Universal Health Care: Five Years in the Making

Universal Health Care (UHC), as it applies to Filipinos, is defined as a health care system that guarantees all of them access to quality health care and services based on need and not on the ability to pay.  In 2009, a team from the University of the Philippines Manila which participated in the 2008 Centennial Lecture Series of the University of the Philippines  converted itself into an advocacy group called UHC Study Group ( UHCSG ) which pushed for the adoption of UHC as the health care system for the Philippines. UHC  was adopted by the then incoming administration of President Benigno Aquino in 2010 and was embodied in Department Order 2011-0188 of the Department of Health, which translated UHC into the Kalusugan Pangkalahatan or KP.  In June2013 he signed RA 10606 mandating a National Health Insurance Program (NHIP).Upon implementation of KP, three strategic thrusts were launched: (1) financial risk protection via the Philippine Health Insurance Corporation (PhilHealth); (2) attainment of the Millennium Development Goals of 2015; and (3) improved access to quality health care facilities under the Health Facilities Enhancement Program (HFEP). The strategic thrust is to be supported by reforms in the traditional sectors of health, namely: financing, service delivery, policy standards and regulation, human resource, information, and governance.  Five years into the implementation of UHC or KP, the following conclusions are supported by evidence: (1) Neither government subsidy nor PhilHealth has adequately protected the poor from financial risk. (2) The poor remain largely unable to access quality outpatient care via rural health units or in-patient facility (hospitals). (3) Millennium development goals of 2015 especially those related to maternal and child health will not be achieved. Based on a study, effective implementation of the objectives of UHC can be speeded up if the following corrections are made now. (1) UHC should be grounded on Primary Health Care (PHC) to promote inclusiveness. (2) Funds intended for health services should be pooled regardless of source and allocated based on a set of priorities that are continuously vetted, for the purpose of giving priority to the poor. (3) Health human resource production should respond to the needs of UHC and government must assure attractive emolument and career path for those working in the health sector. (4) Reforms in leadership and governance must address the problems brought about by devolution. (5) Immediate implementation of a National Health Information System is needed to provide accurate and real time data. While the UHC is only five years old there are enough lessons learned to develop the correct policies and programs.

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