Factors Impact on Revenues of the Health Insurance Fund in Vietnam

Purpose of the Study - To systematize the basic theoretical issues relating to revenue, revenue development and factors that impact the health insurance fund revenues.. - Scope of the s

INTRODUCTION

1 Rationale of the Study

Social insurance and health insurance are great social policies of our Party and

Government These kinds of insurance are always main factors in the social security

system of each country, especially today when the Earth's climate is changing rapidly

in a negative direction and aging speed of population is happening rapidly In our

country, after the economy has transfered to the market economy, the Party and State

have had clear views and policies relating to medical field under the spirit of the

Party's Sixth Congress: "State and citizens are working together "[31] From this point

of view, health insurance policies were launched and gradually were developed until

today At the VIII Congress of the Party, opinion relating to developing health

insurance was included in the Resolution orientation for the first time Accordingly,

"investment for the State is increased, and other funding sources such as health

insurance are created more for health insurance to develop" [32 ] After that, the

Congress IX stated that: "Implementing social justice in health care, and try to

universalize health insurance in the future" [33] In the Congress X and XI, the

opinion of the Party and the State about developing universal health insurance has

shown more clearly under the spirit: "Building a diversity social security system,

strongly develop social insurance system, health insurance and try to develop universal

health insurance for the whole citizens "[34,35] Realizing these views and

orientations, we have institutionalized health insurance policies with a series of legal

documents and started with the Decree 299 / HĐBT in 1992, the Decree 58/1998 /

ND-CP of 1998, the Decree 63/2005 / ND-CP in 2005 and the most important was the

Health insurance Policies adopted by the National Assembly on 14.11.2008 and was

come into effect from the date 01/7/2009

Since health insurance was applied in our country so far, its impact on life -

society economy has been great Specifically, thanks to the policy, the number of

insured people increased rapidly over the years, there have been nearly 70% of the

population benefited from health insurance Accordingly, health insurance fund

revenues also increased rapidly, thus the burden on the state budget reduces significantly In particular, the poor, those who are living in remote and isolated areas have opportunities to get health care through health insurance with the great help from the Government However, the deployment process of health insurance policies in our country has always faced difficulties and challenges Among these difficulties, fiscal health insurance, health insurance revenues and expenditures to ensure the health insurance fund balances to emerging issues is always the toughest issue This is because, collecting money cannot cover costs, which leads to imbalance in the health insurance fund Meanwhile, health insurance is the main and important financial source for each country to cover the costs of medical care for people when they are sick, which makes social security sustainable

So how can we balance the income - cost health insurance fund in Vietnam? This

is a tough, the difficult problem, because it is a broad "economics - society" matter Only one left-hand sided issue of this equation (revenue MI) also has a lot of issues needed to be resolved, such as; health insurance revenues, organizing the collection, managing and collecting health insurance

From this reality, the author does not have the ambition to find an absolute solution for this precise big problem, but the author expected to find a part of the solution and decided to choose the research title: "The factors impact to the revenues

of the health insurance fund in Vietnam" for this dissertation in economics

2 Purpose of the Study

- To systematize the basic theoretical issues relating to revenue, revenue development and factors that impact the health insurance fund revenues

- Analysis of the current situation and the factors impacting to health insurance revenue in Vietnam Thereby, the dissertation clarifies the factors that mainly impact revenues of the health insurance fund

- Recommend perspectives, orientation, solutions to develop the health insurance fund revenue in Vietnam

3 Objects and Scope of the Study

- Research Objects: Factors affecting to health insurance fund revenues

- Scope of the study:

+ Space: Revenues and factors affecting to the health insurance fund revenue in

Vietnam (including compulsory health insurance and voluntary health insurance)

+ About Time: The dissertation focuses on studying real situation of income and

the factors affecting to health insurance fund revenue in Vietnam Especially since the

health insurance policies went into implementation from 2010 to 2014 with

comparative analysis with the operation period of health insurance activities since its

founding in 1992 up to now Thereby, the dissertation proposes solutions to develop

the health insurance fund revenues, contributing to balance the health insurance fund

4 Research Method

Descriptive cross-sectional research method is employed with combination of

qualitative and quantitative methods The dissertation uses some common techniques

such as collecting information, statistics and synthesize to analyse revenues and

factors that impact health insurance fund revenues

The dissertation uses the methodology of dialectical materialism and historical

materialism to further clarify and systematize the basic theoretical issues about health

insurance, health insurance fund revenues

Method to collect information:

Information is gathered from secondary data including statistical yearbook of the

General Statistics Office of Vietnam (GSO), the survey data about Vietnam Household

Living Standard (VHLSS in 2010 and 2012) of the GSO with technical assistance from

World Bank From the annual report on the collection of social insurance Vietnam, the

data collected from the related ministries and agencies such as the Ministry of Labour,

Invalids and Social Affairs, Ministry of Health, Ministry of Finance

Information sources gathered from the primary data are the direct survey and

interview from insured subjects through the questionnaire including: Intentional

survey collected from 400 managers, inspectors of the Social Insurance from all 63

provinces and cities nationwide and staff collecting insurance and the Vietnamese social Insurance board of examination; The author randomly chooses 60 employers selected from enterprises in Hanoi; Intentionally selects 200 employees who were insured in Da Nang; 110 people in Hanoi who are not insured are purposely choosen The total surveys collected for primary information are 770 questionnaires

The survey results are: the author collected 394 questionnaires from revenue managers, social workers who check social insurance from the entire 63 provinces and cities across the country, 52 questionnaire from enterprises, 196 questionnaires from insured people and 103 questionnaires from people without valid health insurance coverage

From the information in the questionnaires, the primary data are processed through SPSS software to analyze, synthetic and clarify the factors affecting to health insurance fund revenues Integrated approaches to analysis mainly used are disaggregated statistics and indicators in combination with the comparative method, with reference to clarify the contents to be analyzed

Methods to analysis and synthesis: On the basis of accumulated knowledge about health insurance, health insurance financing combined with consulting materials both inside and abroad in this field, the author analyzes, synthesizes and systematizes in-depth the basic theoretical issues about health insurance, collected money and revenues of the health insurance fund as well as the factors affecting the revenue Statistical Methods: The dissertation uses synthetic statistics methods such as statistical disaggregation method, indices, reference on the collection situation, the factors affecting the health insurance fund revenues Then it proposes suitable solutions for the development of the health insurance fund revenue in Vietnam to operate safely, sustainably health insurance fund

5 Research Overview about revenues and the factors affecting to the revenues of the health insurance fund

5.1 Studies in the world

1 Diamond;P, 1992, Organizing the Health Insurance Market, Econometrica, 60 (6), 1233 - 1254 [77]

2 Joint NGO Briefing Paper, May 2008: "Health Insurance in low - income

countries" [68]

3 Research of the American Medical Association (2005) "Expanding US health

insurance: AMA proposal for reform", "Mở rộng bảo hiểm y tế Mỹ - dự án cải cách của

AMA" [66]

4 Carrin G (2002) "Social health insurance in developing countries: A

continuing challenge" [74]

5 Dey, M.S and Flinn, C.J., 2005, An Equilibrium Model of Health Insurance

Provision and Wage Determination, Econometrica, 73 (2), 571 - 627 [76]

6 Borrell, C., Fernandez, E., Schiaffino, A., B enach, J., Rajmil, L., Villalbi, J.R

and Segura, A., 2001, Social class inequalities in the use of and access to health

services in Catalonia, Spain: what is the influence of supplemental private health

insurance?, International Journal for quality in Healthcare, 13 (2), 117 – 125 [72]

7 Euson T, San PB Health clarges and exemptions in Vietnam Bamako Initiontive

Operations Research Programme Paper No 1, 1996, UNICEF New York [81]

8 Hiroi Yoshinnosi (professor, Univercity ChiPa) “Social security, medical

insurance in Japan and suggestions to apply in Vietnam” [35]

5.2 Studies in Vietnam

1 Lê Minh Phiêu (2010): " Reorganization of Vietnamese health insurance

system " – Montesquieu University - France [41]

2 Ass.Prof Dr Phạm Tất Dong và Dr Đàm Viết Cương (9/2002) "User fees,

health insurance and the use of health services" in the health cooperation program

Vietnam - Sweden [46]

3 Dr Trần Văn Tiến (2002) in the book " User fees, health insurance and the

use of health services, also has a journal titled "The draft of the roadmap towards

universal health insurance " [65]

4 Phạm Lương Sơn (2012): "Study drug bidding situation for the base health

insurance and treatment in Vietnam " – Economic Dissertation [44]

5 Dr Lê Duy Đồng và Dr Bùi Sỹ Lợi (2001) published the book " Orientations policy

on social development and social development management period 2011 - 2020" [38]

6 Phạm Thị Thu Hường (2013) " Voluntary health insurance in the province of Vinh Phuc - problems and solutions ", Economic Dissertation [47]

7 Dr Đỗ Văn Sinh (2011) “Scientific evaluation schemes to evaluate operation

of social security funds, health insurance, forecast balance calculations social security funds, health insurance until 2020 and vision to 2030” [34]

5.3 Issues needed for further study

Theoretical Gaps: the concepts of the health insurance fund revenues, distinguishing revenue collection activities with health insurance, evaluation indicator system assessing the growth of the revenue, the factors affecting the revenues of the health insurance fund

Gaps in research methodology: Since most of the factors affecting the health insurance fund's revenues are qualitative factors, and there are only few quantitative indicators are: The number of objects and structure of object insured health insurance premiums Therefore, the dissertation uses survey methods using questionnaires with respondents are: health insurance managers, different stakeholders to collect the primary data Then the author uses the method to synthesize, analysize data sources to assess the impact of each factor to the health insurance fund revenues

Gaps in practice: The dissertation conductes a comprehensive, detailed and objective analysis factors affecting the revenues of the health insurance fund in Vietnam

Analysis of factors affecting to health insurance fund revenues in Vietnam to be studied from the perspective of management and policy makers as well as policy implementation Therefore, solutions and recommendations of the dissertation are to purify the policy and it is expected that these policies will quickly come to real life

6 New Contributions of the Study

- New academic, theoretical contributions:

+ The dissertation studies and puts forward the concepts of the health insurance fund revenues, distinguishing revenue to processing, health insurance collecting mechanism

+ Identifies factors that affect to the income of the health insurance fund, explains and clarifies contents of each factor

+ Proposes indicators to assess the development of the health insurance fund

revenues

- New findings drawn from the research findings:

+ Analysis and clarify the status of revenue collection and the health insurance

fund in Vietnam (2010-2014)

+ Clearly identifies factors affecting to the health insurance fund revenue in

Vietnam, including policies and laws on health insurance; objects and structure of

participants; the rate and method of collecting health insurance; Working mechanisms

and organization of the collection; the propagation and dissemination of policies and

legislation; the monitoring and inspection of the implementation of health insurance

and the coordination between the authorities involved in health insurance

+ Proposes some solutions to develope the health insurance fund revenues;

including measuring policies and implementing health insurance policies in Vietnam

7 Conclusion

Besides the introduction, conclusion, list of references, appendices The thesis is

structured into three chapters:

Chapter 1: Rationale and practice on the factors affecting the revenues of the

health insurance fund

Chapter 2: Analysis of the factors affecting the revenues of the health insurance

fund in Vietnam

Chapter 3: The views, orientation and development solutions revenues of the

health insurance fund in Vietnam

CHAPTER 1 RATIONALE AND PRACTICES OF FACTORS IMPACTING TO REVENUES OF THE HEALTH INSURANCE FUND 1.1 Background of health insurance

1.1.1 The concept and characteristics of health insurance

1.2.1.1 Concepts Health insurance is a policy of the State Social security, with community, risk-sharing characteristics, based on the contributions of those who participated in the fund, with the support and patronage of the State for the purpose of paying the cost of medical care for members in the community when they are sick, get diseases It runs with non profit

1.1.1.2 Characteristics of health insurance Health insurance is an objective, diversified and complex need of a society; Health insurance is a social policy lying in a system of social security policies of each country

Sharing financial calculation, risk sharing important contents are always the nature of health insurance

Health insurance involves a lot of parties, depending on the types of health insurance

1.1.1.3 Features of health insurance Firstly, health insurance is a social policy with broad, diversed object with great coverage; therefore, it should be legalized

Secondly, health insurance operates with non profit

Thirdly, health insurance always reflects economical, social, humanitarian and noble humanity

Fourthly, the financial resources meeting the needs in health insurance policies always encounter complex difficulties because eligible subjects for health insurance are extensive

Fifthly, the development of policies and institutions implementing of health insurance policies in different countries are different

1.1.2 The role of health insurance

1.1.2.1 Protecting financial situation for participants

1.2.2.2 Covering health care for the entire population

1.1.2.3 Reducing budget burden for the State

1.1.2.4 Ensuring main responsibilities in the system of social security policies

1.1.3 Main activities of health insurance

1.1.3.1 Disseminating policy relating health insurance legislation

1.1.3.2 Allocating health insurance cards

1.1.3.3 Operating income - expenditure and investment of the health insurance fund

1.1.3.4 Coorperating in organizing health insurance

1.2 The health insurance fund and health insurance fund revenues

1.2.1 The health insurance fund

The health insurance fund is an independent financial fund, working outside the

state budget The formation, existence and development of the health insurance fund

always has its own purpose and subject:

1.2.2 The revenues of the health insurance fund

1.2.2.1 Concept

The revenues of the health insurance fund are the contributions of the

stakeholders, revenues from operating activities and other sources to mainly cover

health care costs for participants when they get sick or have diseases as prescribed

legally and carried out by the health insurance agency

1.2.2.2 The need of developing health insurance fund revenues

Developing revenues for the health insurance fund also means to increase the

number of participants and potential contribution of subjects and object groups This

most critical issue not only relates to health insurance agency but also relates to all

levels and sectors

1.2.2.3 Assessment indicators for the development of the health insurance fund revenues

1 The number of insured employees relating working

2 Number of agencies taking part in insurance as a must

3 Amount of receivable insurance

(1) (2) (3)

4 The number of insured employees relating working(L)

5 The number of agencies taking part in insurance (D)

6 Real amount of money collected from insurance (T)

(4) (5) (6)

7 The growth rate of insured employees relating to working (tL)

8 The growth rate of agencies taking part in insurance (tD)

9 The growth rate of revenues from health insurance (tT)

10 The average of health insurance contribution per employee relating to working (M)

11 The growth rate of health insurance contributions for workers relating to working (tM)

12 Number of insured employees without labour relation (CN) (12)

13 Revenue from the health insurance from employees without labor relations (TN) (13)

14 The growth rate of the insured employees without labour relation (TCN)

15 The growth rate of revenues from employees without labour relation (tTN)

16 Mức đóng góp BHYT bình quân một người chưa có quan hệ lao động trong năm (MN)

17 The average contribution level of health insurance from those who do not have health insurance (TMN)

18 Number of people participating health insurance (DY)

19 Proportion of population with health insurance (TD)

20 Annual total income in health insurance (TY)

21 The growth rate of insured people in general (tD)

22 The growth rate of insurance revenue in general (tTY)

23 The annual health insurance contribution rate per 1 insured person (MD):

24 The general growth rate of insurance contributions (tMY):

25 Interest received from investing activities of idle health insurance fund (LY) (25)

26 Profitability rate from investment activities (Te)

In addition, in view of the fund management, the development of the health

insurance fund revenue must also put in balance relationship between income and

expenses It also needs considering:

Total annual

revenue from health

insurance

=

Total expenditure KCB for the insured during the year

+

Administration expenses in the year

+ Annual Preventive

1.3 Factors impact on revenues of the health insurance fund

1.3.1 Legal policies on health insurance

1.3.2 Social and economic conditions

1.3.3 The awareness of the people about popular propaganda policy on health

insurance policies

1.3.4 Quality health care for those participating health insurance

1.3.5 Organizatiing to collect health insurance

1.3.6 Inspection, testing and monitoring

1.3.7 Participants and organization of the insured people

1.3.8 Health insurance premiums

1.4 Revenues and development of the health insurance fund revenues in

some countries in the world and lessons for Vietnam

1.4.1 Revenues and developing health insurance fund revenues in some countries

in the world

1.4.1.1 In the Federal Republic of Germany

1.4.1.2 In Japan

1.4.1.3 In Korea 1.4.1.4 In Thai land 1.4.1.5 In Taiwan

1.4.2 H ealth insurance fund s ources in Vietnam

1.4.2.1 Appearance and development a/ 1992 – 2008 period

b/ 2009 - 2014 period 1.4.2.2 Organization Management of Vietnam Health Insurance

Hình 1.1: The organization system of Vietnam Social Insurance

BHXH Huyện

Chi trả cho đại lý

1.4.2.3 The coverage rate of health insurance in Vietnam

The government set a target of 2020, the coverage rate is minimum 80%

Table 1.1: Number of participants by health insurance type

Year

Number of health

insurance participants

Health insurance compulsary participation

Health insurance voluntary participation

People

(million)

Growth rate (%)

People (million)

Growth rate (%)

People (million)

Growth rate (%)

Source: Vietnam Health Insurance [4]

1.4.2.4 Lessons for Vietnam

Firstly, health insurance policy needs to be organized appropriately according to

each economic - social development period of the country

Secondly, voluntary health insurance is a coming step to progress to universal

health insurance

Thirdly, the State should always support the health insurance fund

Fourthly, the determination of health insurance premiums should have specific

regulations for each type of health insurance

Fifthly, the State management issues for health insurance should be determined

Sixthly, social health insurance is necessarily sponsored by the State

Sevenly, the State needs to accelerate the complete health care market

CHAPTER 2 ANALYSIS ON FACTORS AFFECTING TO THE REVENUES

OF HEALTH INSURANCE FUND IN VIETNAM 2.1 Current status of the revenues and collected revenues of Vietnam health insurance

2.1.1 Sources of health insurance revenues and results

Sources of health insurance fund include:

1 Fund collected under the Health Insurance Law;

2 Profits from investment activities of the health insurance fund

3 Sponsorship, donation from domestic and oversea organizations and individuals

4 Other legal sources "(Act 33 - Law of Health Insurance)

Table 2.1: The results of health insurance (2010-2014)

Year

Total income of health insurance

compulsory collected health insurance

Voluntary collected health insurance amount

(billion VND)

Growth Rate ( %)

amount (billion VND)

growth rate (%)

amount (billion VND)

growth rate (%)

23.305,2

21.759,3

1.545,9

31.829,4

136,6

29.724,2

136,6

2.105,1

136,2

40.176,9

126,2

37.758,3

127,0

2.417,6

114,8

48.433,8

120,6

44.685,1

118,3

3.748,7

155,1

55.026,0

113,6

51.027,3

114,2

3.998,7

106,7

Source: Vietnam Social Insurance [4]

Rate of health insurance

Health insurance rate is regulated in Act 13 of the Law on Health Insurance

Table 2.2: The average fee of health insurance (2010-2014)

Year

General insurance Compulsory health

insurance

Voluntary health insurance Average

rate per

person

(VND)

Growth rate (%)

Average rate per person (VND)

Growth rate (%)

Average rate per person (VND)

Growth rate (%)

Source: Vietnam Social Insurance [4]

2.1.3 Organisating the collection of health insurance

2.1.4 The revenue and expenditure balance sheet of the health insurance fund

Table 2.3: Surplus income - cost health insurance fund (2010-2014)

Unit: billion

Year Health insurance

Gross

Total expenses insurance

Revenues - expenses differences

Note: The data does not include hedge and management funds

Source: Vietnam Social Insurance [4]

2.2 Analysis of factors affecting the income of the health insurance fund in Vietnam

2.2.1 Health insurance policy 2.2.2 Social and Economic conditions

Table 3.4: The relationship between economic growth - income and health

insurance rate (2010-2014)

%

2 Average income/person/month 1,000 VND 1,150 1,179 1,196 1,294 1,464

4 The average health insurance rate/person 1,000 VND 466.1 612.1 692.6 768.7 859.7

5 The growth rate of health insurance

Premiums

6 The average growth rate of prices

of medical services services% - 14.7 17.6 19.6 22.4

Source: GSO - Vietnam Social Insurance [46]

The dissertation applies the following research models:

a) Model 1: the probability of participating voluntary health insurance

Accreditation results multicollinearity provides the following results:

Variable | VIF 1 / VIF + - -primary |0.130580 7.66 Secondary|0.170446 5.87 Highschool| 5:39 0.185368 quintiles_5 |0.271461 3.68 Quintiles_4| 3:44 0.290361

quintiles_3 | 3:21 0.311263

quintiles_2 |0.361636 2.77

Reg8_8|0.608112 1.64

Reg8_7| 1:54 0.648215

reg8_5 | 1:42 0.704634

reg8_4 | 1:38 0.726024

reg8_2 | 1:35 0.738252

reg8_6 | 1:24 0.807133

urban | 1:16 0.860509

visited | 1:15 0.872969

reg8_3 | 1:10 0.907788

year_1 | 1:09 0.915149

business | 1:09 0.920389

hhsize | 1:08 0.927807

female | 1:01 0.993172

- +

-Mean VIF | 2:41

This result shows that the model has no multicollinearity phenomenon and it is

estimated that the model's variables are statistically significant at 1% (excluding a

coefficient) That R-squared result of the Logit model is low (6%) is consistent with

the characteristics of this model form R-squared of the regression model OLS at

18.5% due to the studies using independent variables are qualitative variables while

the dependent variable is the dependent variable for the purpose of comparing the

difference of the group rather than the beat General price Such results will provide

higher recommendation because the health insurance policy is a broadly covered

policy for the entire population rather than policies focusing on a specific target

group

The group seeking treatment at health units will have a higher probability of

buying medical insurance than those who don’t go to medical units for treatment

(first row, column 1) More specifically, Figure 3.8 shows the marginal influence

(margin) of going to health care center or not to the probability of their choice in buying voluntary medical insurance, about 38% of people who go to health care center compared with 32% of people do not From the regression results in table and figure 1, it is implied that those who go to health care center for health treatment should be encouraged and propagated to purchase voluntary health insurance To reinforce this claim, column 2 line 1 shows that people spending on health insurance will spend about 24% higher in health insurance than those who do not when other elements unchanged

The study took the first quintile of income (or low income groups) as a standard for comparison Probability of purchasing voluntary health insurance rose steadily according to income level This means that the higher income families have, the more they will be able to participate in voluntary medical insurance Specifically, the high income group will have a double probability of participating health insurance than poor groups Thus, to facilitate and increase revenue for voluntary health insurance,

we should focus on the target groups at the upper and middle class

Next, the ethnic minorities have a lower probability of voluntary insurance than the Kinh and Hoa groups This is largely because they are poor or vulnarable groups in the society, along with they are issued health insurance cards for free and they often live in rural and mountainous areas The table statistics show that the number of people participating in voluntary medical insurance in rural areas is 2/3 times higher than those in urban, but the ability to participate is lower, 0.39 compared to 0.32 respectively (Figure 3.9) In fact, the difference is negligible so we should focus on encouraging both rural and urban people to participate in voluntary health insurance What is noteworthy here is that spending on health insurance in urban and rural areas

is not statistically significant, we expected that people living in urban areas will spend more on health insurance; however, this expectation has not been demonstrated This could be a negative signal to those livng in rural areas, because they have to spend for health insurance as much as people living in urban areas

2.2.3 The propagation of policy and legislation

2.2.4 Quality of heath treatment under health care insurance

2.2.5 Participation procedure, charging and expenditure of health insurance

for medical expenses

2.2.6 Inspecting, checking and monitoring health insurance

2.2.7 Participants, structure and participants and the premium of health

insurance

To see the impact of theses quantitative factors to the health insurance fund

revenues of Vietnam, the writer used composite index method in statistical and

secondary data sources of the Vietnam social insurance agency for analysis, namely:

- If the symbol of participants in 2013 and 2014 are and

- If the symbol of health insurance premiums in 2013 and 2014 are and

then a composite index system with 3 factors will be set up as follow:

a) the relative number:

( 1) (2) (3) b) the absolute number:

Table 2.5: Calculation of the factors affecting health insurance revenue in Vietnam under the two types of subjects: compulsory subjects and voluntary subjects

Type of health insurance

Health insurance premiums average

(1,000 VND / person)

Number of participants in medical insurance

(million)

(billion)

1 Compulsory health insurance 812.4 895.2 55.9 57.0 45413.2 51026.4 46306.8

2 Voluntary health insurance 535,5 571,2 7,0 7,5 3.748,5 4.284,0 4.016,2 General 781,59 857,53 62,9 64,5 49.161,7 55.310,4 50.323,0

Source: The author’s investigation documents

2.3 General assessment of revenues development and other factors affecting the income of health insurance in Vietnam

2.3.1 Achievements

Firstly, revenue is increasingly expanding and relatively stable, because subjects participating health insurance is rapidly growing, especially in this kind of voluntary health insurance

Secondly, health insurance has the most powerful and largest to the income of health insurance fund in both relative and absolute numbers

Thirdly, due to economic and social conditions are stable, despite the economic crisis, the pace of economic growth remained relatively high compared with other countries in the region and around world

Fourthly, all of these factors, either qualitative or quantitative, more or less impact on the health insurance fund revenues, but their aggregate impact is important Fifthly, in the recent stage of implementing the Health insurance Law, annual revenues are rising, therefore, basically balance income - cost is ensured