Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam

► Lost income and indirect costs comprise near half the health payment burden for households in a Vietnamese rural commune. ► Poor households are most vulnerable to consequences of funding health treatments through debt and food reduction. ► Policy must account for all health treatment costs, especially self-treatments and lost income. ► Stronger risk-pooling mechanisms should be developed, and official and unofficial payments should be regulated.