Realizing the dream of Universal Health Care

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THE House of Representatives approved on September 6 this year House Bill (HB) 5784 or the Universal Health Coverage (UHC) measure, marking the first step towards providing free healthcare to Filipinos.

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“It is our duty and responsibility to see the enactment of this bill that gives spirit to the right to health of the people and I am very happy that today we took a giant step forward to realizing this,” said Deputy Minority Leader Rep. Harry Roque of Kabayan party-list, one of the proponents of the bill.

“This bill is groundbreaking because, with it, every Filipino is granted the right to health by virtue of citizenship. It provides health security to Filipinos not because they can pay premiums, but simply because they are Filipinos,” he added.

Under HB 5784, the Philippine Health Insurance Corp. (PhilHealth) will be known as the Philippine Health Security Corp. (PHSC) and shall be the sole purchaser of health services in the country.

The bill also provides for the adoption and institutionalization of a periodic Health Technology Assessment (HTA) and the creation of the Health Technology Assessment Council (HTAC).

HTA denotes any process of examining or reporting properties of a medical technology used in health care, including safety, efficacy, feasibility, and indications for use; cost-effectiveness; as well as social, economic, and ethical consequences, whether intended or unintended.

The bill mandates the “income retention” of Department of Health (DoH) facilities, meaning government hospitals are authorized to use their entire income to enhance their capacity and improve the quality of services.

Moreover, the bill will provide a clear separation of functions in the health sector, addressing some problems in the health care system.

“The bill explicitly provides for a division of labor among the DoH, PSHC, the Department of Social Welfare and Development (DSWD), the Department of the Interior and Local Government (DILG), and the local government units (LGUs),” Roque said.

Cuban model
Aside from the measure, the government is exploring other reforms in the health sector by sending key officials to study the health policies of other countries.

In line with this, Health Secretary Paulyn Ubial in August 2016 visited Cuba to study its “efficient and effective” health care model.

Ubial noted that among Cuba’s best practices is providing an adequate number of health professionals, translating to a doctor-to-patient ratio that exceeds World Health Organization standards.

She also cited that Cuba provides outpatient mental health facilities that cover several municipalities.

“In Cuba, they don’t have a mental institution, all their patients are outpatient, and it’s like delivering the services at home. And they have some sort of daycare services. If you’re going on vacation, then they can take care of your mental health patient/family member on a two-to-three-day period. So, that’s not for the long term,” Ubial said.

The health secretary is also looking for a way to implement a community-based mental health program similar to Cuba’s.

The Cuban government has expressed its willingness to cooperate with the Philippines for capacity-building and future exchanges.

“I’m sure that our universal health care dream will benefit from the lessons that we learned in the Cuban model. And we will continue to have this cooperation and relationship with the Cuban Ministry of Health so that we can implement some of their best practices,” she said.

Lessons to be implemented
The Philippine health agenda was crafted based on what Ubial gathered from her visit to Cuba.

Priority programs will include universal health insurance coverage and the lowering of drug prices, as well as the annual check-up for the poorest Filipinos and improving the country’s service delivery network.

From the start of the Duterte administration, the DoH aimed to provide 20 million Filipinos free basic checkup to allow the early detection of diseases.

Early detection will give the department the needed information to treat advanced diseases and ailments.

“[For example], cataract, malnourishment, underweight, under-height – physically, you can see that, and you can intervene already. That’s basic check-up, basically. I’ve been a public health worker, I can diagnose [leprosy]just by looking at the patient. I don’t need a high-tech gadget or a microscope to diagnose that,” she said.

The Health chief has presented to President Rodrigo Duterte the ideal health system, which provides one health worker and one health system for every barangay.

An additional 25,000 medical staff that includes doctors, nurses, midwives and other paramedical professionals will be deployed to rural municipalities. The DoH allotted around P9 billion in its 2018 budget proposal for their salary and benefits.

Using technology
The DoH has been implementing projects to reach people using the accessibility of technology.

In June, it launched the so-called “quitline” to help smokers kick the smoking habit through real-time counseling and support anywhere with the use of phone and mobile-centered services.

Smokers who want to avail themselves of these services can call the hotline 165-364 to have a one-on-one talk with a support representative.

To access the mobile service, text ‘STOPSMOKE’ to (29290)165364, which a support representative will receive directly instead of a voice operator. The service is available to SMART, Sun Cellular and Globe subscribers.

Also in line with the Health department’s advocacy on mental health, it also launched a “hopeline” for people who are suffering from depression and contemplating suicide.

Hopeline is available 24 hours a day, 7 days a week, and can be reached via landline at (02) 804-HOPE (4673); by mobile phone at 0917-558-HOPE (4673) or by dialing 2919

While the DoH admits that UHC is still unattainable, the government will slowly but surely realize that dream be learning from other countries, implementing projects and pushing the healthcare agenda that seeks to improve health services little by little.

With the passage of the UHC bill in Congress, it is just a matter of time before the DoH can provide free healthcare services to all Filipinos.

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