Inclusive care: Health in the national agenda

ONE of the biggest issues in the hotly contested presidential election is the health agenda of the candidates.

The soundbites zeroed in on universal coverage (national health insurance) because everyone knows the heavy burden that health care cost can cause, especially on the poor who cannot afford the needed services. Universal coverage is critical but it addresses only the financing issue and unlike calls and texts, funding is not unlimited.

The common thread in the platforms of the candidates included the strengthening of primary and preventive care, vaccination and immunization programs, making medicines available, the improvement of health facilities, ensuring the full implementation of the reproductive health law, the addition of more rural health units or barangay health stations, and strengthening the coordination with local government units. Most of these are existing programs that would only need continuation or enhancements; a few need more aggressive implementation, like the Reproductive Health (RH) Law.

The new administration will assume office with at least four  enabling/landmark laws already in place that can help carry out the health agenda. These are the Sin Tax Law, the RH Law, the National Health Insurance Act 2013 and the Expanded Senior Citizens’ Law.

The full implementation of these laws can provide quick wins for the new administration.

The new President will also assume office and work with the biggest budget to date for the health sector from around P25 billion in 2010 to P122 billion this year, inclusive of the proceeds from the sin taxes. Huge increases in health budgets notwithstanding, he will continue to deal with the ‘old’ ills of chronic diseases and infectious diseases, especially the rise of HIV and PTB, and of maternal and infant mortality rates; the worsening problem of substance addiction; the growing number of accidents and injuries; and the emerging concerns for mental health.

Health as a priority in the national agenda

To improve the health of the population is the imperative in every health agenda. This is the essence of universal care or inclusive care summed up in one word —access.

Access means health services being available when needed— from preventive to cure and treatment of diseases; access means being able to secure the appropriate care because citizens have adequate and equitable coverage and that such coverage will be assured through their lifetime; access means basic services that will protect the individuals and their communities from health risks and environmental hazards, including climate change and disaster risks, is a given.

To ensure access, there must be accountability. Those who drive health policies must be responsible for ensuring their attainment; those who implement and regulate must show measurable improvements in the indicators of good health; those who fund must account for the efficient and effective management of the financial resources; and the intended beneficiaries must use the care appropriately and responsibly.

Shift from treatment to prevention

Our hopes and expectations are high that the leadership change riding on the wave of a new brand of politics will look at the Philippine healthcare system through a different lens.

The times call for a shift from treating the ‘symptoms/diseases’ through concentration in the provision of curative, hospital-centric care—to greater focus on prevention which will seek to address the causes of the diseases, such as health promotion, preventive care and control/management of health risks/hazards.

The enhanced health care system would be patient/consumer/population-oriented, data-enabled, accountability-measured and multisectoral in perspective.

It must also insulate the sector from political pressures that can derail the achievement of universal care and the sustainable development goals.

The Department of Health will need to redefine its role from largely service provision/delivery to a leadership role in health planning; to act as coordinator and integrator of the national health development plan and reform agenda; to become the enabler of LGUs by systematically providing needed expertise to develop their capabilities and capacities so they can be able, self-reliant partners; to being the patients’ champion through their licensing, regulatory and quality function that ensures safe care in a healthy environment; and to be a stronger voice in the policies that affect health, such as environment, education, local health governance, disaster planning, among others.

Delivering on the new health mandate

Dr. Margaret Chan, director general of the World Health Organization, said “Poverty contributes to poor health, and poor health anchors large populations in poverty. Good health provides the very foundation for a productive life, and thus increasingly figures as a goal in poverty-reduction strategies.”

This underscores the critical importance of improving the health of the population to the nation’s progress and development. It must therefore be central to the national agenda.

This calls for a culture of health.

(The author is Chair of the MAP Health and Wellness Committee; Chair of the MAP Trade, Tourism and Industry Committee; and President and CEO of Health Solutions Corporation. Feedback at <[email protected]> and <[email protected]>.  For previous articles, please visit <map.org.ph>)