UNIVERSAL Health Care

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Consistent with President Benigno S. Aquino III’s commitments on universal health care articulated in his inaugural speech, “Serbisyong Pangkalusugan, tulad ng PhilHealth para sa lahat sa loob ng tatlong taon,” and his first State of the Nation Address, “Para mabigyan ng PhilHealth ang limang milyong pinakamaralitang pamilyang Pilipino,” the Department of Health led the conduct of a nationwide PhilHealth Registration Day on October 2.

Dubbed as “PhilHealth Sabado”, the campaign aimed to increasing public awareness regarding PhilHealth entitlements and responsibilities, enjoin enrollment of the informal sector or those who are self-employed individuals like farmers and fisher folks and even the daily wage earners such as vendors and transport drivers and operators, and the self-practicing professionals, and enroll poor families identified by the Department of Social Welfare and Development through the National Household Targeting System.

During the SONA, P-Noy said that different data on PhilHealth coverage was available. He said, “Sabi ng PhilHealth sa isang bibig, 87 porsyento na raw ang mayroong coverage. Sa kabilang bibig naman, 53 porsyento naman. Ayon naman sa National Statistics Office, 38 porsyento ang may coverage”.

In response to the President’s call to look at PhilHealth coverage, PhilHealth has organized an interagency technical working group (TWG) to identify and address issues related to differences in reports on PhilHealth membership coverage. In the absence of complete enumeration of PhilHealth beneficiaries (PhilHealth principal member plus dependents), one of the first tasks of the TWG was to identify the methodology that provided the best estimate of PhilHealth coverage.

However, enrollment of Filipinos is only the first step towards “financial risk protection” or the ultimate effect of health financing scheme that eliminates if not greatly reduces the out-of-pocket patients pay for health care. The PhilHealth benefit delivery review conducted by the Health Policy Development Project using PhilHealth data of 2008 estimates that the average benefit delivery rate nationwide of the National Health Insurance Program  is around 8 percent. This means that the cumulative likelihood that every Filipino: a) is eligible to claim PhilHealth benefits; b) knows entitlements, able to access and avail health services from accredited providers; and c) whose total health care expenditures are fully reimbursed by PhilHealth is only 8%.

Moreover, another study shows that even those who already have a PhilHealth card do not use it when they access health care. A recent study entitled “Review of Private Hospitals in the Philippines” by the Philippine Institute for Development Studies shows that among those who were confirned to hospitals, only 51 percent of those admitted in private hospitals used their PhilHealth during their confinement while less than a quarter (24 percent) of those admitted in public facilities have used their PhilHealth.

Health Secretary Enrique T. Ona pointed out that “It is very important that we do not just enroll the poor families or enjoin the informal sector to enroll to PhilHealth, it is also very important that we tell them their entitlements and their responsilities of being a PhilHealth member.”

The path towards universal health care does not start or end with PhilHealth Sabado last October 2. This event instead provided an impetus that will propel the health sector in achieving its goal of providing equitable and sustainable financing for health care. In fact, for the P-Noy administration, universal health care means the availability and accessibility of essential health services, basic necessities and appropriate quality health care for all Filipinos. This entails adequate resources, in terms of health human resources, health care facilities, medicines and health financing.

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