Tóm tắt tiếng anh: Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)

Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)Thực hiện chính sách bảo hiểm y tế đối với đồng bào dân tộc thiểu số (nghiên cứu thực tế tại tỉnh Lào Cai)

VIETNAM ACADEMY OF SOCIAL SCIENCES

GRADUATE ACADEMY OF SOCIAL SCIENCES

-NGUYEN VAN HUAN

IMPLEMENTATION OF HEALTH INSURANCE POLICIES FOR ETHNIC MINORITIES (CASE STUDY IN LAO CAI PROVINCE)

SUMMARY OF PUBLIC POLICY THESIS

HANOI – 2022

Work completed at:

VIETNAM ACADEMY OF SOCIAL SCIENCES

GRADUATE ACADEMY OF SOCIAL SCIENCES

Supervisor: 1 Dr Nguyen Duc Truyen

2 Assoc Prof Dr Nguyen Thi Song Ha

Reviewer 1: Assoc Prof Dr Pham Quang Hoan

Reviewer 2: Dr Nguyen The Vinh

Reviewer 3: Prof Dr Tran Trung

The thesis will be defended before the Academy-level Thesis JudgingCommittee meeting at the Graduate Academy of Social Sciences, 477 NguyenTrai, Thanh Xuan, Hanoi at (hour) date month year 2022

The thesis can also be found at:

- Vietnam National Library

- Graduate Academy of Social Sciences Library

INTRODUCTION

1 Urgency of the topic

In the cause of protecting and taking care of people's health,implementing health insurance policies for ethnic minorities is a taskthat the Party and State always pay special attention to However,besides the achievements, the implementation of health insurancepolicies for ethnic minorities is also revealing limitations that need to

be overcome

Lao Cai is a mountainous province with a diversity in ethniccomposition and culture Besides the achievements in implementinghealth insurance policies for ethnic minorities, Lao Cai is also facingdifficulties that need to be overcome With the desire to makecontributions to improving the effectiveness of the implementation ofhealth insurance policies for ethnic minorities, I have chosen the

topic " Implementation of health insurance policies for ethnic minorities", as the topic of my doctoral thesis major in Public policies.

2 Research objectives and tasks of the thesis

2.1 Research objectives of the thesis

On the basis of systematizing and clarifying theoretical issues,analyzing the current situation and evaluating the results of theimplementation of health insurance policies for ethnic minorities(from practice in Lao Cai province), the thesis proposes viewpoints,directions and policies solutions to better implement health insurancepolicies for ethnic minorities in the next period

2.2 Research tasks of the thesis

- Systematize and review research works related to the topic'scontent;

- Clarifying the general theoretical issues of implementinghealth insurance policies for ethnic minorities from the perspective ofpublic policies;

- Analyze the current situation and evaluate the results of theimplementation of health insurance policies for ethnic minorities(practical study in Lao Cai province);

- From the perspective of public policies, propose appropriateviewpoints and solutions to improve the effectiveness of theimplementation of health insurance policies for ethnic minorities inthe next period

3 Research objects and scope of the thesis

3.1 Research objects of the thesis

The research object of the thesis is the policies and organization

of implementing health insurance policies for ethnic minorities inLao Cai province

3.2 Research scope of the thesis

- In terms of content: The thesis focuses on researching

theoretical and practical issues on the organization andimplementation of health insurance policies (process and result ofimplementation of health insurance policies) for ethnic minoritiesfrom the perspective of public policies

- About time: The research contents (theory and practice) are

limited by the thesis from 2014 - the time when the Law on HealthInsurance was amended and supplemented from 2014 to 2021

east, Yen Bai province to the south, Lai Chau province to the west,and Yunnan province - China to the north with a 203 km border Thepopulation as of April 1, 2019 of Lao Cai province is 730,420 people,

of which 483,654 are ethnic minorities, accounting for over 66.2%[112] The province has 152 communes belonging to 7 districts, 1town and 1 city, divided into: Region I: There are 25 communes;Area II: There are 37 communes/166 villages with specialdifficulties; Area III: There are 102 communes/841 villages withspecial difficulties

4 Research methodology and method of the thesis

4.1 Research methodology of the thesis

The thesis is based on the basic methodology of dialecticalmaterialism and historical materialism in the study of social life, thestate, policies, public policies, social policies and health insurancepolicies In addition, the thesis is also based on the system ofguidelines and guidelines of the Communist Party of Vietnam onethnic minority policies and implementation of health insurancepolicies for ethnic minorities

4.2 Research method of the thesis

Firstly: method of document analysis

This method is used to make the most of the system ofdocuments and research results related to the implementation ofhealth insurance policies for ethnic minorities In which, focus is onanalyzing documents related to: (i) guidelines and guidelines of theParty, policies and laws of the State on the implementation of healthinsurance policies for ethnic minorities, (ii) research works onimplementing health insurance policies for ethnic minorities ingeneral and in Lao Cai province in particular, (iii) reports, data,

statistical yearbooks at central and local levels on the implementation

of health insurance policies for ethnic minorities, etc

Secondly: ethnographic fieldwork method

- The purpose of this method is to obtain rich and detailed data

on health system practices and beneficiaries of health insurancepolicies of ethnic minorities in Lao Cai province on the basis ofcontact with EM people at the sites, through recording andobservation, etc Fieldwork area: Y Ty commune, Bat Xat districtand Tan Thuong commune, Van Ban district Time for fieldwork: 4days/commune

Thirdly: survey method by questionnaire

- The purpose of using this method is to collect information of

the subjects to reinforce the thesis's statements The survey content

focuses on the following aspects: health status, selection of medical examination and treatment places, forms and methods of treatment, assessment of the quality of medical examination and treatment covered by health insurance of ethnic minorities; the support of subjects for ethnic minorities in medical examination and treatment covered by health insurance; Expectations of ethnic minorities about health insurance policies in the coming time, etc.

- Research objects:

+ Ethnic minorities living in ethnic minority areas

+ Medical officers and staff working in ethnic minority areas

Sampling method and structure: The thesis uses a random convenient sampling method 185 votes were distributed and 181votes were collected

Data processing techniques: Data was processed by SPSS software

5 New scientific contributions of the thesis

Firstly, the thesis has systematized and evaluated the research works

related to the implementation of health insurance policies for ethnicminorities from the perspective of public policies;

Secondly, the thesis has continued to clarify the general

theoretical issues of implementing health insurance policies forethnic minorities from the perspective of public policies approach.The thesis continues to clarify the concepts of "implementation ofpublic policies", "implementation of health insurance policies" and

"implementation of health insurance policies for ethnic minorities";the role of implementing health insurance policies for ethnicminorities; The process of implementing health insurance policies forethnic minorities; The system of subjects implementing healthinsurance policies for ethnic minorities, etc.;

Thirdly, the thesis has evaluated and analyzed the current

situation and problems posed in the implementation of healthinsurance policies for ethnic minorities In which, the results andissues are raised related to the subject system, the implementation,inspection and propaganda of the implementation of health insurancepolicies for ethnic minorities;

Fourthly, the thesis has proposed viewpoints, orientations and

solutions to improve the effectiveness of the implementation ofhealth insurance policies for ethnic minorities in the next period Thebasic solutions to improve the effectiveness of the implementation ofhealth insurance policies for ethnic minorities are emphasized by thethesis: Renovate and perfect policies contents, improveorganizational and implementation efficiency, improve servicequality, renovate financial mechanism and promote policiespropaganda, etc

6 Theoretical and practical significance of the thesis

6.2 Practical significance

The assessment and analysis of the actual implementation ofhealth insurance policies for ethnic minorities from the reality of LaoCai province can help managers and researchers have more specificperspectives on the implementation of health insurance policies forethnic minorities in our country today The viewpoints and solutionsgiven by the thesis are suggestions for management agencies inbuilding, renovating and perfecting the implementation of healthinsurance policies for ethnic minorities in practice In addition, thethesis can be used as a reference for those interested in this field

7 Thesis structure

In addition to the introduction, conclusions andrecommendations, list of references and appendices, the thesisincludes 4 chapters:

Chapter 1: Overview of research scenario;

Chapter 2: Theoretical issues for the implementation of health insurance policies for ethnic minorities;

Chapter 3: Actual situation of implementing health insurance policies for ethnic minorities from the reality of Lao Cai province; Chapter 4: Proposing viewpoints, orientations and solutions to implement health insurance policies for ethnic minorities.

Chapter 1 RESEARCH SITUATION OVERVIEW

1.1 Research work on implementing public policies and health insurance policies for ethnic minorities

1.1.1 Research work on public policies implementation

In recent years, the issues of public policies and public policiesimplementation are topics that have attracted a lot of attention fromboth scholars and managers Notable works can be mentioned suchas: “Planning and analyzing public policies” (Statistics PublishingHouse, 2002) by Nguyen Huu Hai and Pham Thu Lan; "Basic issues

of policies and policies process" (Ho Chi Minh City NationalUniversity Publishing House, 2000) by Le Chi Mai; "Public PoliciesScience" (National Program Publishing House, 1999) by Ho NgocMinh; "Public Policies" (Information and Communication PublishingHouse, 2014) by Pham Quy Tho, Nguyen Xuan Nhat; "PublicPolicies: Theory and Practice" (Judicial Publishing House, 2017) byCao Quoc Hoang, Nguyen Do Kien; "Public policies of the UnitedStates" (Statistics Publishing House, 2001) translated by author LeVinh Danh; etc

1.1.2 Research project on implementing health insurance policies for ethnic minorities

Among the studies on the implementation of health insurancepolicies for ethnic minorities from the perspective of public policiescan be mentioned: "Contributing to perfecting the model of medicalcare and treatment with health insurance at commune health stations"

by Luong Ngoc Khue (Medical Publishing House, 2011); “Overview

of relevant health programs and orientation towards sustainablepoverty reduction for the people” by Vu Hoang Lan et al (Ministry ofLabour, Invalids and Social Affairs, Ministry of Health, 2015);

Report “Towards universal health insurance coverage inVietnam – Assessment and solutions” (World Bank, 2014) byAparnaa Somanathan et al., etc.

1.1.3 Research project on ethnic minorities and health insurance policies for ethnic minorities in Lao Cai province

Among the relevant research works on ethnic minorities andhealth insurance policies for ethnic minorities in Lao Cai province,some typical works can be mentioned such as: Doctoral thesis in

History "The process of economic and social changes in Lao Cai province from 1991 to 2010" by Nguyen Thi Nguyen (VNU

University of Social Sciences and Humanities); Doctoral thesis inEconomics "Improving Livelihoods for Ethnic Minority Households

in Lao Cai Province, Vietnam" by Kim Sun Ho (Vietnam NationalUniversity of Agriculture); Report "Analysis of the situation of children

in Lao Cai province" jointly implemented by People's Committee of LaoCai province and Unicef (Hanoi, 2016); Five-year summary report(2007-2011): “Poverty monitoring by participatory method in some ruralcommunities in Vietnam” (2013) implemented by Oxfam Vietnam andActionaid in 9 provinces across the country, including Bac Ha district,Lao Cai province

1.2 Evaluation and information that need further research

1.2.1 Evaluation of the research situation

Firstly: In general, the research works aim to analyze the system

of guidelines, policies and the current state of health insurancepolicies of the state for ethnic minorities; Secondly: Studies on theimplementation of health insurance policies for ethnic minoritieshave continued to contribute to clarifying awareness and pointing outissues of concern about ensuring health insurance for ethnicminorities in Vietnam However, studies on implementing health

insurance policies for ethnic minorities in Vietnam are currentlyscattered, not systematic and have not clarified the specificities ofimplementing health insurance policies for ethnic minorities; Thirdly:The research works on the actual implementation of health insurancepolicies for ethnic minorities in general and in Lao Cai in particular,although not comprehensive and complete, have partly clarified thepicture of the ethnic minorities receiving the policies However,despite pointing out the actual situation, the studies only stopped atdescribing the results of participation in health insurance as the mainand still scattered, there has not been a comprehensive assessment ofthe actual implementation of health insurance policies for ethnicminorities from the perspective of public policies; Fourthly: From theanalyzed situation, the research works have proposed many solutions

to improve the effectiveness of the implementation of healthinsurance policies for ethnic minorities Each work, from its ownperspective, has proposed many solutions and recommendations withhigh scientific and practical value These are important suggestionsfor the thesis to absorb and propose solutions to improve theeffectiveness of the implementation of health insurance policies forethnic minorities in the coming time

1.2.2 Inherited contents and needing further study

Compared with the research objectives and tasks, the thesisdetermines that it is necessary to further clarify some contents such

as: Clarifying the theory of implementing health insurance policies for ethnic minorities; point out the actual implementation of health insurance policies for the ethnic minorities in Lao Cai in particular and the actual implementation of health insurance policies for the ethnic minorities in Vietnam in general From the perspective of public policies, the thesis needs to propose viewpoints and solutions

to improve and innovate the implementation of health insurance policies for ethnic minorities in Vietnam.

Brief conclusion of chapter 1

The review results show that there have been many studies onthe implementation of public policies in general and theimplementation of health insurance policies for ethnic minorities inparticular From the perspective of the subject approach, it can be

divided into the following groups of works: Group of studies on public policies implementation in general; Group of studies on the implementation of health insurance policies for ethnic minorities; Research group on implementation of health insurance policies for ethnic minorities in Lao Cai.

Chapter 2 THEORETICAL ISSUES FOR THE IMPLEMENTATION

OF HEALTH INSURANCE POLICIES FOR ETHNIC

MINORITIES 2.1 General theoretical issues on public policies implementation

2.1.1 Public policies implementation concept

Public policies implementation is "the process of transforming the goals and contents of the policies formed during the planning process into reality".

2.1.2 Public policies implementation process

The public policies implementation process usually consists of 7steps:

Step 1: Develop a policies implementation plan; Step 2:Disseminate and propagate the policies; Step 3: Assign coordination

to implement the policies; Step 4: Maintain policies; Step 5: Adjustthe policies; Step 6: Check policies implementation; Step 7:Summarize policies implementation

2.1.3 Factors that affect the public policies implementation process

Firstly: Objective factors

Objective factors affecting public policies implementation

include: The nature of the policies problem; Policies environment; The relationship between the objects implementing the policies; Potential of policies object groups, etc.

Secondly: Subjective factors

Subjective factors are expressed in a number of aspects such as:

Capacity to develop plans to implement policies; Capacity to disseminate