Rx for the Ailing Health Sector: PhilHealth reforms

By the Medical Action Group

IN MARCH 2011, Dr Shin Young-soo, the World Health Organization’s regional director for the Western Pacific expressed concern over “the continued absence of sufficient healthcare coverage in the country.” The WHO official noted that some 250,000 families “fall into financial hardships” because of the excessive cost of health care.

This observation comes in the midst of the Aquino administration’s avowed push for Universal Health Coverage, especially for indigent Filipino families, as one of its health agenda. Such a universal health care system would bridge the healthcare disparities between the rich and the majority poor.

The 1987 Constitution provides that all Filipinos should have access to health services. This policy finds full expression in Article II, Section 15: “The State shall protect and promote the right to health of the people and instill health consciousness among them.” Article XIII, Section 11 provides that “The State should adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable costs. There shall be priority for the needs of the underprivileged, sick, elderly, disabled, women and children. The State shall endeavor to provide free medical care to paupers.”

And yet, from one administration to another, the same issues and deficiencies continue to plague the country’s health sector. Key healthcare issues crippling the nation like the healthcare inequities, failed public healthcare financing, the continuous exodus of health professionals and weak health regulations pose critical challenges for the Aquino administration in attaining Universal Health Coverage.

Badly broken

Calling our country’s health care system “badly broken” and in need of repair, President Benigno S. Aquino III outlined his plans for a reform package based on universal health coverage for all Filipinos. This plan would put the national government at center stage for funding healthcare services by amending Republic Act No. 7875 (otherwise known as the National Health Insurance Act of 1995) or enacting a new law by developing more extensive and equitable tax-based systems, or social health insurance-based systems or mixes of those. To ensure universal health coverage it will be necessary to increase the extent of prepayment and reduce the reliance on out-of-pocket payments and user fees.

This reform agenda for universal coverage is anchored on the provision of comprehensive but accessible and affordable healthcare services to all Filipinos. It focuses on expansion of coverage of the national health insurance system to include all Filipinos within the next three years and provision of effective and affordable health care services that shall be accessible to all Filipinos in private and public hospitals.

While every Filipino is entitled to healthcare as provided by the Constitution, here in the Philippines, healthcare happens to be a privilege. The majority of the Filipinos rely on the private sector for their healthcare needs, thus making these services more of a commodity rather than entitlements. The majority cannot afford such services, resulting in grim statistics: for example, an estimated 60 percent of Filipinos die without seeing a health professional. Putting a stop to these healthcare inequities would require immense political commitment from the present administration.