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Should Expats in Vietnam Evacuate Due to Poor Healthcare?

With Vietnam poor healthcare evacuation is essential

Expats are shocked by the low standards when visiting the best Vietnamese hospitals -like Cho Ray or Bach Mai-. The life saving alternative for serious conditions is a medical evacuation to Thailand or Singapore for hospitalization. 

Vietnam Public healthcare

Expats who live in Vietnam often report that the standard of the country’s public hospitals is not on par with what they are accustomed to. If your case is out of their competencies, they would lack the knowledge of where to evacuate you to a hospital of excellence.

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Public hospitals in Vietnam are often underfunded and inadequately equipped. Doctors and medical staff at these facilities generally only speak Vietnamese. Furthermore, waiting times can be frustratingly long. In rural areas, the quality and availability of healthcare are considerably worse, and in some of the more remote parts of the country, public healthcare is almost non-existent. 

The unsustainably low salaries deter talents and motivation.

For these reasons, it makes sense that expats as well as many Vietnamese people opt for private medical treatment wherever possible.

Most transactions in public hospitals are through the social security payment system.

Private Healthcare limited investment

In the case of private Vietnamese hospitals, they look at patients like clients. Referral to evacuate you or just refer a patient to a better hospital is a loss of income. 

The standard of private hospitals in Vietnam is higher but still far from international standards, which most expats would be used to. Private hospitals in Hanoi or Ho Chi Minh City are often staffed by doctors and medical professionals who complemented their studies in the USA, Korea, Japan and France. 

However, only going through internships and seminars does not mean they have the mindset and skills to run a hospital. Most times staff in private hospitals are the founder and skilled medical specialists, renowned in Vietnam. But it takes much more to run a hospital efficiently.

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As founders are usually individual specialists with no formal management training or financial back-up, the investment in hospital needs is uneven and insufficient in terms of equipment and processes.

The medical team is better paid, the service is good compared to the competition from the government hospitals, everything seems better.

Transactions in private hospitals are mostly cash or credit cards. Local insurers have started to commonly use and pay for their service in direct billing. They seldom deal with international insurers.

International Hospitals

There are 1 or 2 per main city in Vietnam. Due to their small size, they try to cover the whole spectrum of surgical specialists, thus not providing deep enough specialization. Only in complications do they suggest evacuation to Thailand or Singapore.  In most Asean countries, there are very few international standard hospitals with JCI accreditations. NB. the small size is largely due to the huge investment in infrastructure the new international standards hospital must add to the building in itself -electricity, water and waste treatment, labs, imaging, waste recycling, imports of most state-of-the-art equipments and consumables-.

Most of the hospital network is local or outdated due to limited government budgets. The high demand for good medical care by 100 Million inhabitants is not met.

Very few investments are made in building and operating international standards hospitals. The reason is 3 fold:

  • Lack of infrastructure: investment becomes costly to fully equip such hospitals. The investor may have to pay for additional generators for electricity, water treatment, air purifiers and recycling medical wastes.
  • Lack of supporting ecosystem and trained professionals: lab testing, imaging, maintenance, hi-tech medical, lab and pharmaceutical supplies but also doctors and surgeons may all have to be ‘imported’ at inflated prices.
  • Lack of demand for high priced treatment or lack of specialty hospitals -due to lack of offer-: that’s why there’s a need to send patients, evacuate them to ‘the nearest hospital of excellence’, namely Thailand or Singapore and sometimes Europe for expatriates, when such treatments are needed.

Medical evacuation to Thailand and Singapore hospitals

Thailand and Singapore are ‘the nearest place of excellence’ when it comes to healthcare; they have been investing in world-class medical hospitals for more than 30 years, betting on medical tourism. They attract medical workers from many countries and there is a national competition and promotion to attract Western and American patients.

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