The day when every Filipino can get access to basic Health services regardless of their ability to afford it is close to becoming a reality. On October 10, 2018, the Senate approved Senate Bill 1896 or the Universal Health Care (UHC), a bill which seeks to give all Filipinos access to health care coverage and services. With the Universal Health Care for All Filipinos Bill, Filipino citizens will be automatically enrolled into a “National Health Insurance program,” under which membership will be either contributory (applicable to those who can pay health premiums) or non-contributory (applicable to those sponsored such as senior citizens and indigents). The Senate’s passage of the bill came a year after lawmakers in the House of Representatives approved a counterpart measure in September 2017. The future seems to be bright for this Health Reform bill as it proceeded completely unopposed in both the Senate and Congress. This bill is set to change and improve the health care system in the Philippines tremendously. How will it do that? We break down the basics and what we know so far!
What Is Universal Health Care (UHC)In a nutshell, this bill will basically ensure that every Filipino citizen will be entitled to a healthy living, working, and schooling conditions and access to a comprehensive set of health services without any financial hardships. In order to do this, the UHC will provide financial assistance for medical emergencies, hospital admission, and all other medical routines that focus on treatment and rehabilitation. While there isn’t really a final resolution yet for the UHC bill, the proposed features of this said bill are as follows:
1. Philhealth will be renamed Philippine Health Security CorporationThis will emphasize the agency’s role in providing financial security in health rather than just helping people pay for health services. With this reform, the agency will provide uniform benefits for all; develop a single but comprehensive primary care package (include medicines) for all; create supplementary coverage by HMOs and private health insurance; provide network-based licensing, contracting, & accreditation of facilities. Ultimately, the end service will be to ensure No Balance Billing (NBB) for the non-formal members or ward admissions and fixed co-payment for formal sector members or private room accommodation. For Filipinos to take advantage of these benefits, eligibility will be through automatic inclusion to the National Health Security Program.
2. Simplified membershipPhilHealth members will be identified into two (2) groups:
- Direct contributors - Paying members who are by default deducted for the premium through their payroll.
- Indirect contributors (non-contributors) - Non-paying members, basically everyone who isn’t a member of Philhealth. This will be fully subsidized premium from tax collections.
4. Population and individual-based healthcare initiativesThis law will utilize the different agencies to deliver different healthcare services according to their classified scope or function: population or individual healthcare services. Department of Health (DOH)
- To conduct population-based health interventions.
- Their main role is to finance population-based services, set standards and integrate a whole-of-society as well as whole-of-government approach.
- Their tasks include delivery of health interventions to the community as a whole like community healthcare programs such as vaccination and medical missions, health awareness campaigns, and basically streamline the delivery process and standards to all community-based healthcare service providers (community health centers and hospitals).
- Improve the doctor-to-patient ratio and increase the number of hospital beds and equipment. It also calls for the establishment of hospitals in remote areas.
- Focused on individual-based health interventions.
- Their main role is to finance all individual-based level services as a single, national purchaser
- Scope includes delivery of the following but not limited to individual hospitalization, rehabilitation, and emergency healthcare provision.
- The amount of provision will be determined through a fair and transparent technology assessment process.
- Individual-based health services will be financed primarily through prepayment mechanisms such as social health insurance, private health insurance, and HMO plans to ensure predictability of health expenditure.
₱257 billion needed to implement the billThe Department of Health (DOH) will need about ₱257 billion the first year it implements the UHC once the law is passed. In line with the passage of the UHC bill in Congress, Health Secretary Francisco Duque has pushed for increasing tobacco taxes. He said lawmakers and the public should view the two measures as “importantly linked” if the government were to be able to deliver on its promise of health care for all Filipinos. The health secretary likewise asked President Rodrigo Duterte last October 14, to certify as urgent a Senate bill seeking to raise tobacco taxes to fund UHC – just as the President did to help pass the UHC bill. While not entirely the main source of funding, the DOH is pushing to increase the excise tax on cigarettes to ₱90 per pack from the current ₱32.50. This would result in revenues of about ₱45 to ₱47 billion. Other sources of funding for the UHC bill in 2019 would be the following:
- DOH annual budget - ₱ 70 billion
- PhilHealth subsidies to indigent families - ₱70 billion
- Allocations from the Philippine Gaming and Amusement Corporation (PAGCOR) and Philippine Charity Sweepstakes Office (PCSO) - ₱30 to ₱40 billion
- PhilHealth membership contribution - ₱40 billion
- Sin tax proceeds - the remainder of about ₱37 billion
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