EXPLAINER - What Filipinos Can Expect From The Universal Health Care Law

8/6/2019 EXPLAINER: What Filipinos can expect from the Universal Health Care Law
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EXPLAINER: What Filipinos can expect from the Universal Health Care
Law
All Filipinos will be granted health coverage but not everything will be free. Here's what you can expect.
So a Tomacruz
Published 12:27 PM, April 01, 2019
Updated 12:27 PM, April 01, 2019
https://www.rappler.com/newsbreak/iq/226810-explanation-what-filipinos-can-expect-universal-health-care-law 1/14
MANILA, Philippines – Filipinos will begin bene ting from the Universal Health Care (UHC) Act this year, with every
citizen entitled to health coverage that will lower out-of pocket health expenses.
The passage of the law was considered a landmark for the Duterte administration as lawmakers who championed
the bill gathered in Malacañang for a special ceremony last February 20. It was there that President Rodrigo
Duterte a xed his signature on the long-awaited law.
The passage of Republic Act No 11223 was no easy feat. It was hailed as path-breaking as it set the direction for
the reform of the health care sector in the Philippines.
The World Health Organization earlier urged the Philippine government to make a “real investment” in health care,
as it would save lives.
LANDMARK LAW. President Rodrigo Roa Duterte leads the ceremonial signing of the Universal Health Care Act, with congressional
leaders and some lawmakers who spearheaded the bill. Malacañang photo
But ensuring universal health care for all Filipinos does not come cheap.
Health Secretary Francisco Duque III said some P254.8 billion has been allotted for the rst year of
implementation of the law. He earlier said some P257 billion was needed.
Now, the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), along with experts
and concerned agencies are crafting the Implementing Rules and Regulations (IRR). They will have 180 days to
complete the IRR, which will include details on how the law will be executed.
In the meantime, though, Filipinos can already expect to avail of some of the law’s bene ts. Full effects of the law
will be gradually felt over the years as the DOH and PhilHealth start transitioning to the universal health care
system.
What might citizens be able to expect? Here are 8 things to know
PUBLIC HEALTH. Nurses tend to a woman at the Jose R. Reyes Memorial Medical Center in Manila. File photo by Agence France-
Presse
1. ALL Filipinos are covered
Every single Filipino citizen is automatically enrolled into the newly-created National Health Insurance Program
(NHIP). The program classi ed membership into two types:
Direct contributors – those who pay PhilHealth premiums, are employed and bound by an
"employer-employee relationship," self-earning, professional practitioners, and migrant
workers. Members’ quali ed dependents and lifetime members are also included.
Indirect contributors – those not considered as direct contributors, along with their quali ed
dependents, whose health premiums are subsidized by the government
All Filipinos will be granted “immediate eligibility” and access to the full spectrum of health care which includes
preventive, promotive, curative, rehabilitative, and palliative care. This can be expected for medical, dental, mental,
and emergency health services.
Filipinos will also be enrolled with a primary health care provider of their choice. The primary care provider is the
health worker they can go and seek treatment from for health concerns. They will also serve as the person in
charge of referring and coordinating with other health centers if patients need further treatment.
Citizens will not need to present any PhilHealth ID to avail of these bene ts. Meanwhile, poor Filipinos or those
who are located in geographically isolated areas will also be given priority when ensuring access to health
services.
BASIC SERVICES. Only basic services and accommodation are covered by the Universal Health Care Law. Photo by Darren
Langit/Rappler
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2. It is not completely free
Contrary to what some people may think, UHC does not mean every single health expense will be made free.
The law outlines that basic services accommodations will be covered by PhilHealth.
As a patient, that means that if you’re admitted in a hospital you can expect regular meals, a bed in a shared room
with fan ventilation, and a shared toilet and bath to be covered.
All are also entitled to an “essential health bene t package,” which includes primary care, medicines, diagnostic,
and laboratory tests. It also includes preventive, curative, and rehabilitative services.
It will no longer be free when one wants to stay in a hospital room offering private accommodation, air
conditioning, telephone, television, and meal choices, among others.
Meanwhile, public and private hospitals are expected to allocate a certain portion of their beds as basic
accommodations in the following amounts:
Government hospitals – at least 90% of beds

Specialty hospitals – at least 70% of beds
Private hospitals – at least 10% of beds
As long as a patient avails of these basic accommodations, it will be covered by PhilHealth whether in a public or
private hospital.
PAYMENT. Under the Universal Health Care Law, payments outside basic services are regulated by the DOH. File photo by So a
Tomacruz/Rappler
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The law also states that if patients need to pay for extra expenses, their “co-payment” – or what is paid on top of
basic services – should be regulated by the DOH in public hospitals. This means that you should know what to
expect in terms of bills, as opposed to being shocked after treatment.
Aside from this, current case rates or packages PhilHealth has crafted for certain diseases will remain. But
together with the DOH, PhilHealth is expected to work towards including more needs a person may have for a
disease in its case rates.
The two agencies are also expected to craft and implement outpatient bene t services to be covered by the
National Health Insurance Programs within 2 years after the law takes effect.
FUNDS. PhilHealth will be in charge of paying health care providers for health services given to individuals. Photo by Jire
Carreon/Rappler
3. PhilHealth will become the “national purchaser” of health goods and services
This means that PhilHealth will be in charge of paying health care providers like hospitals and clinics for services
given to Filipinos. This is already a job PhilHealth carries out but the universal health care law wants to pool more
funds so it can cover all Filipinos and eventually, more services.
Allocating more funds to PhilHealth will also strengthen its negotiating power with health care providers, which
will foreseeably improve the quality of services and lower health costs.
Funds for PhilHealth will be sourced from the following:
Philippine Amusement and Gaming Corporation – 50% of national government’s share

Philippine Charity Sweepstakes O ce (PCSO) – 40% of its charity fund, net of document
stamp tax payments, and mandatory PCSO contributions
Premium contributions of direct contributory members
PhilHealth annual budget
With multiple fund sources for PhilHealth, Filipinos will no longer need to troop to various government o ces to
secure funds to pay for health expenses. It will also make them less dependent on politicians to help pay for
health services.
By giving PhilHealth more funds, a goal of the UHC is to make PhilHealth the national purchaser of medicines.
This can lower the cost of medicines as these will be bought in bulk.
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Another goals is to have quality of health services improve as PhilHealth can set as a requirement for payment
and contracting, standards for health care providers.
IMMUNIZATION PROGRAM. Health workers administer house-to-house measles vaccinations to children in Payatas, Quezon City
amid a measles outbreak in Metro Manila. Photo by Darren Langit/Rappler
4. DOH will still be in charge of “population-based” health services
While PhilHealth, along with other private health insurance companies, is expected to cover services for
individuals, the DOH is still in charge of delivering health services that cover entire populations.
Think of these as programs for disease surveillance, health promotion campaigns, and mass immunization
campaigns.
The DOH will do this by contracting public health care providers in cities and provinces.
5. Health systems will become city-wide and province-wide
Provinces and highly urbanized cities will now be in charge of overseeing health services in areas as opposed to
the current set-up where municipalities are tasked with managing their own health centers.
The DOH will need to work with the Department of the Interior and Local Government (DILG) to have province- and
city-wide health systems or networks in about two years after the law takes affect.
HEALTH SERVICES. Health care networks will be managed by province and city under the new Universal Health Care Law. File photo
by So a Tomacruz/Rappler
For this, one can imagine as an example, Rizal overseeing its province-wide health care network of clinics and
hospitals compared to each municipality in Rizal taking care of its own health center alone. Similarly, highly
urbanized cities like Cebu or Makati will oversee their own health care network compared to single barangays
being in charge of a health center.
Having access to health networks province-wide can address the problem of inadequae access to health services
due to lack of funds in barangays or municipalities.
Provincial and city health boards will be in charge of pooling and managing a special health fund to nance and
improve health services for residents. PhilHealth’s income will also be channeled to this special health fund.
HEALTH WORKERS. Community health workers hold house-to-house measles vaccinations. Photo by Darren Langit/Rappler
6. Return service in the public health sector
Graduates of health and health-related courses who received government-funded scholarships will be required to
work in the public health sector for at least 3 full years. This will address the need for health workers across the
country.
They will be paid by and under the supervision of the DOH. Those who serve for an extra two years will also be
given incentives, which will be determined by the DOH.
Meanwhile, graduates of health courses in state universities and colleges and private schools are encouraged to
work in the public sector.
7. A “Health Technology and Assessment Council” (HTAC) will be created
Another important feature of the law is the creation of the HTAC – a group of health experts who will be
responsible for evaluating latest health developments and recommending their use to DOH and PhilHealth.
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The HTAC will be responsible for assessing the safety and effectiveness of health technology, devices, medicines,
vaccines, health procedures, and other health-related advances developed to solve health problems.
Reviewing the social, economic, and ethical issues when using these technologies or programs is also required.
DEPARTMENT OF HEALTH. The Universal Health Care Act is seen to set the direction of reform in the country's health care system.
File photo by Rappler
The HTAC will be attached to the DOH for the rst 5 years after the law is implemented. After this, it will become
an independent body attached to the Department of Science and Technology.
8. Health information will be collected
Both public and private hospitals and health insurers will be required to maintain a health information system that
will contain electronic health records, prescription logs, and “human resource information.”
This system will be developed and funded by DOH and PhilHealth. It will also be subject to patient con dentiality
rules and data privacy laws. – Rappler.com
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PHILIPPINES
Expiring meds, lack of infra derail Duterte's universal health care law
The health department has the money it needs to implement Duterte's landmark law, but there is poor
implementation of programs, from procurement of medicines to building health facilities
Lian Buan @lianbuan
Published 7:20 PM, July 26, 2019

Updated 7:20 PM, July 26, 2019
HEALTH CARE FOR ALL. The Universal Health Care Law, which was signed into law in February 2019, is a landmark measure that
aims to provide free health care for all. File photo by So a Tomacruz/Rappler
MANILA, Philippines – President Rodrigo Duterte signed the landmark Universal Health Care (UHC) law in
February 2019, but audit of the Department of Health (DOH) indicates the agency's unpreparedness in rolling out
the program.
The 2018 audit report of the DOH showed poor implementation of programs which would fall under law, such that
it was only able to spend 61% of its budget in 2018.
It also risks to waste P367.158 million worth of medicines which were found to be near expiry.
Even with multiple problems, the DOH more than doubled its budget for 2019 for the rst o cial year of
implementing the Universal Health Care Act.
Expiring medicines
The Commission on Audit (COA) found that P367.158 million worth of medicines are near their expiration dates.
These are medicines found in DOH warehouses, recipient agencies, and government hospitals.
"(It) has exposed these inventories for distribution to the risk of expiration before it reaches the intended
bene ciaries, affecting the immediate and maximum use of said medicines, increasing the probability of losing
their e cacy, slow delivery of health care goods to the intended bene ciaries, and the possibility of resulting in
wastage of government funds," auditors said.
Moreover, auditors found that hospitals are overstocked with medicines worth a total of P52.049 million. These
medicines are called "slow-moving" or "idle" in the hospitals, again depriving the bene ciaries.
Roots of the problem vary from poor inventory processes, poor procurement planning, and slow release of Food
and Drug Administration (FDA) results.
But even if they were confronted with these problems, auditors said the DOH continued to purchase medicines,
thus resulting in overstocking.
The audit comes as a warning because the P12.9 billion worth of medicine purchases in 2018 are still in DOH
warehouses and other facilities.
"If these ineffective or poor procurement planning and inventory management practices will not readily be
addressed and corrected by the Procurement and Supply Chain Management Team, it would have a chilling
effects on the implementation of newly signed Republic Act No. 11223, also known as theU niversal Health Care
Act," auditors said.
Lack of infra
Another key feature of the free health for all program is the Health Facilities Enhancement Program (HFEP), which
aims to build more facilities accessible to more people.
But multiple de ciencies were noted in P4.5 billion worth of projects under the HFEP.
For one, P1.3 billion worth of infrastructure projects were delayed because of insu cient planning and different
problems with contractors.
For the completed facilities, P49.109 million worth of them had defects such as poor tiling, water leakages, old
roo ng, damaged windows, defective pipes, and busted lights, among others.
Infrastructure projects worth P1.47 billion were not completed on time, and P1.43 billion worth of facilities are
either not fully operational or idle. Projects worth P17.689 million have been abandoned or are due for termination,
and P116 million worth of projects have not started yet.
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"Considering that the projects were authorized through the General Appropriations Act (GAA), the government is
indeed committed in achieving its Universal Health Care agenda, which the implementing agencies should
rightfully pay off through prompt implementation," auditors said.
They added, "However, project execution for various HFEP projects only started on the latter part of the last
quarter of the year, and the delay is attributed to several revisions of the plan and de cient/inadequate planning."
Auditors also pointed out that the procurement of P964.729 million worth of HFEP equipment had de ciencies
(poor monitoring, prematurely purchased), while some were not found at all during inspection.
The DOH got a P112-billion overall budget in 2018, but the agency only disbursed 61.08% which is a low
disbursement rate for the health department.
COA said "these low utilization rates re ect the inability to execute the programs and projects on time," overall
affecting the implementation of a pipe dream to provide free health care for all Filipinos. – Rappler.com
In these changing times, courage and clarity become even more

important.
Take discussions to the next level with Rappler PLUS — your platform for deeper insights, closer
collaboration, and meaningful action.
Sign up today and access exclusive content, events, and workshops curated especially for those who
crave clarity and collaboration in an intelligent, action-oriented community.
As an added bonus, we’re also giving a free 1-year Booky Prime

membership for the next 200 subscribers.
Sign up here
You can also support Rappler without a PLUS membership. Help us stay free and independent by making
a donation: https://www.rappler.com/crowdfunding. Every contribution counts.
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EXPLAINER - What Filipinos Can Expect From The Universal Health Care Law

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8/6/2019 EXPLAINER: What Filipinos can expect from the Universal Health Care Law

Thousands of new images, a

What might citizens be able to expect? Here are 8 things to know

1. ALL Filipinos are covered

2. It is not completely free

Government hospitals – at least 90% of beds

27 dead in Cavite as number of dengue cases doubles

UK's Johnson offers new health funds to meet Brexit promise

Funds for PhilHealth will be sourced from the following:

Philippine Amusement and Gaming Corporation – 50% of national government’s share

4. DOH will still be in charge of “population-based” health services

5. Health systems will become city-wide and province-wide

6. Return service in the public health sector

7. A “Health Technology and Assessment Council” (HTAC) will be created

8. Health information will be collected

In these changing times, courage and clarity become even more

As an added bonus, we’re also giving a free 1-year Booky Prime

You May Like Promoted Links by Taboola

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#WalangPasok: Class suspensions, Saturday, August 3, 2019

Everyone in Bagumbayan Is Talking About This Eye Drop!

Detect Irregular Heart Beat with Just 1 Click.

Find & Compare Flight Deals. Save on Flights Today!

Lian Buan @lianbuan

Published 7:20 PM, July 26, 2019

In these changing times, courage and clarity become even more

As an added bonus, we’re also giving a free 1-year Booky Prime

a donation: https://www.rappler.com/crowdfunding. Every contribution counts.

You May Like Promoted Links by Taboola

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