P H I L I P P I N E H E A LT H A G E N D A 2 0 1 6 - 2 0 2 2

PAULYN JEAN B. ROSELL-UBIAL, MD, MPH, CESO II

Secretary of Health
GOALS

The Health System We Aspire For

FINANCIAL BETTER HEALTH

RESPONSIVENESS
PROTECTION OUTCOMES

Filipinos, especially the Filipinos attain the Filipinos feel respected,

poor are protected from best possible health valued, and empowered in
high cost of health care outcomes with no all of their interaction with
disparity the health system
VALUES

The Health System We Aspire For

EQUITABLE & INCLUSIVE TRANSPARENT &

TO ALL ACCOUNTABLE

USES RESOURCES PROVIDES HIGH

EFFICIENTLY QUALITY SERVICES
During the last 30 years of Health Sector Reform, we have undertaken key
structural reforms and continuously built on programs that take us a step
closer to our aspiration.

Milestones

Devolution Use of Generics Milk Code PhilHealth (1995)

DOH resources to Fiscal autonomy Good Governance Funding

promote local health for government Programs for UHC
system development hospitals (ISO, IMC, PGS)
Persistent Inequities in Health Outcomes

2000
Every year, around 2000 A Filipino child born to the Three out of 10
mothers die due to poorest family is 3 times children are stunted.
pregnancy-related more likely to not reach his
complications. 5th birthday, compared to one
born to the richest family.
Restrictive and Impoverishing Healthcare Costs

Tiisin ko na
lang ito..

Every year, 1.5 million Filipinos forego or delay care Php 4,000/month
families are pushed to due to prohibitive and healthcare expenses
poverty due to health care unpredictable user fees or co- considered catastrophic
expenditures payments for single income families
Poor quality and undignified care synonymous
with public clinics and hospitals

Long wait times Limited autonomy Less than hygienic restrooms,

to choose provider lacking amenities

Privacy and confidentiality Poor record-keeping Overcrowding & under-provision of

taken lightly care
Lahat Para sa Kalusugan!
Tungo sa Kalusugan Para sa Lahat
• UNIVERSAL HEALTH
COVERAGE

• STRENGTHEN
IMPLEMENTATION OF
RPRH LAW
Investing in People • WAR AGAINST
DRUGS

• ADDITIONAL
Protection Against Instability FUNDS FROM
PAGCOR
PHILIPPINE HEALTH AGENDA FRAMEWORK
Goals:
Goals:Attain
AttainHealth-Related
Health-RelatedSDG
SDGTargets
Targets
Financial
FinancialRisk
RiskProtection,
Protection,Better
BetterHealth
HealthOutcomes,
Outcomes,Responsiveness
Responsiveness

Values:
Values:Equity,
Equity,Efficiency,
Efficiency,Quality,
Quality,Transparency
Transparency

SERVICE DELIVERY
NETWORK

ALL LIFE STAGES &

3 Guarantees TRIPLE BURDEN OF
DISEASE

UNIVERSAL
HEALTH
INSURANCE

A C H I E V E
GUARANTEE #1

ALL LIFE STAGES &

TRIPLE BURDEN OF DISEASE
Services for Both the Well & the Sick
All Life Stages & Triple Burden of Disease
Pregnant Newborn Infant Child Adolescent Adults Elderly

First 1000 days | Reproductive and sexual health | maternal, newborn, and child
health | exclusive breastfeeding | food & micronutrient supplementation |
Immunization| Adolescent health | Health screening, promotion & information
NON-
DISEASES OF RAPID
COMMUNICABLE,
COMMUNICABLE URBANIZATION &
INCLUDING
INDUSTRIALIZATION*
MALNUTRITION
• HIV/AIDS, TB, Malaria • Cancer, Diabetes, Heart • Injuries
• Diseases for Elimination Disease and their Risk • Substance abuse
• Dengue, Lepto, Factors – obesity, • Mental Illness
Ebola, Zika smoking, diet, • Pandemics, Travel Medicine
sedentary lifestyle • Health consequences of
• Malnutrition climate change / disaster
GUARANTEE #2

SERVICE DELIVERY NETWORK

Functional Network of Health Facilities
Services are delivered by networks that are

FULLY FUNCTIONAL
(Complete Equipment, Medicines, PRACTICING GATEKEEPING
Health Professional)

LOCATED CLOSE
COMPLIANT WITH CLINICAL TO THE PEOPLE
PRACTICE GUIDELINES (Mobile Clinic or Subsidize
Transportation Cost)

AVAILABLE 24/7 & EVEN ENHANCED BY

DURING DISASTERS TELEMEDICINE
GUARANTEE #3

UNIVERSAL HEALTH INSURANCE

Financial Freedom when Accessing Services
Services are financed predominantly by PhilHealth
• No balance billing for the poor in basic
SIMPLIFY
accommodation
PHILHEALTH
RULES • Fixed co-payment for non-basic
accommodation

PHILHEALTH AS THE • Expand benefits to cover comprehensive

MAIN REVENUE
range of services with high support value
SOURCE FOR ALL
HEALTHCARE • Contracting networks of providers within Service
FACILITIES Delivery Networks

PHILHEALTH AS • All Filipinos as members

THE GATEWAY TO
• Formal sector premium paid through payroll
FREE OR
AFFORDABLE and non-formal sector premium paid through
CARE tax subsidy
Our Strategy
A Advance health promotion, primary care and quality

C Cover all Filipinos against financial health risk

H Harness the power of strategic HRH

I Invest in eHealth and data for decision-making

E Enforce standards, accountability and transparency

V Value clients and patients

E Elicit multi-stakeholder support for health

A Advance health promotion, primary care and quality
1. Annual health visits for all poor families
2. PhilHealth to contract with functional networks* of PCB
providers and DOH provide additional resources*
3. Transform selected DOH hospitals into multi-specialty, end-
referral “mega-hospitals”, i.e. teaching/training, reference
laboratory
4. Enact/enforce measures to improve access to lifesaving
interventions and reduce exposure to risk factors for premature
deaths and disability
5. Establishing expert bodies for health promotion (Public Health
Philippines) and surveillance and response (Philippine CDC)

*District hospital paired up with 10+ RHUs or private clinics

*HFEP, deployment vaccines, medicines, trainings
LGU
• Facilitate the process • Expand primary care • Conduct annual health
of network forming benefit to all members visits for all poor families
• Upgrade 3 DOH • Limit contracting of and special populations
hospitals into “mega- PCB providers with (NHTS, IP, PWD, Senior
hospitals” functional networks Citizen)
(not stand-alone) • Collaborate with others
to form networks

A Advance health promotion, primary care and quality

C Cover all Filipinos against financial health risk

1. Mobilize more funds

Sin Tax | PAGCOR, PCSO | Increase Premium | Collection
Efficiency
2. Enroll remaining 8% from non-formal sector into
PhilHealth
3. Expand PhilHealth benefits
Outpatient diagnostics, drugs, blood & blood products
4. Recalculate case rates & link payment to quality
5. Improve contracting and enforce terms
Primary care trust fund | Network-based contracting
LGU
• Support revenue • Undertake costing and • Implement Health
generation measures revise case rates Trust Funds
• Align all health financial • Increase premium rates • Provide income
assistance programs to and collection efficiency retention to health
support Universal • Design additional benefits providers while
for outpatient diagnostics, retaining budgetary
Health Coverage
drugs, blood & blood support
(PAGCOR, PCSO)
products

C Cover all Filipinos against financial health risk

H Harness the Power of Strategic HRH

1. Make health professions curricula responsive

to local and global needs
2. Review government HRH compensation
package such that ARMM, IP, GIDA will have
highest pay
3. Shift to competency versus profession-based
frontline complement
4. Provide scholarships, financial incentives
5. Institute return service schemes
*clinicians and allied health professionals, managers, researchers
and policymakers
LGU
• Form Legislative- • Streamline • Provide the
Executive Health compensation scheme Magna Carta for
Human Resource for health workers HCW benefit
Task Force
2016 – 2017

H Harness the Power of Strategic HRH

I Invest in eHealth and data for decision-making

1. Require online data* submission as

requirement for licensing & contracting of
health facilities and drug outlets
2. Mandate the use of Electronic Medical
Records (EMR) in all health facilities
3. Invest in nation-wide surveys, administrative
data and disease registries
4. Automate major business processes
5. Facilitate open access to anonymized data

* clinical and administrative

LGU
• Revise licensing • Revise accreditation/ • Implement EMR in all
requirements to reflect contracting rules to reflect health facilities
regular electronic data regular electronic
• Improve local civil
submission requirement submission requirement
registration and vital
• Open up data set for • Open up data set for statistics data
researchers researchers
• Submit data
• Provide incentives electronically

I Invest in eHealth and data for decision-making

E Enforce accountability and transparency

1. Publish information that can trigger better

performance
• Prices of common drugs and services
• Non-compliant / erring providers
• National Objectives for Health to guide strategies and
investments by different stakeholders

2. Set up dedicated performance monitoring unit

• Ghost patients and/or surprise visits
• Medical audits or third-party monitoring
LGU
• Collect and publish • Publish annually • Ensure transparent
relevant information accountability procurement
report card process in all health
• Publish annually
facilities
accountability
report card • Regularly submit
data to DOH

E Enforce accountability and transparency

V Value clients and patients, especially the poor and vulnerable

1. Focus all efforts on the poorest 20 million

Filipinos
2. Make all health entitlements simple and
explicit
3. Set up participation & redress mechanism
4. Significantly reduce turnaround time and
improve transparency of processes
LGU
• Coordinate with • Streamline • Set up complaints &
PhilHealth in procedures for redress mechanisms
defining the availing services
healthcare
entitlements of
every Filipino
and publish this
• Set up call center

V Value clients and patients, especially the poor and vulnerable

E Elicit multi-sector multi-stakeholder support for health

1. Harness and align Private Sector in planning SDN,

intervention, and supply side investments
2. Ensure convergence with other government agencies in
delivering services (DOH, DENR, DSWD, DepEd, HUDCC)
• Advocate for Health in All Policies
• Multisectoral work with different agencies to build healthy living, working,
schooling environments, healthy cities, and Health in All Policies
• Mandate Health Impact Assessment for large-scale, high-risk development
projects, e.g. mining, power plants, oil rigs
3. Partake with CSOs in governance
• Budget Development
• Monitoring and Evaluation
LGU
• Develop policy agenda • Expand contracting • Implement healthy
with NGAs, CSOs and mechanisms to include communities/cities
private sector on the private sector (Z interventions
mainstreaming Health in All benefits, PCB)
Policies
• Institutionalize health
impact assessment for
large scale projects

E Elicit multi-sector multi-stakeholder support for health

ATTAIN HEALTH-
SERVICE DELIVERY RELATED SDGs
NETWORK

ALL LIFE STAGES &

TRIPLE BURDEN OF
DISEASE

UNIVERSAL
HEALTH
INSURANCE

Financial Risk Protection

Better Health Outcomes
Responsiveness