Universal Health

Care
Professor: Klyne Ken T. Cabag,
RN
 Legal Basis
• Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan
(KP), is the “provision to every Filipino of the highest possible quality of
health care that is accessible, efficient, equitably distributed, adequately
funded, fairly financed, and appropriately used by an informed and
empowered public”.
• The Aquino administration puts it as the availability and accessibility of
health services and necessities for all Filipinos. It is a government mandate
aiming to ensure that every Filipino shall receive affordable and quality
health benefits.This involves providing adequate resources – health human
resources, health facilities, and health financing.
 Legal Basis
• It is a government mandate aiming to ensure that every Filipino shall
receive affordable and quality health benefits. This involves providing
adequate resources – health human resources, health facilities, and
health financing.
• Parliamentarians and health stakeholders have made concerted efforts
to pass a UHC bill for the past two years, but in reality, the Philippines
has experienced a 50-year process of health reform, under different
names. The UHC Act is the culmination of decades of progress, and
two years of dedicated political and technical work.
 Legal Basis
• It is the first UHC Act of its type in the Western Pacific
region; this is particularly remarkable considering the
strong presence of the private sector in the Filipino health
system existing in parallel with a fragmented and
devolved government health service. The Act prescribes
system reforms in accordance with the multiple financing
and service delivery mechanisms at work in the
Philippines
 Background & Rationale (Universal
Health Care)
• The Universal Health Care (UHC) system in the Philippines
is a significant reform aimed at providing all Filipino
citizens with access to a full continuum of health services
they need, without enduring financial hardship. The
background and rationale for implementing UHC in the
Philippines are deeply rooted in addressing the challenges
faced by citizens in accessing affordable and quality
health care.
 Background & Rationale (Universal
Health Care)
• Background: The UHC system was established
through the signing of the Universal Health Care
Bill into law (Republic Act No.
11223) by President Rodrigo Duterte 1. This law
automatically enrolls all Filipino citizens in the
National Health Insurance Program and introduces
complementary reforms in the health system.
 Background & Rationale (Universal
Health Care)
• Rationale: The UHC Act is a response to the dire need for improved health
care services and financial protection for the people. It aims to:
• Reduce out-of-pocket expenses for health care, which previously accounted
for up to 54% of the country’s healthcare spending1
• Provide equitable access to quality hospitals and health care facilities2
• Ensure that all Filipinos can use the promotive, preventive, curative,
rehabilitative, and palliative health services they need2
• Protect families from the financial burden of health care expenses and reduce
the risk of people being pushed into poverty due to health-related costs
 Background & Rationale (Universal
Health Care)
• The UHC Act represents a political choice to prioritize the health of the
nation and is supported by a broad coalition across the political spectrum. It
is seen as a critical step towards achieving health for all Filipinos,
consolidating financial flows, improving governance, and institutionalizing
support mechanisms like health technology assessment and health
promotion3
• In summary, the UHC system in the Philippines is designed to ensure that
every Filipino has access to the highest possible quality of health care that
is accessible, efficient, equitably distributed, adequately funded, fairly
financed, and appropriately used by an informed and empowered public
 Universal Health Care THRUST
• To attain UHC, three strategic thrusts are to be pursued, namely:
1) Financial risk protection through expansion in enrollment and
benefit delivery of the National Health Insurance Program (NHIP);
2) Improved access to quality hospitals and health care facilities;
and
3) Attainment of health-related Millennium Development Goals
(MDGs).
 Universal Health Care THRUST
• Financial Risk Protection
Protection from the financial impacts of health care is attained by making
any Filipino eligible to enroll, to know their entitlements and
responsibilities, to avail of health services, and to be reimbursed by
PhilHealth with regard to health care expenditures. PhilHealth operations
are to be redirected towards enhancing national and regional health
insurance system. The NHIP enrollment shall be rapidly expanded to
improve population coverage. The availment of outpatient and inpatient
services shall be intensively promoted. Moreover, the use of information
technology shall be maximized to speed up PhilHealth claims processing.
 Universal Health Care THRUST
• Improved Access to Quality Hospitals and Health
Care Facilities
Improved access to quality hospitals and health facilities
shall be achieved in a number of creative approaches.
First, the quality of government-owned and operated
hospitals and health facilities is to be upgraded to
accommodate larger capacity, to attend to all types of
emergencies, and to handle non-communicable diseases.
 Universal Health Care THRUST
• Improved Access to Quality Hospitals and Health Care Facilities
The Health Facility Enhancement Program (HFEP) shall provide funds to
improve facility preparedness for trauma and other emergencies. The aim
of HFEP was to upgrade 20% of DOH-retained hospitals, 46% of provincial
hospitals, 46% of district hospitals, and 51% of rural health units (RHUs) by
end of 2011.Financial efforts shall be provided to allow immediate
rehabilitation and construction of critical health facilities. In addition to that,
treatment packs for hypertension and diabetes shall be obtained and
distributed to RHUs.The DOH licensure and PhilHealth accreditation for
hospitals and health facilities shall be streamlined and unified.
 Universal Health Care THRUST
• Attainment of Health-related MDGs
Further efforts and additional resources are to be applied on
public health programs to reduce maternal and child mortality,
morbidity and mortality from Tuberculosis and Malaria, and
incidence of HIV/AIDS. Localities shall be prepared for the
emerging disease trends, as well as the prevention and control of
non-communicable diseases.The organization of Community
Health Teams (CHTs) in each priority population area is one way
to achieve health-related MDGs.
 Universal Health Care THRUST
• Attainment of Health-related MDGs
CHTs are groups of volunteers, who will assist families with their health needs,
provide health information, and facilitate communication with other health
providers. RNheals nurses will be trained to become trainers and supervisors to
coordinate with community-level workers and CHTs. By the end of 2011, it is
targeted that there will be 20,000 CHTs and 10,000 RNheals.Another effort will
be the provision of necessary services using the life cycle approach. These
services include family planning, ante-natal care, delivery in health facilities,
newborn care, and the Garantisadong Pambata package.Better coordination
among government agencies, such as DOH, DepEd, DSWD, and DILG, would also
be essential for the achievement of these MDGs.