Universal health care for all Filipinos

The House of Representatives on September 6 passed on third and final reading the House Bill 5784, or An Act Providing For A Universal Health Coverage For Filipinos and Appropriating Funds Therefor, by an affirmative vote of 222, with seven members of the Makabayan bloc voting against.

The bill seeks to provide universal health care (UHC) to all Filipinos consistent with the mandate of the State in Article II, Section 15 of the Constitution “to protect and promote the right to health of every Filipino and instill health consciousness among them”. The UHC bill further declares it the duty of the State to “adopt an integrated and comprehensive approach to health development and endeavor to provide every Filipino healthy living conditions and access to needed cost-effective and quality promotive, preventive, curative, rehabilitative and palliative health services, without suffering financial hardship when obtaining them” (Section 2).

Under the UHC bill, the Philippine Health Insurance Corp. (PhilHealth) is reconstituted into the Philippine Health Security Corp. (PHSC) as it becomes the national purchaser of health services. UHC membership will be categorized into two: contributory, or those who pay, such as public and private workers; and noncontributory workers, or those who give no contributions, such as indigents, or Filipino citizens whose income fall below the National Economic and Development Authority defined poverty threshold.

Moreover, the UHC bill provides for the adoption and institutionalization of 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 HTAC will serve as advisory body to the health secretary and the board of directors of the PHSC on the priority entitlements for universal health coverage.

The UHC bill authorizes Department of Health (retained hospitals, specialty hospitals and local government units-hospitals to utilize 100 percent of their income to enhance their capacity and improve the quality of their services.

All members, whether primary or dependent, will be provided with a unique number and identification card that shall facilitate the identification, eligibility, verification and utilization recoding. It shall be recognized as a valid government ID card, but the absence of the ID card at the point of health services shall not prejudice the right of any member to avail themselves of the program benefits or medical services under the program (Section  18). The medical benefits can be primary, or secondary or tertiary level health care. It can be delivered face-to-face or remotely, through telecommunications and information technology. It includes drugs, vaccine, clinical and surgical procedure, preventive and promotive health services and traditional medicine (Section 4[9]). The UHC bill defines a “beneficiary” as any person entitled to health-insurance benefits under the bill (Section  4[b]) which includes “members” who belong to the contributory group or noncontributory group (whose premiums are fully subsidized by the national government) and whose premium contributions have been regularly paid to the National Health Security Program (Section 4 [z]). Dependents refer to the following:

  • The legitimate spouse who is not a member;
  • Unmarried and unemployed legitimate, legitimated, illegitimate, acknowledged children as appearing in the birth certificate, legally adopted or stepchildren below 21 years of age;
  • Children who are 21 years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support;
  • Parents of members who are 60 years old or above whose monthly income is below an amount to be determined by the PHSC in accordance with the guiding principles set forth in this Act; and
  • Parents of members with permanent disability that render them totally dependent on the member for subsistence.

The Makabayan bloc, which rejected the UHC bill, claim that free health care and a unified public health care should be directly funded by the government through public hospitals. The bill allegedly pushes for the privatization and commercialization of the health-care system with the government turning into a “collector of contributions”, instead of a “primary funder” for public health care. The bill further reduces the funding of public hospitals, allowing private facilities to dominate the health-care system. The maintenance and other operating expenses of public hospitals would be removed and, instead, will rely entirely on PhilHealth (www.rappler.com).

A counterpart measure, Senate Bill 1458 introduced by Sen. Joseph Victor G. Ejercito is pending in the Senate. As rightly pointed out by one of the principal authors of the UHC bill, Party-list Rep. Harry L. Roque of Kabayan, the UHC bill gives spirit to the right to health of all Filipinos.

Certainly, this is one time that we can applaud Congress for finally doing its job—to legislate and not to investigate.