This discussion paper aims to synthesise a variety of reports and research projects conducted by the International Programme at the Centre for Health Economics, concerning the Vietnamese health system, over the past 4 years. In particular it focuses on the development of the state voluntary health insurance scheme which is the subject of a current DFID-funded research project. Previous work conducted by the members of the International Programme includes an investigation into the impact of economic reforms on the health system, an evaluation of the impact of user charges on access to health services amongst the poor, and a report providing an analysis of the state health insurance programme. The aim of the current research project is to analyse the experience of voluntary health insurance to date, making recommendations to policy-makers on its future development. A large household survey will form part of the investigations. The paper presents the situation to date, highlighting major developments, successes and failures, and the main challenges facing the scheme. The research project started in July 1998 and is due to be completed in March 2000.