Government spending of P200 billion a year for health care is not realistic with a national budget of P1.5 trillion for 90 million Filipinos. What is needed is the political will to commit more government resources to universal health care.
This was according to Dr. Alberto G. Romualdez, Jr., former secretary of the department of health (DoH), during the Heath Financing Summit dubbed “Universal Health Care: The Role of Health Financing in Achieving Universal Health Care” held at the Davao Medical School Foundation, Davao City, last February 8.
In order to achieve universal health care, he added, there should be a quantum increase in coordinated government spending, public support for reforms, and initial focus on the poor. “Politics is involved in anything we do, and, we need political support in order to get universal health care,” he said.
Romualdez presented to fellow doctors and other participants of the summit, including leaders and representatives from both the public and private sectors, a number of health reform issues in the Philippines.
These include health professions education; admissions to the University of the Philippines College of Medicine; integration of public health and hospital services; pharmaceutical policy (the Generics Law); population and reproductive health; reorganizing the DoH central office; health care financing; hospital reform; devolution of health services; public-private mix (TB, FP, immunization); organ transplantation; tobacco control; health and environment and governance, and the grassroots.
Among these issues, Romualdez only discussed the reorganization of the DoH central office which was done in 2000. He said the objectives of such action were to streamline the central office, and to strengthen regional offices.
Out of the original 4,000 positions in the central office, 1,000 were transferred to augment work forces of other offices while only 1,500 personnel remained after the reorganization. However, strengthening of regional offices, he said, never happened in nine years, which made things more difficult for the central office, forcing them to hire more personnel.
Despite uncertainty in the actualization of universal health care, a town emerged triumphant in implementing it through exceptional political leadership. Sonia Lorenzo, former mayor of the municipality of San Isidro, Nueva Ecija, shared the story of her town’s experience on how it climbed from 5th class to 2nd class municipality in its course of attaining universal coverage of health care.
“In San Isidro, we go beyond service delivery and usher transformation through our participation roadmap. If we can somehow package change within the programs we role-out, we make development digestible. We believe that it is through structured engagement that people appreciate change,” Lorenzo said during her presentation.
By employing an integrated cooperative farming system, San Isidro had total revenue of P18 million in 2009 from a usual income of P2.9 million only a year. It allotted 16.21% of the municipal budget for health along with the establishment of its client-centered clinic, and provided allowances for 158 barangay health workers (BHW).
To incur people’s ownership of the program, the town’s local government integrates health programs in public schools as venues also for information and education campaign (IEC). “Kasi napakamahal po ng IEC,” she said. As a result, feeding programs in public schools became permanent.
San Isidro’s local government also encourages volunteerism among the youth to conduct surveys within the communities to gather information on Philhealth members, farmers’ profile, education profile, OFW families, business establishments, out-of-school youth and adult profile, differently-abled persons profile, family managed health, monitoring scheme, and skills mapping.
“It saved us from expensive surveys,” Lorenzo said, adding that it was more effective than those handled by foreigners or outsiders because the community people would rather tell everything to a neighbor surveyor than disclose personal and health profiles to outsiders.
The town’s increase in local income was due to the improvement of tax collection, quantifiable contributions of departments to local income, increase of Philhealth membership, benefits from Philhealth such as capitation, sharing of P200 a year per family to health program, people’s trust in government, skilled grassroots leaders in the field, and engagement of external stakeholders.
Lorenzo said incomes of families have increased and that they can now invest more on their crops and in health care. “Malakas ang katawan nila at happy sila,” she said, “that’s why they have doubled their harvests since then”.
She ended her presentation by saying, “Public officials may not be there forever, but non-government organizations and civic leaders, when empowered, will continue the work we have begun.” [lorie ann a. cascaro]
