Open AccessPolicy Analysis on Financing Roles for Population- and Individual-based Health Services in Light of the Universal Health Care Act
Author(s) -
Leonardo R. Estacio,
Christine Mae S. Avila,
Ma-Ann M. Zarsuelo,
Ma. Esmeralda C. Silva,
Michael Antonio F. Mendoza,
Carmencita D. Padilla
Publication year - 2020
Publication title -
acta medica philippina/acta medica philippina
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.128
H-Index - 4
eISSN - 2094-9278
pISSN - 0001-6071
DOI - 10.47895/amp.v54i6.2605
Subject(s) - business , health policy , health care , scope (computer science) , population , finance , procurement , government (linguistics) , population health , community health , public relations , economic growth , medicine , political science , economics , environmental health , marketing , linguistics , philosophy , computer science , programming language
Objectives. The health financing scheme brought by the Universal Health Care Act has a significant change in the landscape of allocating funds for health services, as well as in the delineation of roles among the key actors. Consistent with the law, the protection from the health financial risks of Filipinos must be guaranteed. This study aimed to determine the roles of the government and other key agencies in financing population-based and individual-based health services in the Philippines.
Methods. A systematic review of literature was done to generate evidence for the policy brief and proposed policy alternatives. The UP Manila Health Policy Development Hub organized a roundtable discussion in collaboration with the Department of Health participated by key stakeholders from various sectors involved in the policy issue. Systematic review and insights from the discussion were analyzed to produce consensus policy recommendations.
Results. Given the current procurement and financing, the DOH should fund population-based services while PhilHealth, with the assistance of Health Maintenance Organizations (HMO) for premium holders, should fund individual-based services. Health programs with grey areas (i.e. with both individual- and population-based services) need further technical discussions. It is imperative to have clear-cut specific guidelines on the managerial and financial roles of the provincial health board and the scope of financing service delivery.
Conclusion. Delineating the roles of DOH, PhilHealth, and HMOs in financing health services is not without risks. The utilization of the special health fund at the provincial level should be carefully implemented and monitored to minimize inefficiencies and fraud.