After 18 months since it officially came into effect, the Health Insurance Law has failed to attract people living near the poverty line and children under six years old.

Social Insurance Agency (SIA) statistics said that only 692,000 people were using health insurance services by the end of 2010, accounting for just 11.5 percent of the people living near the poverty line in Vietnam .

According to the existing poverty standards for the 2011-15 period, average monthly income levels for households near the poverty line are between 38.5-51 USD in urban areas and 28-38 USD in rural areas.

"Even though the Government pays at least half of health insurance expenses for those living near the poverty benchmark, nearly 90 percent of them still haven't got access to them or benefit from the services," said director of the Ministry of Health's Health Insurance Department Tong Thi Song Huong.

The health insurance participation rate among people living just above the poverty line is even less than 1 percent in Nam Dinh and Ninh Binh, and in Dien Bien only 150 out of 4,500 near-poor households have registered for health insurance services, according to the SIA.

Head of the SIA's Department for Health Insurance Policy Implementation Pham Luong Son explained that the situation in many provinces was down to bad management that only listed poor households but hadn't focused on making a list of people close to the poverty line.

SIA Deputy Director Pham Minh Son said that 53 out of 63 provinces and cities hadn't implemented health insurance services for those living near the poverty line.

"People living near the poverty line still have to pay around 270,000 VND (13USD) per person per year for health insurance. The expense is a burden for people who still struggle to make ends meet," said Son.

According to Son, many rural and mountainous health insurance users do not know how to use the service, or are afraid due to complications and slow procedures.

Huong said that many people, including medical staff, did not know the benefits that subscribers were entitled to.

"Some medical staff do not fully understand the health insurance law, that's why they fail to provide patients with necessary information" said Huong.

SIA also reported that around 2 million among 10 million children under six years old had not been issued free health insurance cards due to mismanagement.

Children under six and the poor are subject to free health insurance cards under Government regulations.

SIA statistics say that health insurance service have covered nearly 51 million people, accounting for 60 percent of the country's population and an increase of 11 million people compared with 2008./.