Nothing "universal" about proposed universal health coverage bill – HEAD

"It's befuddling why government policy insists on universal health coverage as a financing scheme and pours billions of people's money to PhilHealth, even as the corporation continues to be ineffective in decreasing Filipinos' out-of-pocket spending and covering all their health costs," said Health Alliance for Democracy secretary general Dr. Joseph Carabeo on the recent passing of the bill in congress. "The Universal Health Coverage (UHC) Bill will not universalize access to health care."

Under the proposed UHC bill, PhilHealth will be renamed as the Philippine Health Security Corporation (PHSC) and will be the "national purchaser" of health services. Coupled with the mandatory enrollment of all citizens to PHSC, this will ensure that aside from their taxes, everyone will have shell out more money to pay for their health needs through their P2,400-worth mandated contributions.

From 2011 to 2017, PhilHealth has enjoyed a steady increase in funding, with last year's allocation as its highest ever at P53 billion – more than 15 times its 2011 budget of 3.5 billion. Its share in the national health budget also increased from 10% in 2011 to 35% in 2017. And yet Filipinos still paid for more than half of their total health expenses out of their own pockets in 2014 (56%), according to data from the Philippine Statistics Authority. Social insurance paid for only 11%.

The mandatory enrollment will milk profit out of Filipinos with measly wages and unsteady sources of income. In the proposed bill, contributory members will include regular employees and those from the informal sector, such as contractual employees and small-time vendors. Even overseas workers who already have insurance abroad will not be spared from the mandated contribution.

The UHC bill expressly states that only certain benefits included in a "positive-list" will be covered by the PHSC. The PHSC will determine if the benefits to be covered will maintain the financial sustainability of the corporation. Therefore, if a service that patients need is not included in the list of benefits, they will have to pay for it. "How can they call this universal health coverage?" remarked Carabeo.

Finally, it will not be the Department of Health (DOH), but the PHSC as a corporation, which will ensure the quality of care, appropriateness of services, financial protection – for as long as it is financially sustainable and will return its investments. The DOH will fade into the background as a technical adviser with no real power. It is by this virtue that health care in the country will be corporatized.

"What is clear here is the responsibility of health services is relegated to an ineffective and inefficient corporation that is geared towards fiscal integrity. Through the UHC bill, health care in the country will be a commodity that must return its investment, and not as a genuine service to the people, a right to be ensured by the government," Carabeo ended. ###