What would it take to have effective universal health care in the Philippines?
Health is economy.” This key idea, which former Socioeconomic Planning Secretary Ernesto Pernia wrote about in 2020, still resonates today as the Philippines continues to recover from the pandemic.
It certainly resounded among the attendees of the Management Association of the Philippines’ (MAP) Forum on “Making Quality Health Care Accessible: Picking Up the Tabs for Filipinos.” Featuring guest speakers Shirley Domingo, vice president for corporate affairs of Philippine Health Insurance Corp. (PhilHealth), Jose Rene de Grano, president of the Private Hospitals Association of the Philippines and Ellen Fullido, president of People Management Association of the Philippines (PMAP), the forum also presented the results of the study conducted by the EON Group on the Filipinos’ current perception of PhilHealth.
Preventive health care as the way forward
With health at the forefront of Filipinos’ minds for the past few years, there’s a stronger urgency to have a more robust universal health care system. Republic Act No. 11223, or the Universal Health Care Act (UHC), was signed into law in 2019 but bringing it into fruition so citizens will have equitable, quality and affordable health care requires transformation, innovation and an expansion of its directions. As Domingo puts it, it cannot be accomplished overnight but through a progressive realization and collaboration between the government and the private sector.
Alma Jimenez, vice chair of MAP Health Committee, noted that health care shouldn’t only be functional. The use of its resources must also be disciplined to drive down costs. This means putting the appropriate focus on the different stages of health care: preventive, curative and palliative. Since medicinal expenses have been observed as the biggest factor in Filipinos’ health care payments, helping them access quality preventive primary care would help avoid the quick dissipation of public funds.
This is something all the speakers agreed on as the way forward, especially with the pandemic highlighting how expensive curative and palliative care are. The influx of COVID-19 patients had strained the resources of health care institutions. In fact, according to De Grano, unpaid claims for private hospitals had reached P25 billion at one point. To cover costs and pay staff salaries, a number of them had to either downsize, sell properties or close down. While the UHC is about equitable and affordable health care and protection against financial risk, de Grano said it “overlooks private hospitals even though they function as primary care centers.”
Health care a function of public trust
The cost of health care also impacted PhilHealth, particularly its public standing. As the government agency that oversees the provision of health insurance coverage, PhilHealth took a public relations hit in 2020 due to allegations of the abuse/misuse of P15 billion worth of funds from its Interim Reimbursement Mechanism (IRM), the emergency cash advance measure intended to provide hospitals with financial resources to address any imminent health crisis.
Although PhilHealth usually ranked first in client satisfaction surveys prepandemic, Filipinos’ justifiable worries about their health and the financial cost of getting sick drew their critical attention to the agency’s issues. EON’s study shows that 61 percent of respondents still express trust in PhilHealth, but this is a much lower figure compared with what it used to garner. For reference, it had a 92 percent trust rating in the 2019 iteration of EON’s biennial proprietary research Philippine Trust Index, then 83 percent in 2021.
Domingo said that PhilHealth doesn’t take the decline in trust lightly. While the agency asserts that no funds were stolen and nearly all of the IRM has been liquidated, the executive acknowledged that the previous leadership has defined the whole organization, despite the consistency of the service provided by its on-the-ground staff. There’s work to be done to regain the lost trust.
She shared some of PhilHealth’s policies in the pipeline, such as the introduction of benefits plans, the expansion of existing ones between 2023 to 2025 and the digitization of claims processing.
The call for multisectoral work
The lively discussion yielded insights on the best way forward for the UHC to be actualized.
To the question of who picks the tab for Filipinos’ health-care costs, De Grano answered, “It’s the hospitals, the doctors and health-care workers and the direct contributors.” He called on the government to incentivize private hospitals and take into consideration their role as providers of humanitarian services, not just as private businesses.
Fullido concurred with this, adding that PMAP supports the comprehensive implementation of the UHC and espouses having a people-first principle among its member organizations. She encouraged businesses to enforce due diligence in their processes, from paying taxes to enrolling employees so they could avail of social services. However, she also called for support for micro, small and medium enterprises (MSMEs), which comprise more than half the PMAP membership. “How many MSMEs are able to provide for their employees’ medicinal costs, let alone an HMO (health maintenance organization), if they’re small businesses in rural areas?” With the mental health crisis as the next pandemic in her view, she sees making health-care services more accessible to Filipinos in the smallest barangays as a goal that both the government and the private sector can and must work on together.
Health is crucial to the country’s economy and vice versa: Poor health adversely affects the citizens’ productivity and a bad economy affects people’s health through the loss of livelihood and income. As the Philippines works to recover from the pandemic, both public health and the economy must be afforded proper focus, with neither sacrificed for the other. INQ
The author is chair of the MAP Health Committee, vice chair of the MAP CEO Conference Committee, and chair and CEO of The EON Group. Feedback at [email protected] and [email protected].
