Changes in the health care system of Vietnam in response to the emerging market economy.

This paper discusses the impact on the Vietnamese health care system of the change from a centralized socialist system to a market economy. It discusses recent policies based on expectations in relation to actual outcomes, and the impacts these changes have had on health care delivery and health infrastructure in Vietnam. It has become clear that the private medical sector is draining resources from the State rather than complementing the weakened national health system. Impacts on health education, pharmaceuticals, infrastructure support, geographic distribution of physicians, and equity are all discussed in terms of recent economic changes. It is suggested that adjustments must be made to ensure adequate health care for all Vietnamese including those in rural areas and the urban poor. The State must develop mechanisms to support the national health service before further deterioration occurs.