Calculating care: the valuation of medical routes while health seeking in Vietnam

Abstract

ABSTRACT Vietnam has implemented reforms in how health care is financed to provide patient financial risk protection. However, out-of-pocket payments remain high and insurance use is low relative to the country’s high population coverage rate. In this article, I argue that health insurance was not a pre-requisite for obtaining health care in Vietnam; rather, paying for care through health insurance was but one among many ‘medical routes’ for obtaining treatment. I develop the notion of 'calculative practices of care,' which I define as the repertoires of value scales patients employ as they navigate Vietnam's increasingly stratified public-private health system. The findings contribute to ethnographic research on health financing, particularly how patients practice valuation while health seeking.