Abstract
In Vietnam, the near-poor are defined as people having income up to 1.5 times above the poverty threshold. Many of them are the erstwhile poor, facing the risk of falling back into poverty. Healthcare reform is one of the main legacies of the structural transformation in Vietnam since late 1980s. Fees for healthcare have been increasing significantly. Meanwhile, income is not increasing as fast as healthcare price. The government implements social health insurance schemes, aiming to decrease healthcare cost burden for its participants. The near-poor can subscribe to the social health insurance on a subsidised premium, but are charged the same copayment rate as the non-poor.
The thesis bases its conceptual framework on Jennifer Prah Ruger's health capability approach. Under Ruger's view, social health insurance is justified as a way to keep people healthy, protecting them from the consequences of ill health, maintaining their sense of security, and promoting social justice in society.
The thesis is a qualitative research, taken the form of a poly-vocal format for the purpose of presenting the voices of the near-poor. The thesis uses semi-structured interviews as the main sources of data for analysis. During a period of ten weeks, I interviewed 22 near-poor households and three government officials in My Tho City.
The thesis offers an insight into the portrait of the near-poor in Vietnam. It discusses comprehensive reasons why the near-poor participate in social health insurance. Furthermore, it ascertains the presence of certain barriers to the access and the utilisation of the social health insurance scheme, hence assesses social justice of the scheme from the perspective of the near-poor.