Health Care For All Filipinos

Sylvia Estrada Claudio is  a doctor of medicine and a PhD in psychology. When she is not attempting political trade-offs for her hobby horses, she is teaches Women and Development Studies at the University of the Philippines in Diliman. She is a fellow of AER. This piece was published in the January 31, 2011 edition of the BusinessWorld, pages S1/4 to S1/5.

If I were the President, conditional cash transfers or CCT’s  would not be my flagship program. I would instead work on universal health care.

I know, I know. I am not the President. I am also not so arrogant as to presume to give Pnoy unsolicited advise or bad-mouth Sec. Dinky’s thing. This is not about the pros and cons of the CCT, a subject that deserves it own Yellow Pad column.

But universal health care (UHC) is one of my hobby horses. It has been on my mind for the past year for several reasons, one of which is that Dr. Alberto Romualdez and a group of colleagues from UP Manila,  put together a task force for the Centennial Lecture Series of the University of the Philippines and came up with a blueprint  for UHC. The task force’s output is exciting because it is straightforward in its proposal that we can achieve health care for all in a relatively short period of time.

According to the NSCB, our country’s total health expenditure reached P180.8 billion  in 2005.

Using this figure the task force proposes that  around 80 to 120 B pesos would be needed to achieve  health care for all. The task force also proposes several funding mechanisms such as quantum increases in tax-based government spending, national government-tax increases, reallocations, local government-mandatory increases in proportion spent on health and significant increases in public health insurance support value for basic services. AER head honcho Men Sta. Ana, who I asked late last year, also thinks that sin tax increases and foreign borrowings could be tapped as well. It tickles my iconoclastic soul that activists like us would actually approve of foreign debt. But, many of us have always argued that debt that truly benefits the people would not be bad debt.

Thailand is an excellent source of inspiration. It’s total health expenditures for the year 2007 are slightly less than the Philippines. Yet it has achieved universal health care. WHO statistics show that the Thai government provided for 73% of all health expenditures while the Philippine government   provided only 35%.  Simply put, Filipinos are paying for their own health care out of their own pockets. Naturally, the health statistics for Thailand are so much better.

Thailand achieved its universal health coverage over a period of years through a multi-pronged approach that involved, among other things, local-level initiatives.

So, I nagged another good friend, Dr. Dennis Batangan to work out a pilot program for UP Diliman. It is my dream to start piloting for universal coverage, so I thought this should happen in the place where I work.

What Dr. Batangan and I propose is to start a demand-driven and insurance linked health benefits project for UP Diliman.  It begins simply as an information  management  system  and  health  insurance  project  intended  to  expand  the  access  of  the  UP  Diliman  Community  to   available health  benefits.  It  aims  to consolidate  available  information  on  health-related  benefits  intended  for  various  sectors  of  the  UP  Diliman  community  and  expand  access  to  these  benefits  through  demand-driven  mechanisms  and  social  health  insurance  schemes.

This is a first step towards ensuring equity in health benefits for all sectors of the UP Diliman community. It will also serve as a pilot effort towards universal health care coverage.

The  project  will  be  implemented  in  four phases  namely: 1) a policy engagement phase.  to  ensure  the  commitment  and  support  of  the  highest  level  of  authority  in  the  UP  Diliman  Community,  the  Board  of  Regents  and  the   Barangay  UP  Campus  officials;  2) a   data  integration  phase that includes  the  designing  of  the  data  framework  and  capture  forms   to  consolidate  the  available  health benefits  and  insurance   information  for  employees, students  and  community  residents  participating  in  the  project.  The data framework will also attempt to capture current demand for health services for the stakeholders concerned as well as health expenditures per capita and for UP Diliman as a whole;  3)   a network  expansion  phase that involves  the development  of  a  directory  for  and    organizing   into  a  network   of  the  health  service  providers  the  psychosocial ,  biomedical  and  alternative  health  service  providers  in  the  community.  The  information  gathered  from  the  network  will  be  made  available  to  the  UP  community  through  an  internet  portal  and/or  SMS  services and; 4) a  benefits convergence  and  development  phase where  institutions  and  organizations  offering  health  related  benefits  will  be  guided  on  the  process  of  converging  or  integrating  their  benefits  for  same  beneficiaries  and  improving  efficiency  in  the  provision  of  these  benefits.  At  the  same  time,  new  benefit  packages   for  health  related  or  psychosocial  services  will  be  developed  or  expanded  for  the  benefit  of  the  community.

The  goal  of  the  project  for  UP  Diliman  employees, students  and  community  members  have  easy  access  to  consolidated  information  on  health  related  benefits  they  can  avail  of  in  times  of  need.  In  the  process,  the  beneficiaries  will also  be  provided  inputs  on  how  to expand  the  health  benefits  they  are  currently  receiving  through  social  health  insurance  schemes  and  development  of  other  demand  side  benefits.

So, if I promise, promise, promise to cooperate with Pnoy’s CCTs, can he spare me a bit of change to begin piloting universal health care in UP Diliman?

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