In February 2019, amid the ongoing, decades-long push for comprehensive health reform, the Philippines’ first Universal Health Care (UHC) bill was signed into law.
The UHC Law, also known as Republic Act No. 11223, aims to reduce the risk of Filipinos being forced into poverty just because they can’t pay their medical bills, while increasing access to quality health care for the poor and those living in remote areas. Fully enacted, it will entitle every Filipino citizen to health coverage that will cost them far less than what they have to pay for at present.
Studies conducted within the last 10 years (such as Lasco et al., 2021) have shown that most Filipinos still rely on personal funds to pay for health care, and that health-related spending continues to lead many people into debt and poverty. Consequently, in order to “save money,” most people consult a doctor or seek hospital care only when their illnesses have become severe.
Many countries have similar health care laws in place that provide access to health care at little or no cost to their citizens. In fact, some of the best public health care systems in the world, such as those of Sweden, Denmark, and Germany, all have successful universal health care programs. Among the many inspirations for the Philippine version is the United Kingdom’s National Health Service, which has provided UK citizens access to free public health care since 1948 (WHO, 2019).
Here are the basics of the Philippine UHC Law:
1. All Filipinos will now have access to a full range of health services - promotive, preventative, curative, rehabilitative, and palliative services, all for free to a certain extent. These will include medical, dental, mental and emergency health services.
2. All Filipinos have been automatically enrolled in the National Health Insurance Program. They will either be direct contributors--those who can pay PhilHealth premiums, like employees, professionals, and OFWs--or indirect contributors, whose premiums will be subsidized by the government.
3. Everyone will be enrolled with a primary care provider of their choice. This provider will be the health worker who will be the first point of contact for an individual’s health concerns.
4. Everyone will be entitled to an essential health benefit package, which will include medicines, diagnostic tests, and primary care.
5. Not everything will be for free, but PhilHealth will continue to cover basic services and basic accommodations. For example, basic accommodation like a hospital stay in a shared room with fan ventilation and regular meals will be covered; a private room with air conditioning and a TV won’t be.
6. In case a patient might need to spend for care on top of basic services, the DOH will regulate this co-payment to ensure one will always know what to expect in terms of finances and won’t be surprised by the amount of the bills.
7. PhilHealth will become the national purchaser of health goods and services, which means they will be in charge of paying for medical services given to Filipinos. People will no longer have to spend days filling up forms just to pay for health expenses.
8. There will also be structural changes. Provinces, rather than municipalities, will be in charge of overseeing health services. Highly urbanized cities like the component cities of Metro Manila will manage their own health care networks, instead of individual barangays. This will make it easier to fund geographic areas that lack access to proper services.
Additionally, the UHC Law has created the Health Technology and Assessment Council, a group of health experts who keep an eye on the latest developments in health, from technology to medicines and vaccines to health-related political issues. They make recommendations to the DOH and PhilHealth to ensure the health care system continues on its new path of reforms.
1. Lasco, G., et al. (2021). The lived realities of health financing: A qualitative exploration of catastrophic health expenditure in the Philippines. Acta Medica Philippina. https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/2389/2455
2. WHO. (2019). UHC Act in the Philippines: A new dawn for health care. https://www.who.int/philippines/news/feature-stories/detail/uhc-act-in-the-philippines-a-new-dawn-for-health-care
Johann Ulrik Go/ CONTRIBUTED