A 30-year failure (Healthcare)

[Lee]

Quote

 

Going by the absolute numbers alone, the growth in the Philippines’ total expenses on health over the past 30 years has been more than impressive, ballooning from P40.3 billion in 1991 to a whopping P1.1 trillion in 2022, for an average yearly increase of 10.95 percent.

But a further dissection of the Philippine health sector’s performance reveals a troubling state of affairs that demands urgent reforms. Indeed, after correcting the numbers for inflation and considering the near-doubling of the Philippine population over that period, health spending actually rose by just 3.9 percent a year. Worse, the single biggest portion of total health expenditure (THE) over the past 30 years came from Filipinos’ own wallets, despite the billions annually poured into the public health sector.

These were among the disturbing findings of the groundbreaking study on the Philippine National Health Accounts from 1991 to 2022 conducted by professor Orville Solon, former dean of the University of the Philippines Diliman-School of Economics; former professor Alejandro Herrin, also of UPD-SE; and Dr. Michael Mo. “Out-of-pocket payments from households have been the biggest contributor to health-care spending ever since records started in 1991,” Mo underscored during the recent presentation of the research paper released by health think tank Unilab Center for Health Policy, a program of Unilab Foundation.

Heaviest burden

For instance, of the P1.12 trillion in health expenditures in 2022, P502 billion or 45 percent came from Filipinos’ pockets, equivalent to P4.50 for every P10, more than double the 20-percent limit on out-of-pocket spending set under the Health Sector Reform Agenda (HSRA) issued back in 1999.

In contrast, the national government contributed in 2022 just P234 billion (21 percent), local government, P109 billion (10 percent), while the Philippine Health Insurance Corp. (PhilHealth) accounted for just P153 billion or 14 percent of the total expenditures, thus falling far short of its mandate “to provide health insurance coverage and ensure affordable, acceptable, available, and accessible health-care services for all citizens of the Philippines.”

The balance was shouldered by private insurance companies, including health maintenance organizations, which are far out of reach of the poor who need the government benefits the most but end up bearing the heaviest burden.

The paper’s findings complement similar results yielded by a 2023 discussion paper of state think tank Philippine Institute for Development Studies that said that the elderly, women, rural, and poorer Filipinos are more likely to pay out-of-pocket health-care costs that are “expected to increase for the entire population” in the coming years.

Health expenditures

The findings of these two studies fly in the face of the declarations made by successive administrations, from the late president Corazon Aquino to Rodrigo Duterte and now under President Marcos, that they prioritize the health needs of Filipinos and have therefore increased budget outlays over the past three decades.

As the researchers revealed in their study, which for the first time analyzed data collected annually from 1991 to 2022, the share of public health spending to THE “has not significantly increased over the past 30 years.”

Particularly troubling is the finding that the local government units that are at the frontline of public service and entrusted with a bigger responsibility to deliver health services under the Local Government Code of 1991 have not been contributing as much as they should to health expenditures.

Instead, what increased was the share—from 44 percent to 52 percent—borne by Filipino citizens who are counting on the government to shell out the bigger portion considering their regular contributions to PhilHealth.

Groundbreaking study

As Mo stressed, the targets under the HSRA were for national and local government spending to reach 40 percent of THE and for social health insurance, particularly PhilHealth, to account for 30 percent of the total spend—and not just 14 percent as seen in 2022—thus easing the burden on Filipinos.

Fortunately, Mr. Marcos has taken the right steps with his commitment in his July State of the Nation Address for increased benefits for stroke, pneumonia, and common cancers while PhilHealth has also increased its benefits package for the first time since 2013 this year.

Preliminary data from the Philippine Statistics Authority also showed that in 2023, out-of-pocket expenses went down slightly to 44.4 percent from 44.7 percent in 2022.

If the Marcos administration takes the groundbreaking study to heart and spends better and more for the health needs of the poor, it will have the distinction of having done what governments in the past three decades have failed to do.

 

A 30-year failure (msn.com)

[hk blues]

There is next to zero chance any changes will be made that significantly change the balance of payment from citizens to government.  

[Mike J]

The flipside is that healthcare here is more affordable than many other countries.

[scott h]

1 hour ago, Mike J said:

The flipside

We have had a campaign  of "faith healers" in our barangay recently. Banners all over the place. A buddy of mine asked me if I believed in faith healing. I said sure!...............I have faith in BIG PHARMA!

[Joey G]

Before to 21st Century.... jungle and farm medicine kept many living into their 80's and 90's. Diets were better as well. That's all water over the dam now, and the lifestyle's most have picked up have affected health (poorly) more than lack of "modern medicine".  As far as costs... someone's gotta pay... insurance only can pay what we people put in.

 

[Mike J]

9 minutes ago, scott h said:

We have had a campaign  of "faith healers" in our barangay recently.

Common here in Moalboal.  There is a couple that will "live on site and pray for recovery" for those with a terminal illness.  The family of the terminal subject is expected to provide food, shelter, allowance, etc.  

[Tommy T.]

1 hour ago, Mike J said:

The flipside is that healthcare here is more affordable than many other countries.

Sorry, Mike, but I will respectfully disagree with your statement... Upon personal experience - and observations of L and her co-teachers - I would modify your comment to say that quality healthcare is not more affordable than many other countries.

[scott h]

11 minutes ago, Tommy T. said:

quality healthcare is not more affordable than many other countries.

That might be born out by the "medical tourism" figures. I read recently that Thailand and other "developing" countries out strip the PI in this. That most of it is from Balikbayan's getting facelifts and dental procedures in conjunction with family visits.

[Tommy T.]

Personally, if I can not wait for medical procedures using Medicare in USA, I would then go either to Thailand or Taiwan. Both offer excellent medical care at fairly reasonable prices.

I will pass on the face lift because nothing can lift or help my face at this stage of my life!

Edited August 15 by Tommy T.

[Mike J]

58 minutes ago, Tommy T. said:

Sorry, Mike, but I will respectfully disagree with your statement... Upon personal experience - and observations of L and her co-teachers - I would modify your comment to say that quality healthcare is not more affordable than many other countries.

Seeing a neurologist who has his office at Chong Hua in Cebu City.  Very bright, very competent.  Spent about 30 minutes given me multiple tests, etc.  Cost was 1200 peso.  In the USA, this would not even cover the co-pay.  Several years ago I had kidney stones.  I received exactly the same care here as I did in the USA for kidney stone.  The cost here was approximately 10% of what I paid in the USA for the same level of care.   So it depends on where you go for care and what you want to spend.  In the Philippines health care spans the gamut for non-existent, to which doctor, to so-so, to adequate, to very good, to excellent.  My neurologist told me that if I needed cervical surgery the cost would be up to 800K peso (about 14.5K dollar).  I assume he was referring to Chong Hua prices.  Fourteen years ago I had lower back surgery in the USA.  Cost was 86K dollars and it was outpatient surgery.   The cost for very good or excellent health care here is far less than the USA but you may have to travel to another city or province to find it.