Social services policies in a developing market economy oriented towards socialism: The case of health system reforms in Vietnam

Abstract

This paper analyzes Vietnam's health policies. It adopts an interpretative framework stressing that policy approaches to strategic and commercial services, on one hand, and social services, on the other hand, should be fundamentally different, given the structurally different nature of such diverse services activities. The paper analyzes the evolution of health policies during the doi moi period and reviews the national and international debate on health systems reforms, arguing that an approach prone to blur the intrinsic difference between social and non-social services has led to market-oriented health reforms that are severely flawed in Vietnam, with negative impacts on universality of access, equity, poverty, and efficiency. In sum, social services policies, and policies in the domain of health in particular, appear to constitute the weakest and most contentious component of Vietnam's otherwise extremely successful development strategy. Therefore, they are a prime candidate for critical re-examination.