Despite the inclusion of more elderly Filipinos in the government’s health insurance, their out-of-pocket (OOP) medical expenses went up, according to a discussion paper published by the Philippine Institute for Development Studies (Pids).
This was part of the findings of a discussion paper authored by Pids Senior Research Fellow Michael RM Abrigo; and University of Hawaii at Manoa Associate and Assistant Professors Timothy J. Halliday and Teresa Molina.
The researchers said health insurance coverage increased 16 percentage points since the inclusion of the elderly in the system in 2014. However, per-capita health expenditures of the elderly rose to P1,931.24 in 2016, from P1,874.15 in 2014.
“We estimate that insurance more than doubles medical spending for those who are induced by the policy to take up insurance. This increase in spending is driven by increases in outpatient and drug expenditures, which are typically not covered by this insurance,” the researchers said.
The study noted that higher health expenses are consistent with increased diagnoses of hypertension, a condition that is often treated with medication and could, therefore, result in higher drug expenditures.
Another reason is the increase in the use of inpatient services. With a health insurance in place, more elderly may be availing of inpatient services which also increase health costs.
The hike in expenses may be due to the possibility that doctors are treating patients with and without health insurance coverage differently.
In this case, some doctors would be more inclined to recommend aggressive treatment for those covered by health insurance which results in higher expenses.
“It suggests that government officials should ensure that the increased expenditures reflect higher use of necessary care. In addition, policy-makers should ensure that physicians are not charging higher prices to newly insured patients who have a less elastic demand,” the authors said.
Based on data from the Philippine Statistics Authority, the country’s total health expenditures at current prices rose by 8.3 percent in 2018 amounting to P799.1 billion, from P737.8 billion in 2017. It contributed 4.6 percent to gross domestic product.
However, more than half of this amount or 53.9 percent were contributed by households. Data showed that OOP expenses of households reached P413 billion in 2018.
More than half or 50.1 percent of OOP worth P206.7 billion were spent on pharmacies while hospitals received the second-largest amount of OOP, at P148.8 billion.
The bulk of hospital expenditures went to private general hospitals, at P108 billion; followed by providers of ambulatory health care at P55.7 billion, or 13.5 percent; and ancillary services at P1.7 billion.