Since 1987, Viet Nam has been moving from a centrally planned to a market economy. The public sector became weaker, and public resources were no longer sufficient to respond to all healthcare needs. The government then recognized the need for cost-sharing, and in August 1992 issued a national Health Insurance Decree calling for compulsory health insurance for salaried workers in both the public and private sectors. Voluntary membership for dependants, farmers and the self-employed was also encouraged from the start. Currently, the number of insured persons reaches almost 9.5 million. Future challenges include the extension of coverage, especially to the low-income rural and urban population, modification of provider payment methods so as to enhance cost-containment, and organizational development in general.