‘PH should not fear public-private partnerships’

Health Secretary Enrique Ona

Remember the “Sin Tax”? Smokers will remember this as the culprit for the current price of each cigarette stick—which is double the previous price on the streets.

The coffer from the state regulation on cigarettes and alcoholic beverages now benefits the health sector, Health Secretary Enrique Ona told the Inquirer. Much of it is now aimed at funding the universal healthcare agenda, he said.

“In 2008, the DOH budget was a little under P19 billion, which increased slightly to almost P24 billion in 2009,” he explained. “When President Aquino took office in 2010, the DOH budget was about P25 billion. Today, four years later, it is almost P90 billion.”

A huge chunk of that is funneled to troubleshooting issues on facilities, healthcare registration and accessibility, among others.

The Sin Tax felt like a novel form of offense for some. Many worried about how they could get by without their usual fill of cigarettes or liquor. But this is one measure that perfectly reflects a big issue in UHC.

Financing

About 25 million Filipinos belonging to the poorest households are now covered by PhilHealth, with the government shouldering their annual premium payment of P2,400 per family. The money had to be sourced somewhere.

Health financing is always a big problem, especially for developing economies.

David Grainger, the global public policy director of Eli Lilly and Co., said the Philippines should not fear public-private partnerships, as cooperating with the private sector gives governments cap space for such subsidies.

“Scientists are increasingly engaged in collaborations,” he said. “Our company might have expertise in one area and another company in another area… By collaborating with organizations like PhilHealth, we find ways to come out with win-win solutions which do get more treatments to more people.”

“Through public-private partnerships, the DOH is modernizing government hospitals and building new modern health facilities to better serve Filipino patients,” Ona also said.

Modernization of the Philippine Orthopedic Center and construction of the Philippine Center for Hematologic Diseases and Blood Transfusion are ongoing. To provide Filipino patients across the country with quality healthcare, the DOH and its private-sector partners will establish nine cancer centers, eight heart centers and seven transplant centers in strategically located  regional DOH medical centers.

Investment in research

Meanwhile, the World Health Report 2013 said that investment in research in low- and middle-income countries—all but Singapore and Brunei in the Asean region—has been growing by 5 percent each year, although unevenly.

“Research for UHC is not a luxury; rather, it is fundamental to the discovery, development and delivery of interventions that people need to maintain good health,” the report noted. Governments have to seek funding for this endeavor as well, Grainger volunteered.

And then there’s the question of willingness. Where there are resources, are they being used? Where there is no fund, does the government seek?

“Like all health systems, people are going to make choices about where they spend their money,” said Grainger, referring to the politics around healthcare. “[Even] in very mature health systems like Australia … we’re still going to make choices as new things become available.”

“That’s a policy decision on how much we are prepared to invest in health,” he added. Some European countries benefited from high tax revenues infused into the health and education sectors, he said.

In China, they have achieved a coverage of 95-98 percent, Grainger noted. He described the healthcare system there as “a mile wide and an inch deep,” but applauded the current “deepening” of the packages and the decisiveness to “invest money in what needs to be done.”

First in Southeast Asia

“The Philippines is the first country in Southeast Asia to implement routine rotavirus vaccination for children,” Ona revealed. Rotavirus is the most common cause of severe diarrhea among infants and young children. Vaccines were given to 220,000 children. Around 700,000 poor children have been immunized as of June 2013.

The DOH also distributes basic medicine packs for diseases like hypertension, diabetes and asthma to all rural health units nationwide quarterly.

In a speech last year, the World Health Organization’s Margaret Chan said that UHC “is a struggle. It takes time. It takes unwavering political commitment at the highest level of government.”

“The way that [PhilHealth has] identified the different segments of the population, and is inclined to tailor its efforts to address each to the best of their resources and capabilities at the moment … is a great start,” Grainger said, repeatedly saying that the agency has the right framework. However, he was quick to add, “It really needs more resources.”