives of workers receiving social insurance pensions is very difficult.
Regarding voluntary health insurance, although the benefits of participating in voluntary health insurance are highly appreciated, people's satisfaction with it is not high. Perhaps this is also the general situation of health insurance today. According to Mai Ngoc Cuong (2009), when asked about people's satisfaction with medical examination and treatment under the health insurance regime, 24.1% of people
6.9% of respondents said they were "satisfied" with the medical examination and treatment under the health insurance regime, 21.6% said they were "difficult to answer"; the quality of medical examination and treatment at district hospitals is low; there are still many "incurred expenses" during the medical examination and treatment process;... This makes the persuasiveness of participating in the voluntary health insurance scheme not high [35].
3.1.4.2. Farmers' participation in social security is not based on the principle of contribution.
Firstly, on regular social assistance. From 2006 to 2009, the coverage of the group of beneficiaries of social assistance nationwide was increasingly expanded. Compared to 2006, the number of beneficiaries of social assistance nationwide was about 5 times higher.
In 2010, the whole country had 1,439 thousand people eligible for social assistance in the community, an increase of nearly 10 times compared to 2000 and about 3.12 times compared to 2005. The number of beneficiaries increased due to the expansion of the target and scope of beneficiaries of the policy during the completion process [31]. With a population of about 86 million people in 2010, the rate of beneficiaries receiving assistance compared to the population reached 1.65%; compared to those in need of protection, the coverage rate reached 9.22%.
Table 3.3: Percentage of subjects covered by social security in 2010
Unit: %
TT
Object Type | Compared to population | Compared to BTXH objects | |
Shared | 1,650 | 9.22 | |
1. | TEMC, abandoned children | 0.100 | 65.18 |
TEMC, abandoned children | 0.070 | 47.43 | |
Individuals and households adopting TEMC | 0.030 | 17.75 | |
2. | Elderly (single and over 85 years old) | 0.790 | 8.41 |
3. | NTT (including mentally ill) | 0.470 | 7.47 |
4 . | People with HIV/AIDS | 0.002 | 1.06 |
5. | Households with two or more severe NTT | 0.010 | 28.66 |
6. | Poor single person raising young children | 0.114 | 95.58 |
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Source: Department of Social Protection, 2010.
The annual policy implementation budget also increased correspondingly with the increase in the number of beneficiaries and the subsidy level. Specifically, the total source was 108,895 million VND in 2000, increased to 430,527 million VND in 2006, to 1,681,633 million VND in 2007, to
2,076,433 million VND in 2008, decreased slightly to 2,003,301 million VND in 2009, and continued to increase to 3,575,521 million VND in 2010. The total cost of implementing the 10-year policy from 2001 to 2010 was 10,844,354 million VND [31].
In the three surveyed provinces, in 2009 alone, the total number of people receiving social assistance was 241,091. With a total population of 7,546,600 people, the social assistance coverage rate in the three provinces was 3.19%. The total social assistance subsidy amount in the three provinces reached 391.84 billion VND. The average amount that each person received from social assistance was 1,625 thousand VND (see Table 3.4).
Table 3.4. Social insurance of the three provinces of Thanh Hoa, Nghe An and Ha Tinh in 2009
Thanh Hoa | Nghe An | Ha Tinh | |
1. Orphaned and abandoned children (infected with HIV since 2008) ( people ) | 1,670 | 2,603 | 734 |
- Cost ( billion VND ) | 2.47 | 4.13 | 1.08 |
- Percentage of people receiving assistance (%) | 1.4 | 2.9 | 2.1 |
2. Elderly ( people ) | 10,373 | 15,385 | 2,737 |
- Cost ( billion VND ) | 15.43 | 24.54 | 4.08 |
- Percentage of people receiving assistance (%) | 8.9 | 17.2 | 7.7 |
3. People aged 85 and over without pension ( people ) | 40,622 | 39,211 | 17,132 |
- Cost ( billion VND ) | 58.5 | 56.46 | 24.67 |
-Proportion of subjects receiving assistance (%) | 35.0 | 43.9 | 47.9 |
4. Disabled, mentally ill, HIV infected people ( people ) | 42,506 | 24,531 | 11,503 |
- Cost ( billion VND ) | 81.52 | 42.46 | 19,838 |
- Percentage of people receiving assistance (%) | 36.6 | 27.5 | 32.2 |
5. Households and individuals adopting TEMC/abandoned ( people ) | 3,807 | 1.875 | 280 |
- Cost ( billion VND ) | 11.11 | 5.45 | 0.8 |
- Percentage of people receiving assistance (%) | 3.3 | 2.1 | 0.8 |
6. Households with 2 or more severely disabled people who are unable to take care of themselves ( people ) | 751 | 164 | 49 |
- Cost ( billion VND ) | 2.2 | 0.48 | 0.14 |
- Percentage of people receiving assistance (%) | 0.6 | 0.2 | 0.1 |
7. Poor single person raising small children ( people ) | 16,388 | 5,459 | 3.311 |
- Cost ( billion VND ) | 23.8 | 7.9 | 4.78 |
- Percentage of people receiving assistance (%) | 14.1 | 6.1 | 9.3 |
8. Number of subjects of provinces ( people ) | 116.117 | 89,228 | 35,746 |
9. Population ( people) | 3,404,300 | 2,914,500 | 1,227,800 |
10. Coverage rate to population (%) | 3.41 | 3.06 | 2.91 |
11. Total budget of provinces ( billion VND ) | 195.03 | 141.42 | 55.39 |
12. Social insurance amount per person/year (thousand VND) | 1,679.6 | 1,584.9 | 1,549.5 |
Source : Department of Social Protection, 2010.
Second, about emergency social assistance. According to the Department of Social Protection, in 5 years (2006 - 2010) natural disasters caused 2,127 deaths and 4,195 injuries.
315,887 thousand houses collapsed, collapsed, and washed away, 1,523,618 houses were damaged, total damage amounted to 62,728 thousand million VND [31].
TGXHĐX has covered the following subjects: households with dead or missing people:
3,000,000 VND/person; households with seriously injured people: 1,500,000 VND/person; households with collapsed, washed away, burned, or severely damaged houses: 7,000,000 VND/household; households that must evacuate urgently due to the risk of landslides or flash floods: 7,000,000 VND/household; hunger relief aid: 15 kg of rice/person/month, for a period of 1 to 3 months; people who are at risk outside their residential area and are seriously injured and whose families do not know how to take care of them: 15,000 VND/person/day; homeless people who beg for food while waiting to be brought back to their place of residence: 10,000 VND/person/day but not more than 30 days. In special cases where it is necessary to extend, the maximum period of receiving the allowance shall not exceed 3 months and the allowance shall be equal to the monthly allowance at the social welfare facility. With these policies, the total resources for relief within 5 years (2006 - 2010) were 256,001 tons of rice and 4,603 billion VND [31].
Table 3.5 below shows the damage and social security situation in 2010 of the three provinces of Thanh Hoa, Nghe An and Ha Tinh.
Table 3.5: Social Development Fund from the State budget of the three provinces of Thanh Hoa, Nghe An and Ha Tinh in 2010
Number of deaths (people) | Number of injured (people) | House collapsed, collapsed, drifted (thing) | Flooded and damaged house (one) | Damage (billion VND) | Number of households receiving emergency relief (household) | Demographics of the Socialist Republic of Vietnam (People) | Relief rice (tons) | Relief budget (billion VND) | |
Thanh Hoa | 6 | 0 | 7 | 278 | - | 42,500 | 170,000 | 5,677 | 30 |
Nghe An | 38 | 51 | 402 | 35,981 | 1,000 | 110,141 | 458,136 | 11,200 | 150 |
Ha Tinh | 55 | 46 | 1,940 | 37,389 | 845.6 | 29,391 | 101,752 | 6,500 | 270 |
Source: Department of Social Protection, 2010.
According to the observation model, in terms of the number of subjects as well as the value of the assistance that farmers receive, we see a trend that at the lowest, highest, or average levels, all show positive changes over the years, except for some special cases such as subsistence allowances during lean months, crop failures, or natural disaster relief allowances, the value of the assistance as well as the number of subjects
The number of beneficiaries depends on the specific situation of each year and each locality. For example, the average Tet subsidy per household in 2009 was 0.16 million VND, in 2010 it was 0.18 million VND, in 2011 it was 0.2 million VND. Other subsidies also increased similarly as shown in Table 3.6.
Table 3.6: Summary of social security according to the survey of 3 provinces Thanh Hoa, Nghe An and Ha Tinh in 2009, 2010, 2011
Number of observations (household) | Lowest level (million dong) | Highest level (million dong) | Average level (million dong) | |||||||||
2009 | 2010 | 2011 | 2009 | 2010 | 2011 | 2009 | 2010 | 2011 | 2009 | 2010 | 2011 | |
Cash allowance Lunar New Year | 18 | 26 | 31 | 0.10 | 0.10 | 0.10 | 0.60 | 0.80 | 1.08 | 0.16 | 0.18 | 0.20 |
Monthly living allowance grain, crop failure | 9 | 19 | 22 | 0.05 | 0.05 | 0.04 | 0.90 | 0.90 | 0.90 | 0.21 | 0.21 | 0.22 |
Recovery allowance natural disaster | 13 | 35 | 17 | 0.05 | 0.04 | 0.05 | 0.50 | 7.00 | 0.20 | 0.14 | 0.50 | 0.11 |
Examination, treatment and cure sick | 6 | 6 | 12 | 0.05 | 0.15 | 0.10 | 2.00 | 1.00 | 2.40 | 0.57 | 0.46 | 0.85 |
Source: Author's survey results.
When examining the surveyed districts, we see that the districts in the midland and mountainous areas have the highest number of beneficiaries of social assistance, while the districts in the coastal areas have the lowest number of beneficiaries of social assistance. Notably, in 2011, no households in the coastal areas declared the social assistance status that their families received (see Appendix 3.7).
In terms of the value of the assistance, except for the Lunar New Year assistance which is the same at a low level for the beneficiary group over the years, the remaining assistance shows heterogeneity depending on the local circumstances and the beneficiaries themselves. Among the surveyed households, the group of households in the plain districts received the highest level of assistance, however, the districts in the midland and mountainous areas are the places where the number of components of the TGXHĐX that households received at a high level is the highest.
When considering communes, there is a situation where households in communes with good economic conditions
The better the economic situation, the higher the possibility of receiving social assistance and vice versa. In other words, from the survey data, we see that the number of beneficiaries of social assistance in well-off communes is the highest, while poor communes have the lowest number of households receiving social assistance.
When considering each component of the social assistance program, in better-off communes, the number of households receiving social assistance to ensure their livelihood during the lean months, crop failures or natural disaster relief assistance is higher and the value of the assistance is higher, while in average and better-off communes, the number of households receiving Tet allowance is larger. However, when considering the average value of the social assistance programs received by farmers, we see that the value of the assistance received by farmers in better-off communes is usually higher than the amount received by farmers in other communes according to the survey sample (see Appendix 3.8).
When looking at the groups of households, we see that the rich households in the three observation years did not receive any social assistance, the number of poor households receiving the most assistance. However, receiving social assistance does not follow the income trend, it is not true that households in difficult economic circumstances will have more opportunities to receive social assistance than households in economic conditions above the difficult level. In the three observation years, except for the number of poor households receiving social assistance which is always the highest, the number of middle-class households receiving social assistance is higher than that of near-poor households (see Appendix 3.9).
In terms of the value of the assistance, poor households are the households that receive the highest value of assistance, which is assistance related to family education and medical treatment. Although most of the social assistance for poor households is usually at the highest level, except for the exceptional cases discovered from this survey, the average level of emergency assistance for middle-income households is at the highest level. The reason is that only one middle-income household received financial support for medical examination and treatment, and this amount is also higher than the average cost of medical examination and treatment of household groups.
Third, on community social assistance . Along with the state budget's social assistance, community-based social assistance activities are also focused on. There are many organizations doing this work. The following is an excerpt of the results of community-based social assistance activities by social and residential organizations of the Vietnam Red Cross, a very strong social assistance organization in our country during the period 2007 - 2012 (Box 3.1).
Box 3.1: Results of some areas of work of the Red Cross Society nationwide 2007 - 2012
Domestic and international organizations and individuals, through the Red Cross, have supported people affected by natural disasters to overcome the consequences of storms and floods and provide emergency relief worth over 1,500 billion VND.
Movement “Tet for the poor and Agent Orange victims”: worth 1,060,786 million VND, average: 212.2 billion VND/year, supporting 4,667,768 poor households and Agent Orange victims (average of nearly 1 million households/year, taking care of Tet for 1/3 of poor households nationwide).
The campaign "Each organization, each individual is associated with a humanitarian address": after 4 years of implementation, 1,974,577 people in especially difficult circumstances have been profiled, 1,243,125 people have been assisted (accounting for 62.95% of the number of profiles) with a total value of 1,622,521 million VND (average assistance of 1,305,000 VND/subject). Of which, the Red Cross Society assisted 52% of the humanitarian addresses, the remaining 48% were assisted by other organizations and individuals.
“Red Cross House” model: 27,523 Red Cross houses have been built in the past 5 years (average 5,500 houses/year), worth: 336,739 million VND, of which 20.9% is from the Central Association’s source, 79.1% is from the province’s source. The average cost of building a Red Cross house is 12,230,000 VND/house, the highest is
60,000,000 VND/apartment, lowest 7,000,000 VND/apartment.
“Cow Bank” project: in 2 years (June 2010 – June 2012), the project donated 6,196 breeding cows to people in 33/62 poor districts nationwide, accounting for 52.23% of poor districts with a total amount of 42,778 million VND, of which 98.73% was mobilized and supported by the Central Association and 1.27% was contributed by the local counterpart fund. After 2 years of implementation, 3.32% (206/6,196) of the breeding cows have spawned.
Care and support for Agent Orange victims: reached a value of 403,310 million VND, assisting over 1.5 million victims, an average of over 300,000 subjects/year, accounting for 10% of the number of Agent Orange victims needing assistance. Agent Orange victims received medical support and health care mainly (accounting for 41.2%) of the total assistance; cultural and spiritual support accounted for 20.9%; support for life and economic development was limited with the corresponding rates of 6.0% and 1.0%.
Propaganda and mobilization of voluntary blood donation: 3,036,685 units of blood were collected in the 5 years from 2007 to 2012. Blood donation campaigns during Tet and the Spring Festival (2008 - 2012), the "Pink Blood Drops" Campaign in the summer (2009 - 2011) basically overcame the serious blood shortage during Tet and summer in 63/63 provinces and cities in 2010 and 2011.
Every year, the Red Cross receives and organizes the implementation of about 30 international projects with a total value of 792,989 million VND in the period 2007 - 2012. Of which, support for the field of Disaster Management and Emergency Relief accounts for the highest proportion (72.95%), Health Care accounts for 20.38%, Social Work and Organizational Development accounts for a very low proportion with the corresponding figures: 2.73% and 3.94%.
The total operating value of the Association in the period 2007 - 2012: reached 7,316,704 million VND.
Source: Red Cross, 2012.