Policy bottlenecks

bypass health centers, and less than 20 percent of health spending is allocated to primary and preventive care, making them more vulnerable to spend from their own pockets.

In 2017, the Philippine Statistics Authority ( PSA) announced that the Filipinos’ out- of- pocket ( OOP) expenditures in health was 54.2 percent of the total health spending of the country for 2016.

Filipinos shelled out P259 billion for their hospital bills, P173 billion for medicines and other medical needs, and P53.3 billion for doctors, PSA said.

Also, a 2016 study by the Philippine Council for Health Research and Development showed that only 13 percent of the health care providers and 40 percent of specialty hospitals are in rural and geographically isolated and disadvantaged areas.

In the PSA’s 2015 report, it said that out of the 560,605 registered deaths in the country, 331,874 or 59.2 percent were medically unattended, which was 18.7 percent higher than medically attended ones at 227,217.

Among all regions, the National Capital Region (Metro Manila) had the highest number of medically attended deaths, which the PSA attributed to “better access” to health facilities.

Meanwhile, the top regions, which had the most number of unattended deaths were Region 4A (Calabarzon), Region 3 (Central Luzon) then the National Capital Region. In 2012, the Philippine Health Insurance Corp. (PhilHealth), under former president Benigno Aquino 3rd, rolled out the Implementing Guidelines for Univers

(PCB) 1 Package for its accredited providers, which expanded the primary

incentives to PCB providers and ensured complete and timely reporting of health data for the purposes of monitoring and evaluation.

However, the DoH said that PhilHealth’s PCB package has limited coverage for outpatients that are indigents and none for emergency cases. It also has

for each member.

Lawyer Paula Tanquieng, advocacy program officer of Ayos na Gamot sa Abot Kayang Presyo ( Agap) Coalition, echoed this, saying: “The primary care benefit package of PhilHealth does not include maintenance drugs for certain diseases like hypertension, heart diseases and stroke. Even when the patient’s situation calls for medicine, PhilHealth does not cover medicines after you go out of the hospitals.”

There is also a price ceiling for medicines for the private sector. Generic medicines were introduced, and 80 percent of the medicines were off- patent. However, there is still a big portion of the population that still cannot afford the cheap medicines, especially maintenance medicines, Tanquieng noted.

There is also a high and uncontrolled co-payment levels or balance billing, which lead to high OOP for patients, as well as “vague prioritization mechanism” of which services will be funded by the government, said the DoH.