“We arranged a health checkup, but they won’t go.” “They look unwell, but they won’t see a doctor.” Companies that employ Vietnamese staff often find themselves puzzled by situations like these. Behind them lie fundamental differences in healthcare systems and views of health between Japan and Vietnam. This article explains how Vietnam’s healthcare system works, how it differs from Japan’s, and the health management points HR professionals should keep in mind.

Vietnam’s Healthcare System ①: Basic Structure of the System

To understand Vietnam’s healthcare system, you first need to grasp its basic framework. As in Japan, public health insurance exists—but how it works in practice is quite different.

Public health insurance (BHYT) is widely seen as “hard to use”

Vietnam has a public health insurance system called BHYT (Bảo hiểm y tế). The Vietnamese government aims for universal coverage, and as of 2023 the enrollment rate exceeded 93%. Even so, there are many restrictions on which medical institutions and treatments are covered, and many Vietnamese people feel that “having insurance still does not mean you can get adequate care.”

For example, when using insurance, patients must first visit a designated medical institution tied to their place of residence under a referral system. That makes it inconvenient to freely choose the hospital they prefer. In addition, the scope of insurance coverage is limited, so out-of-pocket costs are not uncommon. For these reasons, while BHYT exists as a system, it is hard to describe it as something people can “use with peace of mind” the way Japan’s health insurance is used.

A two-tier structure of public and private hospitals creates disparities in care

Medical institutions in Vietnam fall broadly into public and private hospitals. Public hospitals are relatively inexpensive, but chronic overcrowding and aging facilities are ongoing issues. Private hospitals, by contrast, offer higher-quality facilities and service, yet costs can run several times those of public hospitals. In other words, a defining feature of Vietnam’s healthcare system is that the quality of care is closely tied to economic means.

Pharmacies function as the “first point of care”

In Vietnam, it is common practice to go to a pharmacy first when feeling unwell. Given the time and cost of seeing a doctor, many people find it more practical to describe their symptoms at a pharmacy and buy medicine there.

At Vietnamese pharmacies, medicines that would require a prescription in Japan can sometimes be purchased without one. As a result, the idea that “for mild symptoms, the pharmacy is enough” is widespread. Knowing this background makes it easier to understand why Vietnamese employees may be reluctant to go to a hospital even when they are unwell.

Vietnam’s Healthcare System ②: Decisive Differences from Japan

With the basic structure of Vietnam’s healthcare system in mind, it is important to look at the concrete differences from Japan. The three differences introduced here are likely to affect day-to-day communication in the workplace directly.

Perceptions of how “generous” health insurance is differ completely

In Japan, presenting a health insurance card generally keeps the patient’s share of medical costs at 30%. In Vietnam, however, out-of-pocket costs can still be substantial even for those who are insured. As a result, many Vietnamese people strongly associate “going to the hospital” with “spending money.”

Even after coming to Japan, it is not uncommon for people not to fully understand that health insurance reduces their out-of-pocket burden. Carefully explaining that “Japan’s insurance is different from Vietnam’s and can actually be used reliably” can lower the psychological barrier to seeking care.

A culture of regular health checkups is not rooted in society

In Japan, the Industrial Safety and Health Act requires companies to conduct health checkups at least once a year. In fact, Vietnam’s Law on Occupational Safety and Health, which took effect in 2016, establishes a similar obligation. Even so, there is a wide gap between the legal requirement and social reality, and it is hard to say that the habit of receiving regular health checkups is widely established.

That said, this does not mean health awareness is low. It is better to understand that in Vietnamese society it is common to think, “If nothing feels wrong with your body, there is no need to see a medical institution.” For that reason, simply circulating a notice about a health checkup may not lead people to attend. It is important to explain specifically why checkups are necessary and what benefits they offer.

Social stigma around mental health remains strong

In Vietnam, social stigma against speaking up about mental distress remains strong. The very concept of “mental illness” is not widely recognized, and people who feel stress or anxiety often find it hard to confide in those around them.

In Vietnamese culture, ties to family and the local community provide emotional support, but that support is easily lost in life in Japan. There is also a tendency to view mental health issues as “weakness,” so workplaces need to build systems for mental health care.

Vietnam’s Healthcare System ③: Practical Steps HR Should Take

Understanding differences in systems and culture is important, but it is not enough on its own. Here we introduce concrete initiatives HR professionals can put into practice on the ground.

Explain in their native language what health checkups mean—and that they are free of charge

The first step toward raising health checkup participation rates is to improve how information is provided. It is reassuring to prepare notices in Vietnamese that clearly state that “the company covers the cost of the health checkup” and that “it is done for prevention.”

It is also effective to explain in advance how the health checkup will proceed. Because it may include unfamiliar items such as blood draws and electrocardiograms, carefully explaining in their native language “what will be done” and “why” helps improve participation rates.

Build support systems for medical visits and consultations

When Vietnamese employees visit medical institutions in Japan, the language barrier can be a major obstacle. Anxiety about not being able to describe their symptoms leads some to avoid seeking care altogether.

For that reason, we recommend preparing a list of multilingual medical institutions. Local governments and international exchange associations sometimes provide information on facilities that can serve patients in foreign languages. Assigning support staff who can accompany employees to appointments and sharing how to use telephone interpretation services are also effective measures.

For mental health support, designing an easy entry point for consultation is key

In mental health support, the most important thing is to lower the barrier to seeking help. In Vietnam, people tend to feel strong resistance to confiding mental distress to others. For that reason, it is better to create a broader entry point—such as “life consultation” or “trouble consultation”—rather than a direct label like “mental health counseling desk.”

Of course, when professional counseling is needed, coordination with external support organizations is also essential. It is important to identify in advance counseling services that can respond in Vietnamese, notice changes through everyday check-ins, and connect people to appropriate support at an early stage.

Vietnam’s Healthcare System ④: Cultural Background That Is Easy to Overlook

In addition to differences in healthcare systems, understanding Vietnam’s cultural background is also essential to supporting international employees.

Trust in Eastern medicine and traditional therapies runs deeper than many expect

In Vietnam, Eastern medicine and traditional therapies are widely trusted alongside Western medicine. For example, a folk remedy called “cạo gió” (cao gió) is based on the idea of scraping the skin with a coin or special tool to drive out “bad wind” from the body, and it is commonly practiced at home for colds and general malaise.

Traces of such traditional therapies can remain on the body and sometimes cause misunderstanding in Japanese workplaces or medical settings. Rather than rejecting traditional therapies, it is more effective to encourage medical visits by saying something like, “It is reassuring to have a Japanese medical institution examine you as well.”

Remittances for family medical costs in the home country create financial pressure

Many employees who come from Vietnam to work in Japan regularly send money to family in their home country. Those remittances often include family medical expenses. When a family member falls ill, the amount sent can rise sharply and put pressure on the employee’s own living costs.

If you notice sudden absences or a drop in concentration, it is worth considering that family medical costs may be in the background. There is no need to probe directly into money matters, but consistently showing a stance of “please talk to us if something is troubling you” helps build trust. For more on Vietnamese attitudes toward money and the culture of remittances, see also the article “What Matters Is Money and Family: Vietnamese Attitudes Toward Money Differ from Those of Japanese People.”

Conclusion

When Vietnamese employees avoid health checkups or do not go to the hospital even when unwell, multiple factors are intertwined: public insurance that is hard to use, a pharmacy-centered approach to care, the limited establishment of checkup habits, and stigma around mental health, among others.

Rather than treating these differences as “strange,” understanding the cultural and institutional background and providing appropriate support is the first step toward protecting the health of international talent and supporting their retention in the workplace. By starting with what you can do—such as providing information in their native language and building systems to support medical visits—you can help create an environment where Vietnamese employees can work with peace of mind.