SAS 17-18: PHILIPPINE HEALTH CARE SYSTEM

philippine medical association / PMA

was signed by President Ferdinand E. Marcos on August 4, 1969

initiated the MARIA Project to provide medical assistance to rural indigents

health care is provided through a dual system, primarily funded by taxes

MARIA Project preceded the implementation of the Medicare program in the Philippines

medical care act

was implemented in August 1971, overseen by the Philippine Medical Care Commission (PMCC)

letter of Instruction (LOI) # 949 required the Ministry of Health to improve healthcare delivery during Martial Law

contributions for the Medicare program began to be collected by the Social Security System (SSS) and the Government Service Insurance System (GSIS) on January 1, 1972

1987 Philippine Constitution

recognized health as a basic human right

generics act

aka: RA no. 6675

was approved to be used on September 13, 1988

the act ensures an adequate supply of drugs at the lowest possible cost for indigent patients

promotes, requires, and ensures the production, distribution, use, and acceptance of drugs and medicines by their generic names

local government code

aka: RA no. 7160

was signed into law on October 10, 1991

was effective on January 1, 1992

provincial governments

manage and operate district and provincial hospitals

municipal governments

provide primary care

through the rural health units, health centers and barangay health station

including preventive and promotive health services and other public health programs

private sector

whether for profit and non-profit operation existed

where payment is usually made per service as rendered, by the one providing the services.

national health insurance act

aka: RA no. 7875

enacted in 1990s to improve government health care

signed by President Fidel V. Ramos on February 14, 1995

established Philippine Health Insurance Corporation (PhilHealth)

mandates social health insurance coverage for all Filipinos in 15 years

became the basis for the creation of the Philippine Health Insurance Corporation (PhilHealth)

Philippine Health Insurance Corporation / PhilHealth

provides financial risk protection to Filipinos

operates under the Department of Health (DOH)

covers self-employed individuals and the informal sector

mandates social health insurance for all Filipinos within 15 years

manages the National Health Insurance Program for accessible, affordable healthcare services

subsidies various treatments, including inpatient care and non-emergency surgeries.

traditional and alternative nedicine act / TAMA

aka: RA no. 8423

to promote the use of herbs proven to be safe, effective and affordable.

was signed by President Fidel V. Ramos. It was approved to be implemented on Dec.9, 1997.

it is the policy of the State to improve the quality and delivery of health care services to the Filipino people

through the development of the traditional and alternative health care and its integration into the national health care delivery system

kalusugan para sa masa

launched in 1999

included the initiative “Isang Milyong Sepilyo Para sa Masa.”

involved campaigning for toothbrush donations for distribution to barangays

a DOH program under President Joseph Estrada, whose real name is Jose Marcelo Ejercito

national health insurance act

aka: RA no. 7875 of 1995

87% suffer from dental caries

imposes heavier penalties on violators

77% of Filipinos have never visited a dentist

signed by President Gloria M. Arroyo on February 20, 2004

public health centers, hospitals, and schools provide dental services

defines abuses and unethical practices by healthcare providers, employers, and members

republic act 10606

signed by Benigno Simeon C. Aquino III Signs Act on Health Insurance"

key features include full national subsidy for the indigent sector, as defined by the DSWD's 'Listahanan’

reflects the government's commitment to achieving Universal Health Care, or "Kalusugan Pangkalahatan."

health maintenance organizations / HMOs

emerged in the Philippines during the 1980s, primarily linked to insurance companies

part of employer-funded health care schemes, significant for providing insurance plans to private sector employees

executive order no. 192, series of 2015

signed by President Benigno Simeon C. Aquino III on November 12, 2015

transferred regulation and supervision of HMOs from the Department of Health (DOH) to the Insurance Commission (IC). 

2 focused on health financing

Sin Tax Law (2014)

National Health Insurance Act (2013)

4 focused on health service delivery

Reproductive Health Law (2012)

Graphic Warnings Act (2014)

Immunization Law (2011)

Tuberculosis Law (2016)

sin tax law

being implemented by PhilHealth

changes to the Health Insurance Act

generated significant revenues for subsidizing health services for the poorest 40% of the population

reproductive health law

advocates and program managers continue to push for the implementation of other provisions of the Reproductive Health Law

implemented after three decades but is facing challenges, particularly regarding contraceptive implants, which have been temporarily restrained by the Supreme Court

universal health care law

aka: RA No. 11223

first universal Health Coverage Act in Western Pacific region

signed by President Rodrigo Roa Duterte on February 20, 2019

ensures automatic enrollment of all Filipinos into the National Health Insurance Program

to provide accessible health care services without causing significant financial strain on the citizens

guided by the Declaration of Alma-Ata, reflecting the government's commitment to primary health care (PHC) as resources allow

2 types of primary health care workers in the Philippines

intermediate level primary health worker

barangay health worker / village health worker (BHWs)

department of health / DOH

government owned agency

regulates all health services and products

the provider of special or tertiary health care services

mandated to be the over-all technical authority on health

technical assistance to other health providers especially to the Local Government Units (LGUs)

population-based health service

free at point of service

funded by national government through DOH

individual-based health service

primarily through pre-payment mechanisms (SHI, PHI, HMO)

sources that fund the UHC program

DOH annual budget

PhilHealth membership contribution

PhilHealth subsidies to indigent families

Philippine Charity Sweepstakes Office (PCSO)

Philippine Amusement and Gaming Corporation (PAGCOR)

promoting & supporting community managed health care

done by making the people feel that health is in their hands

believed that through this, the government will be closest to the people

encourage the process of capacity building of the communities and organization to plan, implement and evaluate health programs at their levels

increasing efficiency in health sector

human resources must align with country's needs and policies

technology enhances effective, affordable, accessible, and culturally acceptable services and resources

DOH supports public and private institutions in faculty development, curriculum enhancement, and standard teaching materials development.

essential national health research / ENHR

considered an integral strategy for organizing and managing research using intersectoral, multi-disciplinary and scientific approach to health programming and delivery

education for health

one of the important ways for information dissemination

promotes the partnership of both the family members and the health workers in the promotion of health as well as in the prevention of illnesses

locally endemic disease control

focuses on the prevention of its occurrence to reduce morbidity rate

ex: malaria control & schistosomiasis control

expanded program on immunization

exists to control the occurrence of preventable illnesses especially for the children below 6 years old

DOH is giving for free the immunization for poliomyelitis, measles, tetanus, diphtheria, chicken pox and other preventable diseases

maternal / child health and family planning

dental care is included in this program.

the mother and the child are the most delicate members of the community

the aim of Family Planning includes spacing of the children and responsible parenthood

protecting them from illnesses and other risks would ensure good health of the community

environmental sanitation & promotion of safe water supply

this is necessary in the maintenance of healthy lifestyle

safe water and sanitation is needed for the basic promotion of health.

water is one of the basic needs for life and a factor in man’s environment

defined as the study of all factors in the man’s environment which may cause harmful effect on his well-being and survival

nutrition and promotion of adequate food supply

another basic need of the people is food

malnutrition is one of the problems in our country.

properly prepared food is an assurance for health family

there are several food resources available in the communities but due to the lack of knowledge regarding proper food planning and faulty preparation, these are not utilized to the maximum to give proper nutrition to the family

treatment of communicable diseases and common illness

diseases spreading through direct contact pose a great risk for those who can be infected

the government is focusing their efforts on the prevention, control and treatment of these illnesses

tuberculosis — one of the communicable diseases continuously occupying in the top 10 among the causes of death

most communicable diseases are preventable if the people will practice proper hygiene and increase their immune system aside from preventing to get near those who are infected

supply of essential drugs

the Generic Act of the country is enacted as a response to this

focusing on the information campaign on the proper utilization and acquisition of drugs

5 A's

accessibility

availability

affordability

acceptability

appropriateness of health services.

—should make use of the available resources within the community, wherein the focus would be more on health promotion and prevention of illness

community participation

considered as the heart and soul of PHC

people

the center object and subject of development.

success of health work relies on people's participation at all levels

health work should start from where people are and build on their existing resources

partnerships with community agencies, social mobilization, and decentralization are key

participation includes decision-making, planning, implementation, monitoring, and evaluation

barriers to community involvement include lack of motivation, attitude, resistance to change, dependence, and lack of managerial skills.

self-reliance

community participation and the cohesiveness of the people’s organization can generate support for health care through social and local resources mobilization and networking

the leadership and their management skills of these people should be developed

the existence of sustained health care facilities managed by them is one of the major indicators that the community is leading to self-reliance

recognition of interrelationship between the health & development

good health is manifested by the progressive improvements in the living conditions and the quality of life enjoyed by the population

health is a social phenomenon recognizing the interplay of the political, socio-cultural and economic factors as its determinant

development refers to the quest for an improvement in the quality of life for all which is multidimensional. This is measured by the ability of the people to satisfy their basic needs.

social mobilization

enhances people’s participation or governance, support system given by the government, networking and developing them as secondary leaders

decentralization

facilitate proper allocation of budgetary resources

ensure empowerment which can only be facilitated if the administrative structure

will provide local level political structures with more than enough responsibilities for development initiators

minimum of 1 day and a maximum of 45 days

minimum and maximum number of days for the hospitalization to be paid by Philhealth

cooperative

fair share of risks/benefits

common bond of interest

equitable capital contributions

patronage of products/services

autonomous, registered association of individuals

aims to meet social, economic, and cultural needs

adherence to universally accepted cooperative principles.