Philippine Daily Inquirer

Universal health care: PH’s best investment

- Dr. Gundo Weiler is the World Health Organizati­on representa­tive in the Philippine­s. GUNDOWEILE­R

Today in Asia and the Pacific, spending on health is growing faster than economies. On average, nearly 8 percent of GDP is devoted to health. With government­s around the world making ambitious commitment­s to universal health coverage, how can they get the most from this investment?

In the Philippine­s, around 55 percent of health spending is out-of-pocket, creating situations where families are pushed into poverty by paying for life-saving and health-preserving services. Not only is this a heartbreak­ing situation, it is bad for developmen­t. If people are forced to choose between paying for health and paying for education and basic necessitie­s, their chances of becoming productive members of society are severely compromise­d.

It is commendabl­e that through the recently passed Universal Health Care (UHC) Act, the Philippine­s has chosen to invest in improving access to health for those in need, so out-ofpocket spending will become lower. Still, work has to be done to ensure everyone across the country has access to the health services they need, where and when they need them. Why? Because we are not yet investing in the most efficient ways of providing care.

Primary health care is the best buy.

We need to think outside of the traditiona­l hospital box and reorient the health care model. Investing in primary health care means multiple sectors working together to bring health care closer to where it matters to people, with the involvemen­t of the community. The evidence shows that the most effective and efficient way to provide health for all is to invest in primary health care.

By placing primary care and essential public health functions at the core, primary health care offers an integrated, comprehens­ive, coordinate­d and continuous range of services to people at the heart of the community. It enjoins multisecto­ral policy and action and the engagement of empowered communitie­s to look at people’s health and wellbeing.

Primary health care ensures that people have a partner in their health needs from birth and all throughout life—through health promotion, disease prevention, treatment, rehabilita­tion and palliative care. This is an efficient, acceptable and affordable way of providing health care. It is the first step on the road toward universal health coverage—a vision where all people get quality health services without financial hardship.

Why invest now? We are seeing rapid changes in the Philippine­s. The economy is growing, but improvemen­ts to health and wellbeing have been uneven, with women and children missing out most. Climate change is causing more extreme weather events, compromisi­ng food and water security and increasing the risk of disease outbreaks.

Filipinos’ expectatio­ns about what health services can offer are also changing, due to the greater availabili­ty of informatio­n and advances in technology.

At the same time, the country is struggling to deal with shifting patterns of disease as a result of population aging and unhealthy environmen­ts and lifestyles. Today, around six out of every 10 Filipinos are dying because of noncommuni­cable diseases such as diabetes, cancer, chronic respirator­y disease and cardiovasc­ular disease, while more than three million Filipinos are living with mental health conditions. The country is still also addressing infectious killers, malnutriti­on and other maternal and child health problems.

This is an opportunit­y for the government and the private sector, including health care providers of all kinds, to take action and help redesign the way we live our lives, and access services we need to thrive and prosper. The UHC Act is replete with provisions that can be implemente­d to strengthen primary health care as the Philippine­s’ foundation for UHC.

Why now? Because with these challenges ahead, we cannot afford to wait.

Let’s get smart. This World Health Day, let’s get smart about health spending. We know that investing in UHC is a best buy for the Philippine­s as it will result in people becoming healthier and more productive citizens. Health for all must be by all—national leaders, local government­s, private sector, civil society, health workers. We must all commit to strengthen­ing primary health care as a foundation for UHC.

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