Ayala Group participates in UHC delivery

How the current administration will pursue its avowed universal healthcare program for Filipinos with the broad participation of the private sector’s health delivery services will be crucial in defining its success, especially during the first few years.

The Universal Health Care (UHC) Law, which was passed just last February, promises a comprehensive set of health services to all Filipinos under the National Health Insurance Program (NHIP) supervised by the Philippine Health Insurance Corp. (PhilHealth).

With current government health services still not ready to respond to an expected influx of more than six million newly enrolled PhilHealth members through the law, the network of established private clinics and hospitals in the country would be in the better position to act.

AC Health CEO Paolo Borromeo says initiatives by the private sector, like FamilyDoc of Ayala Healthcare Holding Inc. (AC Health), are working examples of how community-based primary care clinics can offer reliable healthcare through the services of qualified doctors and health personnel.

What is needed to encourage the expansion of these clinics would be well-defined terms of reference on their participation under the UHC Law, much like a set of incentives that is made available by government to the private sector.

For now, AC Health, a unit of Ayala Corp., has allotted P1.3 billion to build 100 clinics over a period of five years until 2020 within the Greater Metro Manila area to serve middle-income communities through affordable healthcare services and facilities.

Three-in-one

FamilyDoc’s unique three-in-one medical clinic concept comprises a clinic staffed by carefully screened family medicine residents; a diagnostic facility that offers various imaging services such as X-ray, 2D echo, and OB sono; and a pharmacy that carries both branded and generic medicines – all under one roof.

Established in December 2015, FamilyDoc aspires to provide affordable, accessible, and quality healthcare for the community while advocating preventive and primary healthcare. It holds regular health education activities in the communities through the help of the local government.

To date, Borromeo says there are 68 operating FamilyDoc clinics that have served 400,000 unique patients who enjoy the added benefit of having their medical record on a database that can be viewed at any branch they need to go to.

Patients automatically become FamilyDoc lifetime members, eligible to a succeeding P350-consultation fee rate inclusive of a free follow-up check-up within seven days. (The first consultation fee is P500.) The laboratory and imaging rates offered at FamilyDoc facilities are also at least 50 percent lower compared to other providers in the surrounding environs.

FamilyDoc clinics are open to partnerships with companies that wish to provide their employees with healthcare benefits, and even households that want to give their hired helps some form of enrolled health protection that augments with what the local government health centers provide.

Rollout issues

The UHC Law is expected to become “operational” once its implementing rules and regulations (IRR) are approved, but PhilHealth will not be able to implement a full nationwide roll-out of the programs specified under the law because of funding problems.

PhilHealth is also weighed down by human resource issues, not having enough health workers, including doctors, nurses and midwives, to provide the services that consulting citizens need. Many times, new health workers employed in government agencies work on a contracted basis, something that should change with the new law.

The private sector, on the other hand, has the manpower complement to run its facilities since it is in a better position to attract health workers because of higher salaries and more attractive remuneration package.

While the UHC Law has a number of provisions that deal with manpower issues, including requiring all professional health graduates of government-funded scholarships to render at least three years of return service, bankrolling the salaries will be a challenge.

The Department of Finance (DOF) has already singled out the UHC program as a risk in the national government’s financial position since it will compete with so many other new costs incurred from other recently passed laws, including increases in salaries of military personnel.

The escalating budgetary requirement of the P8.4-trillion Build Build Build infrastructure program, which needs prioritization, will also vie for financial resources that the national treasury appropriates every year.

Social ‘investment’

The newly minted UHC Law, however laudable its intentions, represents a social investment – which is still an expense – that needs to be funded by taxes, and as stipulated by the law, from sin products like tobacco and alcohol.

If collected sin taxes will not be enough, then the Department of Budget and Management (DBM) will have to reduce the budgets of other government agencies, or propose higher taxes, or increase borrowings, or scale down the UHC appropriation – all unpalatable measures.

The current government has chosen to bite the bullet by beefing up investments in the country’s social programs and its human resources as a way to hasten inclusive growth among those in the lower-income segments of society.

It is banking on one of the longest runs of economic growth that the Philippines has experienced in decades to justify the continued increases in the national budget, one that can be expected to hit P4.1 trillion next year.

Given the restraints, and weighing on the importance of social investments like UHC, private sector participation should be given more incentives. Companies like Ayala, for example, have a long history in the country, and would be more than willing to invest in nation building.

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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.