Health insurance for the informal economic sector in Hanoi

Market economy has brought profound economic changes to the country.

- society. The economy is growing rapidly, the economic structure is shifting towards progress, the average income of workers is increasing, the economic and social life of the people has improved significantly. The issue of improving and raising the living standards of workers is always the immediate and long-term goal of the Party and the State. In addition to issuing policies to promote production and business development, the State always cares about and attaches importance to implementing social policies for workers. The Resolution of the 9th National Congress of the Party, when mentioning synchronous measures and taking care of people's health, said that we must move towards universal health insurance. Universal health insurance is a task that creates the foundation for political stability and social development, ensuring fairness for all people. Therefore, implementing the health insurance policy for workers in the informal economic sector is extremely necessary.

On November 14, 2008, the 4th session of the 12th National Assembly passed the Law on Health Insurance. The Law on Health Insurance was issued and took effect from July 1, 2009. Workers in all sectors have the right to participate in health insurance and enjoy health insurance policies. However, up to now, the number of people participating in health insurance in the informal economic sector is still very limited. The reason for the small number of participants is due to the characteristics of the subjects in the informal economic sector in our country: limited education level and social awareness, the majority of workers are untrained, unstable jobs, low income. The problem is how to make workers aware of the need to participate in health insurance; what solutions to solve the problem of workers participating in health insurance when their income is unstable; institutional issues, implementation organization, and management staff. Due to the limitations of the research process, the author only chose to consider within the scope of Hanoi.

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For the above reasons, the author has chosen the topic " Health insurance in the informal economic sector in Hanoi " as a research topic.

2. Research situation

Since the first health insurance regulations were issued in 1992, many decrees and guiding circulars have been issued to adjust and amend health insurance policies, demonstrating the Government's interest in implementing health insurance, while also demonstrating many difficulties in the implementation of health insurance policies. There have been a number of scientific research works related to health insurance policies and the informal sector published in various forms (reference books, topics, theses, magazines, etc.). These include:

- “ Basic solutions to move towards implementing universal health insurance ” – Scientific research topic of Dr. Pham Dinh Thanh - Center for Social Insurance Science Research. In the topic, the author mentioned some basic theoretical issues about health insurance. The author also introduced the health insurance model of many countries in the world and basic solutions to move towards implementing universal health insurance.

- “ Report on assessment of health insurance policy and implementation ”

- Institute of Health Policy Strategy. The report clarifies the results of implementing health insurance policies, difficulties and obstacles in the process of implementing health insurance policies; the ability of health insurance policies to respond to the orientation of developing a fair, effective and developed health system; Analyzes and forecasts the ability to develop health insurance in economic, social and legal aspects.

- “ Thematic report on financing and provision of health services in Vietnam ” by the World Bank. The report pointed out the challenges of health insurance.

In Vietnam: the ability to expand coverage and develop service depth to reduce costs for patients.

- " Improving financial policies to ensure social security " - Nguyen Tien Hung's speech at the workshop held at the Academy of Finance - Ho Chi Minh Branch.

- “ Implementing health insurance policy in our country: achievements, challenges and solutions ” by Associate Professor, Dr. Dao Van Dung (Propaganda Magazine No. 8 - 2009).

- “ Health insurance for the poor ” – Thesis by Nguyen Thanh Binh.

- “ The EU social security system and lessons for Vietnam ” by Associate Professor, Dr. Dinh Cong Tuan – Social Sciences Publishing House 2008.

- Scientific research topic: " Informal economic sector - current situation and issues raised in management " project leader Dr. Pham Van Dung.

In general, the above scientific works have mentioned many different aspects of the health insurance issue. However, there has not been any research on the development of health insurance in the informal sector in a fundamental, comprehensive and systematic way.

3. Research purpose and tasks

3.1. Research purpose.

Clarifying the theoretical and practical basis of health insurance in the informal sector. From there, analyzing the current situation and on that basis proposing solutions to promote and improve the effectiveness of health insurance in the informal sector in Hanoi in the coming time.

3.2. Research tasks.

- Systematize theoretical and practical issues on health insurance in the informal sector.

- Assess the current status of health insurance participation, achievements, limitations and ability to participate in health insurance of workers in the informal sector.

- Propose some solutions to develop the health insurance system in the informal sector.

4. Research object and scope

The research object of the topic is informal sector health insurance in Hanoi.

The scope of the research is the results of health insurance implementation in the informal sector in Hanoi up to 2010.

5. Research methods

- Methodological basis: The thesis researches using the methodology of dialectical materialism and historical materialism of Marxism - Leninism, Ho Chi Minh thought and the viewpoints of the Communist Party of Vietnam in the Party Congress documents on social security work in general and health insurance in particular.

- Research method: The thesis uses statistical methods, synthesis, analysis, investigation and inherits previous studies on related issues. Analyze legal documents on health insurance policies, available reporting information from different sources.

6. New contributions of the thesis

- Systematize theoretical and practical issues on health insurance in the informal sector in Hanoi.

- Analyze the current status of health insurance in the informal sector in our country, its successes and limitations.

- Propose some solutions to develop and expand the number of health insurance participants in the informal sector.

7. Thesis layout

In addition to the introduction, conclusion and list of references, the thesis consists of 3 chapters:

Chapter 1: Health insurance in the informal economy – theoretical and practical issues.

Chapter 2: Current status of health insurance in the informal economic sector in Hanoi.

Chapter 3: Some basic solutions to promote the development of health insurance in the informal economic sector in Hanoi in the coming time.

Chapter 1‌‌

HEALTH INSURANCE IN THE INDIRECT ECONOMY: THEORETICAL AND PRACTICAL ISSUES

1.1 Informal economic sector

1.1.1 Concept of informal economic sector

The concept of the informal economic sector (Informal sector) appeared in the late 60s. However, until now there has been no name, no unified concept of this economic sector. Because this is a very complex economic sector; in each country, this sector has very different characteristics; this sector can be studied and examined from different perspectives. Therefore, it is difficult to give a concise definition that fully covers the nature and characteristics of this sector. The definition of the informal economic sector of the United Nations, the International Labor Organization (ILO) has many reasonable points and is more suitable to the conditions of developing countries. In order to measure and evaluate the position and role of the informal economic sector in the national economy, the United Nations has defined: The informal economic sector is a production unit that uses inputs of capital, labor, goods and services to create certain goods or services performed by individual workers or households or small groups of workers but not registered according to the provisions of law, not implementing the business accounting regime. With this concept, the informal economic sector is considered not only by conventional criteria, but also by its internal structure; the informal economic sector is studied as a component part of the economy.

As a developing country, informal economic activities in Vietnam are quite common. In recent years, the informal economic sector has

The knowledge sector still retains its common characteristics and develops strongly due to the open economic mechanism and the economy developing more favorably towards the market. However, there are many conflicting opinions about the actual scale of this economic sector. Vietnam has a high labor structure in the agricultural sector, and due to the seasonal nature of agricultural production, since ancient times, during the off-season, farmers have always looked for additional jobs to increase their income and living standards. Non-agricultural jobs created by farmers have appeared since ancient times such as: men splitting bamboo strips, weaving; Women trade, raise silkworms, grow mulberry, weave... Gradually, along with the development of the productive forces, many other occupations appear: paper, ceramics, glass, textiles, food processing, metal forging... In each locality, due to different potentials and strengths, certain occupations are developed, forming different craft villages: Bat Trang pottery, Van Phuc silk,... Up to now, although craft villages have had ups and downs, they still continue to exist. In rural areas without craft villages, agricultural and non-agricultural production activities always coexist, complementing each other to meet the needs of production and life. It can be said that informal economic activities appeared in Vietnam very early.

The informal economic sector is the area consisting of people and households that have business activities but have not or do not need to register their business with the authorities. They include freelancers, individual business households, from shoe shiners, newspaper sellers, street vendors, motorbike taxi drivers to construction workers, service workers or other individual production households. Most of them are self-employed, some employ others. The informal economic sector is understood as the unregistered part of the private economic sector.

Researching on the forms of operation and labor organization in the informal economic sector in general, and in urban areas in particular, a number of research projects by the Ministry of Labor, War Invalids and Social Affairs have divided activities in the informal economic sector into the following main types:

- The first type: operating alone, including individuals doing freelance jobs such as: hawking, street vendors, barbers, tailors, cyclo drivers, motorbike taxi drivers, porters, housekeepers, tutors, lottery ticket sellers, newspaper sellers, shoe shiners... This group mostly operates in urban areas and is more diverse than in rural areas.

- The second type: collective activities organized by groups of people, but with little investment capital and rudimentary equipment. This type is often limited in scale to small households or a few people who contribute capital to organize and do business together.

In urban areas, the informal economic sector includes diverse economic activities in all fields and professions on a small scale, individualized, using mainly personal and family labor or hiring a small number of workers. These are private groups, small-scale private enterprises (less than 10 workers); individual business households and freelance individuals with production and business locations that are often unstable and do not specify working hours, most of which operate at home, in market alleys, train and bus stations, sidewalks, etc.

1.1.2 The role of the informal economic sector in Vietnam

The informal economic sector exists as an objective necessity, always subject to the impact of economic laws, socio-economic development policies as well as the effectiveness of the legal system at different levels depending on each country. This sector has become an integral part of the economy of all countries in the world, especially developing countries. In Vietnam, according to statistics, the informal economic sector provides

Health insurance for the informal economic sector in Hanoi - 2

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