The study is based on secondary data of health insurance Vietnam 2009-2012. Research methods: expert analysis and health economic analysis. Results: (1) Input of health insurance is the same, (2) the output of health insurance (essentially a package of health services) are different, leading to different service benefit. Lower output in line with medical facilities and significant disparities between the health system and provincial basis, (3) The balance of health insurance for the poor (due to both weak and insufficient health services at primary health care levels, due to the behavior of people seeking health services, the quality of the service pack is not high...), the phenomenon of reverse subsidies, (4) voluntary health insurance fund deficit due to adverse selection, health insurance fund deficit (retirement) due to inflation dung. Recommendation: Must be defined package of health services.