I.

INTRODUCTION

Filipino these days need an affordable universal health insurance from the Philippine
government, Can the government give what the people need? The Philippine health care
system has rapidly evolved through time. Early this year the President has signed into law
the New Universal Health Care Law of the Philippines. The UHC Act is the culmination of
decades of progress, and two years of dedicated political and technical work. The Act will
mean all Filipinos get the health care they need, when they need it, without suffering
financial hardship as a result. The Act seeks to (a)Progressively realize universal health care
in the country through a systemic approach and clear delineation of roles of key agencies
and stakeholders towards better performance in the health system; and (b) Ensure that all
Filipinos are guaranteed equitable access to quality and affordable health care goods and
services, and protected against financial risk.

The question is has this been addressed with the New Universal Health Care Law? Will the
UHC Law cover a lot more health care services? Will it significantly reduce out of pocket
expenses spending of the households especially for those who lives in rural areas that has
less access to medical facility.

The majority of Filipinos only consult a doctor when their illnesses are already at
their worst because of the lack of government support to the health department. Most of
the households feel that going to a hospital is a burden. That they still need to pay higher
copayment and coinsurance and worse they have to pay the full hospital bills.
Affordability is the main reason for going to a government medical facility, while excellent
service is the main reason for going to a private medical facility.

Towards the end of this research the reader will understand the implementation of the
UHC Law in terms of the reduction of members out of pocket expenses from their hospital
bills as well as the members coverage provided by the government insurance. I will also
discuss how members are enrolled in the insurance and if they have to pay monthly
premiums and their cost sharing in terms of their prescription, diagnostic and laboratory
tests, hospitalization and other outpatient health services. The discussion of the government
roles will also be discussed as well as its rules and regulations.

II. BACKGROUND OF THE STUDY

With the Philippine Health Insurance Corp.’s (Philhealth) mandate to cover 100 percent
of the population, demand for quality, affordable and accessible healthcare is on the rise.
Among other opportunities, this allows the private healthcare sector to collaborate with
public counterparts in providing improved services to Filipinos. Early this year of 2019, the
President has just signed a Universal Health Care (UHC) Bill into Law known as Republic
Act No. 11223 that automatically enrolls all Filipino citizens in the National Health
Insurance Program and prescribes complementary reforms in the health system. This gives
citizens access to the full continuum of health services they need, while protecting them
from enduring financial hardship as a result. The Act contains fourteen chapters and
provisions. The Act shall be known as the Universal Health Care Act. The UHC Act is the
culmination of decades of progress, and two years of dedicated political and technical work
and the amendment of the Republic Act 7875 otherwise known as the National Health
Insurance Act of 1995. Formerly, the Philippine Health Insurance Corporation (PhilHealth)
was created in 1995 to implement universal health coverage in the Philippines. This is a
government owned agency and is exempted from tax and a controlled corporations of the
Philippines and is attached to the Department of Health.
Despite the numerous progress made with the introduction of the scheme, several
challenges still persist. The majority of Filipinos only consult a doctor when their illnesses
are already at their worst because of the lack of government support to the health
department. According to our Department of Health, up to 54% of the country’s healthcare
spending in 2016 came from out-of-pocket expenses. That means Filipino families still
account for the lion’s share, they still carry the biggest burden when their loved ones seek
treatment for whatever sickness they have. Section 4 (I) of the RA 11223 states that
Essential health benefit package refers to a set of individual-based entitlements covered by
the National Health Insurance Program (NHIP) which includes primary care; medicines,
diagnostics and laboratory; and preventive, curative, and rehabilitative services. Premium
contributions under section 10 of the provisions states that for direct contributors premium
rates shall be in accordance with the members monthly income and floor ceiling. Those who
can’t afford and they are called the Direct contributors. These are members who can afford
to pay the premium. The premium ranges from 2.75% from P10,000 to P50,000 monthly
ceiling in the year 2019 up to the maximum premium rate of 5% in the year 2025 those
members with monthly income ranges from P10,000 to P100,000.

On the other hand, those members whose premium shall be subsidized by the national
government they’re automatically enrolled in the program, they are called indirect
contributors.

In the US, they have the very controversial Healthcare Act known as the Obama Care.
III. ANALYSIS/DISCUSSION

The question is has this been addressed with the New Universal Health Care Law? Will the
UHC Law cover a lot more health care services? Will it significantly reduce out of pocket
expenses spending of the households especially for those who lives in rural areas that has
less access to medical facility?

Th reality is that illnesses can strike anytime and hospitalization cost is always a
concern particularly when paying out of pocket is your only option.

IV. CONCLUSION

A. TABLE OF CONTENTS
B. TABE OF AUTHORITIES
C. BIBLIOGRAPHY

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. WHO’s global drive for UHC came at an opportune
time to advocate and inform the consultation and drafting process of the Bill in the Senate
during the second half of 2017. By that time the Bill had already passed the House of
Representatives. In order to get it passed through the upper house, the Bill needed technical
refinement to ensure that it was comprehensive, practical and feasible, and would eventually
achieve universal health coverage.

WHO Philippines, in close liaison with the WHO Regional Office for the Western Pacific,
gently steered the process in the areas of people-centred integrated service delivery and
health financing, drawing on experiences from other countries and regions with positive
UHC experiences. This included the UK’s National Health Service model, China’s model of
devolved health service provision and PAHO’s expertise in service delivery networks in
US-influenced health systems.

The UHC Act contains provisions that consolidate local health systems and provide for a
shared bank account. This was initially controversial, as local government units were
skeptical about its potential effectiveness.

The Act will mean all Filipinos get the health care they need, when they need it, without
suffering financial hardship as a result. Although there is much work to be done to
implement the UHC Act, it takes a critical step towards achieving health for all in the
Philippines. The landmark law expands access to health services by automatically enrolling
all Filipinos in PhilHealth’s National Health Insurance Program (NHIP). It seeks to ensure
that all Filipino citizens have access to a comprehensive set of health services without
financial hardship. The law aims to address a number of recurring problems in the health
system. First and foremost,it assures 100 percent population coverage of PhilHealth - from
the 98 percent population coverage in 2018 based on the same year’s Socioeconomic Report
by NEDA. According to the law, PhilHealth members will be classified into two groups:
contributory (premium contributors from payroll) and non-contributory (fully subsidized
from tax collections.

In addition, the new law is expected to significantly reduce the high OOP expenditure for
health. In 2017, about 54.5 percent off total health payment came from Filipino’s own
pocket, with medicines and drugs as the main contributors. Lack of PhilHealth coverage of
medicines for outpatients and the high cost of drugs and medicines in the country push the
OOP expenditure up. High out-of-pocket medical expenses push more people into poverty.
When households spend more on hospital bills and medical treatments, they are forced to
spend less on other basic necessities like food, housing, and education. According to
DOH the implementation of the UHC law for its first year needs P257 billion.
Department of Health, 2010