P-Noy's universal health care dream

No doubt, health care is now one of the biggest concerns of Filipinos given the high cost of medicines and hospitalization, not to mention doctors’ professional fees. So it’s not surprising that this would be high up in the current administration’s agenda.

In the unveiled Universal Health Care program of the P-Noy government, one target is to enroll in the state’s health insurance program 40 percent of the current population who belong to the poorest segments of society and are largely not covered under PhilHealth.

In 2010, the health department estimated that health insurance coverage by the Philippine Health Insurance Corp., a government owned and controlled company, is still at a measly 54 percent of the population after 16 years of trying to achieve its mandate of 85 percent coverage.

Worse, of those holding PhilHealth cards, only 42 percent are actually able to access benefits. And even the given benefits are partial, representing only 34 percent of actual medical bills. Subsequently, this translates to only eight percent health insurance support.

The Universal Health Care program or AHA (for Aquino Health Agenda), in essence, will need the support and help of local government units which will be the national government’s link to the combined poorest and next poor population of around 9 million families.

The poorest 20 percent segment of about 4.7 million Filipinos is defined as earning about P3,500 or less in a month. On the other hand, the next poor sector, composed of about four million families, earn P3,500 to P6,000 a month.

Not just health insurance

Health secretary Enrique Ona may come up with all the pep words and sweet talk to local chief executives encouraging them to continue and even expand the number of enrollees under PhilHealth, but at the end of the day, everything will boil down to the need for more state support for health delivery.

One stark reality as to why health insurance coverage does not reach the poorest of the poor is the lack of health centers within reach of this deprived sector of society. And even if there were one nearby, chances are it would not possibly be accredited by PhilHealth.

Last year, about 900 rural health units had yet to be enrolled in the government’s insurance mechanism while about a hundred state hospitals needed to qualify for accreditation. This seems to be unacceptable given that both are within the ambit of the public health system.

And if the health facility is accredited, many complain of the bureaucratic red tape that comes with trying to get reimbursements, which often is regarded as no longer commensurate to the administrative effort involved.

Need for reforms

If the health secretary is pushing for a truly universal health coverage, there is need to reform the current healthy delivery organization. Aside from the lack of more health centers, it is popular knowledge that public hospitals and clinics deliver below-quality standards of service because of a lack of funds and qualified personnel.

The problem becomes more magnified as the local government unit becomes smaller and poorer. This is one obvious downside resulting from devolution of the health reform agenda from one that was formerly national government-centered to one that now relies more on local government funds.

Ironically, it is the poorer LGUs that need more state support to maintain decent barangay health clinics that are staffed by at least one doctor. But if there is not enough money to pay for a doctor, how can one even expect up-to-standard medical facilities in the remote barrios’ clinics.

Third world realities

But this is not saying that we should stop dreaming of having a decent health delivery within reach of our poor countrymen. America may be clamoring for the demolition of its state-subsidized health insurance scheme, but their citizens live in an economy where most have the money to pay for basic health care.

In contrast, most Filipinos now forego medical consultations and treatments because they not only do not have enough money to make the trip to the nearest health facility, they also cannot afford to pay for professional fees, confinement if needed, and medicines.

PhilHealth is a system that currently is able to provide partial support for the medical needs of its members. And while there are moves to amend its charter such that it will receive more government funds to widen its scope of coverage and increase the amount it can give, this should not be the be-all and end-all of the current government health program.

Obviously, the current health budget of P7 billion will need to be augmented with more funds so that more barangay health stations can be established, and existing ones be improved to gain the needed recognition by PhilHealth.

Funding a dream

Without adequate funding, P-Noy’s universal health care program for Filipinos will remain a dream. Given the budgetary constraints of the P-Noy government, as well as pronouncements that it will not resort to new tax measures, one revenue enhancing scheme that is worth deliberating on is the restructuring of the current taxation system on sin products.

We all know the irrefutable ill-effects that smoking and drinking have on the nation’s health, and yet the Philippines continues to maintain one of the lowest levies in the world on tobacco and spirits.

Studies have shown that the tax income from these “sin” products are not enough to pay for the health cost of illnesses associated with smoking and drinking. In effect, whatever meager government resources that is allocated to health promotion is unjustly spent on curing diseases spawned by these unhealthy habits.

If smokers or alcoholics want to ruin their lives by indulging in these unhealthy habits, then they should at least pay for it.

Would it not be appropriate that taxes from cigarettes and alcohol which cause several health problems should be a major contributor to the funding of a health program for the benefit of all?

Should you wish to share any insights, write me at Link Edge, 25th Floor, 139 Corporate Center, Valero Street, Salcedo Village, 1227 Makati City. Or e-mail me at [email protected]. For a compilation of previous articles, visit www.BizlinksPhilippines.net.