Third in a series

IF THE NEW PRESIDENT PREFERS A rude awakening to the problems facing the Philippines' healthcare system, he should look for transcripts of the Health Financing Summit held April 14 at the GT-Toyota Asian Center Auditorium in UP Diliman. He would have to seek answers to these six-year questions:

Why does the poor have to subsidize the rich? Why is lowering the prices of medicine not nearly enough? When does the hospital system become part of the problem? What is universal healthcare and why is healthcare financing the first step to achieving it? Is universal healthcare just a matter of money? Why is a car worth more than a human life when insurance is concerned?

Representatives of the academic institutions behind the staging of the health-financing summit are asking the new President to consider these issues and the need for universal healthcare. They say the first step to achieving such a universal healthcare (and probably solve many health issues, as well) would be through healthcare financing.

Universal healthcare system

The Ateneo Graduate School of Business Health Unit, the Asian Institute of Management Center for Developmental Management, the De La Salle Health Management, and the UP System collaborated during the summit and laid the groundwork for a universal healthcare system.

This was the first time four academic pillars, together with key medical stakeholders, came together to discuss the most revolutionary healthcare initiative that the Philippines has seen to date.

In a position paper on healthcare financing?a ?road map? for health presented by Dr. Kenneth Hartigan-Go?one of the key questions asked was, "Why are Filipinos lost in the maze of healthcare??

The figures presented that led to such a question: An estimated 60 percent of Filipinos die without the benefit of a health professional. The government health budget accounts for less than five percent of the gross domestic product. The Philippines has a highly resourced private sector; 70 percent of all health workers are employed in the private sector, servicing only 20 to 30 percent of the population?the sector that can afford to pay for healthcare.

The poor subsidizing the rich

?More than being a function of an inequitable health system and of poverty, this can be appreciated more fully in the light of social injustice and market failure. There is a phenomenon of epidemiological polarization; a dual health economy exists?one for the rich and another for the poor. There are also geographical differences between rural and urban settings. These result in wide variability in health policy,? Hartigan-Go said.

Revelations

The summit revealed the following:

?Minimum wage earners set aside 1.2 percent of their monthly salary for their Philippine Health Insurance Corp. (PhilHealth) contributions, while company executives pay less than 0.6 percent of their salaries.

?Middle-income and upper-class families avail of PhilHealth more than poor families do, even though middle-income and upper-class families are more likely to have private HMOs that offer other health benefits.

?9 out of 10 top users of PhilHealth are, in fact, private tertiary health facilities (i.e. Medical City, St. Luke?s Medical Center, Makati Medical Center).

?Inequity to access?the poor do not seek hospital care if there are collateral expenses to be paid out of pocket: transport costs, competing needs like food, need for daily wages, hospital deposit.?

Dr. Eugenio Jose F. Ramos, Philippine College of Physicians president, who warned that a universal healthcare would suffer from underfunding, told Inquirer Health ?the only way that the new President can achieve bigger results is to get all the players in healthcare delivery to work together. Getting the Filipinos to be responsible for their own health is essential; the worst thing that can happen is when we drive the country to become a welfare state.?

In a statement, the convenors of the health summit said they believe that part of the solution lies in correctly applying the true spirit of equity and solidarity in health financing and insurance. Models from various parts of the world, including Singapore, China and Vietnam, show that health financing and insurance has potentially the most impact across public health, preventive and clinical medicines. If and when fixed, universal healthcare for Filipinos can be achieved.