Model of Some Related Studies.

people in a more profound and practical way. Not only does it raise awareness of the benefits of health insurance, but it must also be combined with raising awareness of community benefits and sharing to help limit ethically risky behavior.

-Improve the quality of medical care with health insurance. According to the report of the UBTVQH (2013), the quality of medical care with health insurance is one of the reasons leading to the low health insurance participation rate. Improving the quality of medical care with health insurance will increase the value of health insurance.

- Adjust prices of medical services, especially services related to outpatient medical care to limit ethical risks in outpatient medical care. However, pricing policies need to be carefully calculated to limit moral risks while ensuring social security. Besides, it is necessary to design appropriate health insurance fees to avoid increasing service prices leading to fund bankruptcy.

-Design more health insurance packages to serve many different subjects. Research results show that region 1 (Red River Delta) and region 5 (Southeast) have low health insurance participation rates even though these are regions with high average income. Therefore, it is possible to introduce an advanced type of health insurance in addition to the basic type of health insurance, allowing users to enjoy better services to meet more medical needs.

Maybe you are interested!

Limitations of the topic.

Because the study is based on the VHLSS data set, the health factor, the most important factor in this study, has not been evaluated completely accurately. In addition, other factors that affect the ability to buy health insurance as well as the number of medical examinations such as distance to medical facilities, fees, and service quality have not been considered, leading to the level of explanation of the medical facilities. model is not high.

The study only provides a conclusive model about whether or not there is adverse selection and moral hazard, but cannot compare between different policy periods to be able to assess the level of moral hazard and choice. Whether or not the backlash will decrease after implementing the new policy.

Propose further research directions

Using more specialized medical data with more information about health, adding factors related to the decision to buy health insurance as well as the number of medical examinations to get more accuracy in conclusions and functions. policy idea.

Future research directions can consider choosing a model that can evaluate the increase or decrease in adverse selection and moral hazard through policy changes as well as in-depth research. , more specifically about moral hazard behavior for each type of health insurance.

Regional factors have an impact on both the probability of purchasing health insurance and the number of inpatient and outpatient medical examinations. Future research can delve into regional characteristics to further explain the differences in health insurance. Number of medical examinations and ethical risk behavior between regions.

REFERENCES

List of Vietnamese documents

Ministry of Health, 2011. Report on research results on the possibility of implementing universal health insurance .

Dao Van Dung, 2009. Implementing health insurance policy in our country: Achievements, challenges and solutions . Propaganda Magazine , No. 08-2009. < http://tuyen Giao.vn/Home/MagazineContent?ID=871 > [Access date: February 2, 2015]

Ha Thuc Chi, 2011. Balancing the medical examination and treatment fund under health insurance from a management perspective. Social Insurance Magazine.

<http://tapchibaohiemxahoi.gov.vn/newsdetail/lyluan_nghiepvu/12715/news.htm#>[Access date: February 2, 2015]

Ho Si Sa, 2000. Insurance textbook . National Economics University.

Le Manh Hung, 2012 . Research on some basic factors affecting revenue and expenditure of health insurance medical examination and treatment fund, period 2002-2006 . Doctoral thesis. Hanoi University of Pharmacy.

Health Insurance Law , 2008. No. 25/2008/QH12

Law amending and supplementing a number of articles of the Health Insurance Law , 2014. No. 46/2014/QH13

Nguyen Van Ngai and Nguyen Thi Cam Hong, 2012. Asymmetric information in the voluntary health insurance market: The case of Dong Thap province. Scientific magazine of Ho Chi Minh City Open University, No. 4 (27) 2012.

Pindyck, RS, and Rubinfeld, DL, 1991. Microeconomics. 3rd edition. Translated from English, National Economics University, 1999. Statistics Publishing House, Hanoi.

Standing Committee of the National Assembly, 2013. Report on results of monitoring the implementation of policies and laws on health insurance in the period 2009-2012 , No. 525/BC-UBTVQH13.

Institute for Legislative Studies, 2013. Universal Health Insurance - Current Situation and Opinions

recommendation.

Institute for Legislative Studies, 2013. Foreign experience in organizing medical examinations

diseases and treatment for health insurance participants, and recommendations to contribute to the development of the Vietnam Health Insurance Law.

List of English documents

Adhikari, BK and O'Leary, VE, 2008. Gender differences in risk aversion: A developing nation's case. Journal of Personal Finance , Vol 10, Issue 2, pp.122- 147.

Akerlof, GA, 1970. The Market for “Lemon”: Quality Uncertainly and the MarketMechanism . The Quarterly Journal of Economics , Vol.84, No.3, pp.488-500.

Albert, S.M. and Duffy, J., 2012. Differences in risk aversion between young and older adults. Neurosci Neuroecon . doi:10.2147/NAN.S27184.

Baker, T. and Jha, S., 2012. The economics of Health Insurance. Journal of the American College of Radiology , Vol.9, Issue 12, pp.866-870.

Barros, PP et al., 2008. Moral hazard and the demand for health services: A matching estimator approach. Journal of Health Economics , 27 (2008) 1006–1025.

Cameron, AC and Trivedi, PK, 2005. Microeconometrics Methods and Applications . Cambridge University Press.

Carrin, G. and James, C., 2005. Social health insurance:Key factors affecting the transition fowards universal coverage . International Social Security Review, Vol.58, January 2005.

Cuong, NV, 2011. The impact of voluntary health insurance on health care utilization and out of pocket payments: new evidence for Vietnam .Health Economics , Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/hec.1768.

Dong,Y., 2012. How Health Insurance affects health care demand – A structural analysis of behavioral moral hazard and adverse selection. Economic Inquiry , Vol 51, Issue 2, pp.1345-1356 .

Feldstein, MS, 1973. The Welfare Loss of Excess Health Insurance. The Journal of Political Economy , Vol. 81, No. 2, pp. 251-280.

Ha, NT and Leung, S., 2010.Dynamics of health insurance ownership in Vietnam, 2004 – 06 .The Australian National University . CEPR Discussion Paper ,No. 643.

Hutchinson, MK and Holtman, MC, 2005. Analysis of Count Data Using Poisson Regression. Research in Nursing & Health , 2005, 28, 408-418.

Jowett, M., 2001. Voluntary Health Insurance in Vietnam: An evaluation.

Health and Population - Perspectives and Issues 24(1): 29-44, 2001.

Kefeli, Z. and Jones, G., 2012. Moral Hazard and the Impact of Private health insurance on the utilization of health care in Malaysia. Jurnal Ekonomi Malaysia, Vol. 46, No. 2, pp. 159 – 175.

Long, J.S. and Freese, J., 2005. Regression Models for Categorical Dependent Variables Using Stata. Stata Press.

Minh, NT et al., 2012. The impact of Asymmetric Information in Vietnam's Health Insurance: An Empirical Analysis .Journal of Economics and Development ,Vol.14, No. 3, pp. 5-21.

Normand, C. and Weber, A., 2009. Social Health Insurance. A guide book for planning . World Health Organization and International Labor Office.

OECD, 2004. Private Health Insurance in OECD Countries . OECD, 2004. Proposal for a taxonomy of Health Insurance .

Pauly, MV, 1974. Overinsurance and Public Provision of Insurance: The Roles of Moral Hazard and Adverse Selection. The Quarterly Journal of Economics , Vol. 88, No. 1, pp. 44-62

Phuong, NV, 2013. Moral Hazard Problems Under Public Health Insurance Evidence from Vietnam . VNU Journal of Economics and Business , Vol. 29, No. 5E (2013) 56-66.

Savage, E. and Wright, DJ, 2003. Moral hazard and adverse selection in Australian private hospitals: 1989–1990. Journal of Health Economics , Vol 22 (2003), pp.331–359.

Tomislav, V. and Danijel, N., 2008. Asymmetric Information in Health Insurance: Some Preliminary Evidence from the Croatian Sate- Administered Supplemental Plan. Privredna kretanja I ekonomska politika , 115/2008.

Wang, H. et al., 2006. Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China. Social Science & Medicine 63 (2006) 1236– 1245 .

Wolferen, JV et al., 2013. Moral Hazards in the insurance industry . The Netspar Panel papers 33.

World Health Orgainzation and Ha Noi Medical University, 2012. Assessment of Financial Protection in the VietNam health system: analyzes of VietNam Living Standard Survey Data 2002 -2010 .

APPENDIX

Appendix 1. Models of some related studies.

Research by Tomislav and Danijel Vukina and Danijel Nestic (2008)

Croatia's state health insurance system includes mandatory health insurance and supplementary health insurance. All Croatian citizens have mandatory health insurance. Compulsory health insurance in Croatia only provides basic health services for people free of charge, while other health services must be paid from 15-50%, so there is also additional health insurance. People with supplementary health insurance will receive most medical services for free at a pre-determined maximum cost, and can choose to buy or not buy this type of supplementary health insurance.

 Check for existence of adverse selection:

Tomislav and Danijel believe that with this type of supplementary health insurance, there will easily be an adverse selection problem because only people with poor health think they need to use medical services outside the list of free medical examination and treatment. new purchase fee.

To study individual choices, the author uses a survey data set that includes personal information such as age, gender, marriage, education, occupation and 2 medical questions.

Question 1: type of health insurance that the individual uses (compulsory health insurance, supplementary health insurance, private health insurance or no health insurance)

Question 2: personal health status (very good, good, average, poor, very

least).

Testing the hypothesis that adverse selection exists in decision making

Purchasing additional health insurance is performed on a logit model, with the dependent variable Y = 1 or 0 (= 1 if the person has purchased additional health insurance and = 0 if not). Tomislav and Danijel use two logit models.

1st logit model: Y = β 0 + β i X i + u i

with explanatory variables X i including: gender, age, marital status, urban area, education level, occupation, income.

Second logit model: Y = β 0 + β i X i + αH i + u i

least)

With H i is an additional variable of health status (very good, good, average, poor, very

If adding the health status variable H i improves the fit of

If the model and parameters are statistically significant, it can be thought that the problem of backward selection is important.

After comparing the two models, it shows that the model fit has not improved much and the parameters have not changed significantly. The author concludes that adverse selection does not exist in the Croatian supplementary health insurance program.

 Check the existence of moral hazard:

Tomislav and Danijel hypothesize that people with additional health insurance will prefer to use medical services more than people with only compulsory health insurance. He used an OLS regression model to test the existence of moral hazard.

OLS regression model: dependent variable Y is the number of medical examinations

The model's explanatory variables include: type of health insurance used, gender, age, and occupation.

The results show that people with supplementary health insurance or free health insurance have more medical visits than people with only compulsory health insurance. In addition, the number of medical examinations and treatments for people with supplementary health insurance is also higher than for people with free health insurance. This is due to the effects of both adverse selection and moral hazard. The number of medical examinations and treatments of people with supplementary health insurance may be due to the impact of adverse selection (people with poor health only buy and therefore often seek more medical treatment due to their health) and due to the impact of moral hazard. (like to use the service more because they have bought health insurance), while people with free health insurance are only affected by moral hazard. The author concludes that the difference between the number of medical examinations and treatment between these two subjects compared to people with compulsory health insurance is the impact of moral hazard.

Research by Hong Wang et al et al (2006)

Hong Wang et al (2006) conducted a study based on a dataset of 3492 residents from 1020 households in a rural area of China.

The author uses logistic regression with the dependent variable Y being health insurance registration status (with value 1 meaning health insurance registration and 0 meaning not registered). Independent variables include:

Health status: The health index used in this study is based on two health questions. Question 1: “Have you had any health problems in the month before the interview?”. Question 2: “If you had any health problems in the month before the interview, how serious were those health problems?” with the answer being “not serious” or “serious”. Based on the two questions above, health status is classified into 3 groups: good health, average health and poor health.

Other control variables: Age, gender, household size, marital status, education level, income, and distance from home to health center.

Regression results show that people in poor or average health participate in health insurance 2.59 and 1.26 times more than people in good health in partially registered households. In addition, age, marital status and distance to the nearest medical facility were also statistically significant. In addition, to see the hidden impact of adverse selection, the author makes statistics on medical spending and concludes that individuals participating in health insurance often have higher medical spending than those who do not participate.

Research by Kefeli and Jones (2012)

In Malaysia, private health insurance (PHI) in Malaysia only covers inpatient treatment or hospitalization. This study uses a probit model to test the existence of moral hazard on the use of medical services by people with PHI health insurance compared to people without PHI, with the hypothesis that people with PHI are more likely to have health insurance. more likely to use health services or spend more on health care because they know they are protected. The author shows that there is evidence of the existence of moral hazard in 1996 but not in 2006. In addition, the results also show that individuals with low income, low education level, living in the

Comment