The signing of the Universal Health Care Act by President Rodrigo Duterte on February 20, 2019 is considered a landmark measure that would provide health care coverage for all Filipinos. The law ensures that all Filipinos are guaranteed equitable access to quality and affordable health goods and services and protected against financial risks by automatic enrollment to the National Health Insurance Program (NHIP). Under the measure, membership in the NHIP will be classified as either “direct contributors” for those who have the capacity to pay premiums, or “indirect contributors” for those sponsored by the government such as indigents, senior citizens, and persons with disabilities.
The law also grants every Filipino “immediate eligibility” and access to preventive, promotive, curative, rehabilitative, and palliative health services delivered either as population-based or individualbased health services. It will expand PhilHealth coverage to include free medical checkups, laboratory tests, and other diagnostic services. The signing of the Universal Health Care Act by President Rodrigo Duterte on February 20, 2019 is considered a landmark measure that would provide health care coverage for all Filipinos.
The law ensures that all Filipinos are guaranteed equitable access to quality and affordable health goods and services and protected against financial risks by automatic enrollment to the National Health Insurance Program (NHIP). Under the measure, membership in the NHIP will be classified as “direct contributors” or those who have the capacity to pay premiums, or “indirect contributors” or those sponsored by the government such as indigents, senior citizens, and persons with disabilities. The law also grants every Filipino “immediate eligibility” and access to preventive, promotive, curative, rehabilitative, and palliative health services delivered either as population-based or individualbased health services. It will expand PhilHealth coverage to include free medical checkups, laboratory tests, and other diagnostic services Following the enactment of the bill, the formulation of its Implementing Rules and Regulations (IRR) has to contend with several controversial and unclear issues and provisions that need to be defined and operationalized. To help provide evidence-based inputs to the IRR, the UP Manila Health Policy Hub has been conducting roundtable discussions (RTDs) since 2018 on the essential but ambiguous aspects of the law. This is part of UP Manila’s goal to facilitate health policy management through policy statements, briefs, and policy analysis papers which ensure that cutting edge policy issues are anticipated and/or discussed by different stakeholders. As a result, the university can come out with a position, recommendation, or policy direction.
The first RTD was entitled “Beyond Hospital Beds: Equity, Service, and Quality” held on Nov. 29, 2018. This expounded on the policy implications of the Senate version of the bill to the Philippine public health system. The second, held on Dec. 6, 2018, aimed to identify the health services that should be classified as individualbased or population-based and clarified the financing roles of the funding institutions (see UP Manila Newsletter NovemberDecember 2018 issue). The third RTD provided a status of existing service delivery networks and the roles of provincial and municipal health officers in the current setting of devolved health care. The forum served as a staging ground for possible policy gaps and discussed how to come up with realistic, systematic, and sustainable interventions.
The fourth RTD, entitled “Financing Health Services: Co-payments and Personnel Cost,” was conducted on January 24, 2019 to identify services requiring co-payments and minimize duplication in financing personnel cost in public health facilities.
Dr. Hilton Lam, UP Manila Health Policy Hub Chair presented the policy brief highlighting the different types of cost sharing and their good features given as (i) to decrease moral hazard, (ii) to decrease behavioral hazard, and (iii) to decrease catastrophic risk and to encourage healthier lifestyles. He explained the unique features of PhilHealth as a social insurance. Unlike other kinds of insurance, PhilHealth is an insurance of the first peso with a support value of 33%. Nevertheless, it also functions as an insurance of the last peso through recipients of the ‘no balance billing’ and the coverage of catastrophic care through the Z-benefit package. A proposed flowchart for identifying health services requiring co-payments was presented for discussion. Furthermore, analyzing the strengths and weaknesses of different options in mitigating duplication of personnel cost was tackled. For more details on each of the points, please go to: www.upm.edu.ph. (Based on reports provided by the UP Manila Health Policy Hub).
Published in UP Manila Healthscape No. 372 (January – February 2019)
