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Universal Health Care Act
An act instituting universal health care for all Filipinos prescribing reforms in the health care system and appropriating funds
February 20, 2019
Universal Health Care Act is approved on
Pres. Rodrigo Duterte
Universal Health Care act is signed by
Comprehensive health approach
Ensuring health literacy, healthy living conditions, and protection from health risks
Equitable health car access
Providing affordable, high-quality health services without financial hardship, prioritizing marginalized populations.
Collaborative Framework
Adopting a whole-system, government, and society approach for health policies and programs
People oriented programs
Delivering health care that respects cultural, value based and individual differences
Have systemic approach
Have clear definition of roles
Ensure that all Filipinos are equitable access to quality and affordable health care
General objective of Universal Health Care Act
Co insurance
Refers to a percentage of a medical charge that is paid by the insured, with the rest paid by the health insurance plan.
Co payment
Refers to a flat fee or predetermined rate paid at point of service
Contracting
Refers to a process where providers and networks are engaged to commit and deliver quality health services at agreed cost, cost sharing and quantity in compliance with prescribed standards.
Direct contributors
Refer to those who have the capacity to pay premiums
Entitlement
Refers to any singular or package of health services provided to Filipinos for the purpose of improving health
Health Maintenance Organization (HMO)
Refers to an entity that provides, offers, or covers designated health services for its plan holders or members for a fixed prepaid premium
Indirect contributors
Refer to all others not included as direct contributors, as well as their qualified dependents, whose premium shall be subsidized by the national government including those who are subsidized as a result of special laws
Prepayment
Refers to approach in the purchase of health services by which health care provides are paid in advance for the cost of goods and services for specific package of health benefits based solely on pre determined and fixed budget
Prospective payment
Refers to a method of reimbursement in which payment is based on a predetermined, fixed amount. The payment amount for a particular service is based on disease or diagnosis related groupings and validated costing methodologist
Health facility
May be public or private, devoted primarily to the provision of services for health promotion, prevention, diagnosis, treatment, rehabilitation and palliation of individual suffering from illness, disease, injury, disability or deformity or in need of obstetrical or other medical and nursing care
Health care professional
who may be a doctor of medicine, nurse, midwife, dentist, or other allied professional or practitioner duly licensed to practice in the Philippines.
Community based health care organization
Refers to an association of members of the community organized for the purpose of improving the health status oft hat community
RA 9711
Food and Drug Administration Act of 2009
Pharmacies and Drug outlets
Sell or offer to sell any health product directly to the general public or entities licensed by appropriate government agencies
RA 10918
Philippine Pharmacy Act
Laboratories and diagnostics clinics
Refer to licensed facilities where tests are done on the human body or on specimens thereof to obtain information
Filipino citizen
They shall be automatically included into the National Health Insurance Program, hereinafter referred to as the program
Population based health services
Funded by the national government through the DOH and provided free at the point of service for all Filipinos
Individual based health services
Primarily financed through prepayment mechanism like social health insurance, private health insurance and HMO plans to ensure predictable health expenditures
Direct contributor
Indirect contributor
Program membership
Direct contributor
Program membership that is actively paying members
Indirect contributors
Program membership that subsidized by the government
Primary care providers
As first point of contact such as family doctors, general practitioner or community health workers; serve as the entry point into the healthcare system
Health care provider networks (HCPN)
Ensure coordinated care, group of healthcare facilities and providers working together to deliver integrated and continuous care
LGU and DOH
Establish health care delivery system, responsible for organizing and managing healthcare services at the local and national levels
5 ex officio members
3expert panel members
5 sectoral panel members
Philhealth board of directors
13 members
The philhealth board of directors have maximum consisting member?
President of the Philippines
The president and ceo of philhealth is appointed by the
Filipino citizen
Must at least have 7 years of experience in public health, management, finance, health economics
Eligible criteria for a president and ceo of philhealth
200,000
Offenses by health providers like fraud is fined per how much count
50,000
Members committing fraudulent act fined how much per violation
