Overview of the Healthcare System in the Philippines

Healthcare System

organized way in which healthcare services are provided to a population.

Patients

Those who receive the healthcare services.

Healthcare Providers

The institution and the staff who deliver care.

Payers

Those who pay for the medical finances, including the patient, government, PhilHealth, and Taxes.

Policy Makers

Those who have the power to provide policies that may enhance and regulate healthcare services, including governments and institutions.

Public Healthcare

Funded and governed by governments, accessible to all citizens, and may be free or heavily subsidized.

Private Healthcare

Provided by private entities, where individuals pay for services out-of-pocket or through private insurance.

Single-Payer

A healthcare system where the government or a single public entity is responsible for the finances, funded through taxes.

Multi-Payer

A healthcare system involving multiple entities (government, private insurers, employers) for finances, commonly seen in the Philippines.

National Health Services (NHS)

A healthcare system where the government owns most hospitals and provides insurance to cover healthcare costs, but healthcare services may remain in the private sector.

National Health Insurance (NHI)

A healthcare system where healthcare services are private, but payment comes from government-run insurance funded by taxes.

Beveridge Model

A healthcare model provided and financed by the government through taxes, resembling a single-payer and NHS type of healthcare system.

Bismarck

A healthcare model financed by insurance systems, jointly funded by employers and employees, mandatory but non-profit.

NHI

A healthcare model that is a blend of the Beveridge and Bismarck models, where healthcare is private but payment comes from government-run insurance.

Health Outcomes

Metrics to measure healthcare services, including life expectancy, infant and maternal mortality rates, disease-specific outcomes, access to care, and quality of care.

Patient Safety

Ensuring that care does not cause harm to patients.

Effectiveness

Delivery of care based on scientific knowledge and evidence-based practices.

Patient Satisfaction

Measuring how well services meet patient expectations in terms of care, communication, and comfort.

Resource Utilization

Examining how well resources are used in healthcare delivery.

Cost-effectiveness

Evaluating whether healthcare provides value for money.

Equity in Healthcare

Ensuring fair access to healthcare services regardless of differences, addressing health disparities between population groups.

Universal Health Care

A system where 100% of citizens must be involved, providing a wide range of services with a percentage of expenses covered.

Department of Health (DOH)

Primary agency responsible for developing policies, programs, and regulating healthcare providers in the Philippines.

Local Government Units (LGUs)

Entities closest to the community, especially in rural areas, under the DOH.

PhilHealth

The national social health insurance program in the Philippines, aiming to provide affordable healthcare to all citizens.

Universal Health Care Law (RA 11223)

Enacted in 2019, mandates automatic enrollment in PhilHealth for every Filipino citizen, with expanded coverage for primary care services and preventive health programs.

Private Health Insurance Providers

Many Filipinos purchase private health insurance to supplement their coverage and access private healthcare facilities.