Universal health care gets P166.5 billion for 2020

MANILA, Philippines — A total of P166.5 billion has been allocated for the universal health care (UHC) program for its first year of implementation next year.

Of the amount, according to budget documents submitted by Malacañang to the House of Representatives, P67.4 billion would be earmarked for government subsidy to the Philippine Health Insurance Corp. (PhilHealth) for free health insurance coverage for millions of Filipinos.

Some P9.5 billion would be for the deployment of health care personnel to the provinces, P9.4 billion for medical assistance to poor patients and P5.9 billion for health facilities.

To augment UHC funds, Quezon Rep. Angelina Tan, who heads the House committee on health, proposed to allocate for the program the P1.2 billion returned to the government last year by Dengvaxia maker Sanofi.

“We should be able to use the refund to support expanded health services to benefit more of our people under the program,” Tan said.

She said there is still time to appropriate the Sanofi refund while the proposed P4.1-trillion national budget for next year is pending in the House.

“Including it in the funding for UHC will reduce the estimated P62-billion budgetary shortfall for the program on the first year of its implementation in 2020,” she said.

Davao City Rep. Isidro Ungab, appropriations committee chairman, said he would look into the proposal.

Last week, Health Secretary Francisco Duque lll told the appropriations committee that the Sanofi refund was “with the national treasury.”

The refund represented the value of unused Dengue vaccines when the Department of Health (DOH) decided to stop the vaccination program due to deaths that parents and the Public Attorney’s Office blamed on the vaccine.

The amount was part of the P3-billion Dengvaxia procurement of the DOH under then-secretary and now Iloilo Rep. Janette Garin, who is facing charges in connection with the vaccine purchase.

In the last Congress, the House and the Senate tried to appropriate the Sanofi refund in a supplemental budget, which the two chambers failed to approve due to disagreement on its use.

Tan also urged the appropriations committee to set aside funds for cancer assistance as no such money is earmarked in the DOH budget for next year despite the mandate of a recently signed law.

Cavite Rep. Abraham Tolentino, meanwhile, urged the DOH to finally transfer a drug rehabilitation center in Tagaytay, which he said the city government wanted relocated because it is near city hall and the city college.

“We have been repeatedly asking for the transfer for years and the DOH has been promising to move out, but they have not been transferred,” he said.

He said the facility’s present location is a property of the city, which has offered another property as relocation site.

‘Gradual’ UHC implementation

The implementation of the UHC next year faces no delays, Duque said yesterday, even as PhilHealth president and chief executive officer Ricardo Morales admitted that the UHC may take three more years to fully implement due to lack of funds and personnel.

Morales said the program is “ambitious” and “challenging” but the Duterte administration intends to make it happen.

For one, he said the budget approved by the Department of Budget of Management this year and next year is the same.

“PhilHealth cannot implement more than what the budget allows. But what we can do is to organize to be able to implement the UHC when it happens… We can start reorganizing, so when the funds become available, we will be able to provide the service,” he told reporters.

He explained that even in other countries like Taiwan and those in Europe, the implementation of UHC was gradual.

“It was not a grand opening where you just opened the curtain and everything was there already. They do it in several years until it became 100 percent,” he said.

Morales claimed that aside from funding, the other issue in UHC implementation is the “absorbtive capacity of the organization” as they have to recruit more people, put up more local insurance offices and extension offices.

“It will be a gradual, soft rollout. For full implementation, candidly it will take three years,” he added.

Implementation sites

The health secretary said the inclusion of only 33 provinces and cities in his agency’s UHC Implementation Sites (UIS) for 2020 does not mean that UHC will not be implemented at all in a certain area next year.

“Though it is a critical step to address fragmentation in the health system, the UIS Program is only one of the many reforms. Let us not confuse or equate UIS with UHC,” he noted.

Under the UHC program, every geographical area of the country will be represented under the 2020 UIS. Luzon has 13 implementation sites, 10 in Mindanao, eight in the Visayas and two in the National Capital Region.

The DOH is expecting the mandatory enrollment of all Filipinos in the National Health Insurance Program (NHIP) of PhilHealth to be completed by next year.

“Right now, we are at 98 percent enrollment. We expect to achieve 100 percent enrollment by the end of the first year of UHC implementation,” he said in a statement.

And once 100 percent enrollment is achieved, the individual-based medical services which PhilHealth reimburses or pays for will become available to all Filipinos at all health care facilities accredited by the PhilHealth nationwide, Duque said.