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Message of Secretary Enrique T. Ona delivered by Asec. Madeleine de Rosas- Valera -13th National Health Research Forum for Action

November 20, 2012

Pan Pacific Hotel, Malate, Manila

Good morning!

It is auspicious that we are having our 13th National Health Research Forum for Action amidst the backdrop of hopeful expectation for the health of our people.

We are anticipating that by the evening of this day, the Philippine Senate would have passed the alcohol and tobacco excise tax reform bill, and that before the year ends, the President has signed this bill into law. With this legislative measure being enacted, we will be receiving 85% of P 40 to 45 billion annually for health.

The incremental revenues generated from this measure will be used to enroll to PhilHealth an additional 5.6 million families, the next poorest 20% of our population or Q2. This will be on top of the 5.2 million families, the poorest 20% or Q1 already enrolled to PhilHealth. We will be able to expand the benefits of PhilHealth – increase the number of medical and surgical conditions under case rates with no balance billing for the poor as well as expand our catastrophic care package to include heart attacks, strokes, other cancers and trauma. At long last, we will have the funds needed to finally eliminate public health threats such as malaria, schistosomiasis, filariasis and rabies. With more funds for upgrading and modernization, the stereotype of decay and deficiency associated with our government hospitals and other health facilities will be banished. And we will be able to hire more doctors, nurses and other health professionals to seal our gaps in health human resources.

With our health sector being afforded this much-needed shot in the arm and building on our gains in the two years of implementing KalusuganPangkalahatan, we are invested withthis unique opportunity to establish the directions for ensuring the sustainability of universal health care in the Philippines.

Evidence must guide us in charting the next steps for universal health care. Evidence is crucial in sound policy making and implementation. At the same time, we can learn from the experiences of other health systems undergoing reform processes similar to ours. Best practices of other countries can be modified and put to good use, while their pitfalls can be avoided. As a relative “latecomer” compared to Mexico or Thailand, we have the advantage of learning from their experiences and avoiding their mistakes, but we must take into consideration our unique situation and needs.

As we move forward, strong health policy research is imperative in answering policy questionsthat will inevitably come up in our journey towards universal health care.  Let me share with you some policy concerns the health sector needs to face.

With PhilHealth becoming the dominant third party payer for health services in the years to come, and with our program of case rates with no balance billing for the poor enrolled in the Sponsored Program and fixed co-payment for other members, we must find out the fair and acceptable fee that our doctors are willing to accept for certain defined medical services. This determination has been done in the Philippine College of Surgeons in the past and must be updated and expanded to cover the non-cutting specialties, such as medicine and pediatrics.

We must also define the different benefit pacakages of PhilHealth that will correspond to varying levels of premium PhilHealth members are willing to pay. For example, the Department of Education has long mentioned that teachers may be willing to pay additional PhilHealth premium for add-on medical services such as annual x-ray and medical examinations. Those who are in the formal sector might be willing to pay higher premiums for increased benefits, and the specifics of the premium amounts and corresponding add-on services must be worked out in detail.

Yesterday, during my remarks at the Provincial Health Officers Association of the Philippines, I stressed that after 21 years of devolution, we need to agree on the level by which our local health systems will be consolidated to address fragmentation and ensure viability, sustainability and reasonable economies of scale.  I have the sense that limiting devolution to the provinces and putting the municipal health systems under the provincial government is a better alternative to what we have at present. But this proposal, or other proposals for reforming devolution, must be supported by evidence.

As we invite the participation of private sector capital, initiative and expertise in our ongoing health reform through public private partnerships, we must be able to define the so-called rules of engagement as well as the scope of services the private sector can work with us. We must study how PPPs proceeded in other countries and determine their best practices worthy of emulation and their pitfalls we must avoid. The specifics of the working relationship of the government and private sector must be threshed out. This is most critical in the revenue and human resources component of PPP  projects.

In our desire to reform our national hospital system through good governance using corporatization, the administrative structures for carrying this out needs extensive study. We want our hospital managers to be accountable to their boards to be composed of representatives of government, the private sector, civil society, among others.

I am aware that we have institutions devoted to health policy research: the UP School of Economics, the Philippine Institute for Development Studies, the UP-National Institutes of Health, among others. We need to ensure that our various research institutions are complementing each other, to avoid duplications in outputs, which is a waste of time, effort and resources. We must also collate and organize health policy researches done in the past. Relevant data must also be made available for us to be guided in our continuing efforts for health reform.

I believe that the UP College of Public Health must go beyond the study of microbiology and parasitology and take the lead in formulating health policy recommendations while working with the Department of Health.

At the same time, for health reform to be effective, we must recognize the multidisciplinary nature of health policy and engage the services and outputs of our social scientists, psychologists, communications experts and economists.

In rising to the challenge of ensuring a strong policy research for the health sector, the Department of Health has undertaken several steps for enhancing our capacities for research, analysis and evidence-to policy links must be enhanced.

Starting this year, DOH assured the allocation and pooling of the 2% research allocation from the Maintenance and Other Operating Expenditures in the General Appropriations Act amounting to P 150 million. This will help us fund the DOH research activities.

We established the Health Research Hub, chaired by Dr. Ernesto Domingo, as an initial step in executing our research and policy agenda. This research hub will harmonize our research resources, maximize the use of funds, ensure that research results are put to good use and translated into policies and programs for implementing KalusuganPangkalahatan.

Another venture we started this year is the mobilization and participation of young blood in research with thirty (30) Policy Planning Health Research Fellows who are being mentored by our DOH Program Managers with the help of Philippine Institute for Development Studies and the Philippine Council for Health Research and Development of the DOST. Eventually, these Research Fellows may opt to join DOH or the health sector and add to our pool of Health Researchers in the country.   We will also be building the capacities of our DOH staff in health research together with our Research Fellows.

Lastly, the Health Policy Development Program II of the UP Econ Foundation, funded with a $ 15 million grant by the US Agency for International Development, will be assisting the DOH through its health policy platform.

Evidence-based policy making, rooted in sound health policy research is critical in sustaining our gains under KalusuganPangkalahatan. Let us strengthen the culture of policy research in the health sector and ensure the generation of effective policies and programs that will significantly uplift the health of our people.

Thank you and good morning.