A little over six months after it was signed into law, the implementing rules and regulations (IRR) of the landmark law on Universal Health Care (UHC) were finally signed and issued. It was on Feb. 20 when President Rodrigo Duterte signed Republic Act (RA) 11223 otherwise known as the Universal Health Care Act of 2019.
Department of Health (DOH) Secretary Francisco Duque III who led the signing rites yesterday, however, clarified that the IRR will only take effect 15 days after publication of its copies in the Official Gazette and newspapers of general circulation.
The issuance of the IRR will officially make the Philippines join the ranks of 18 countries that offer true universal health coverage. These countries include Australia, Canada, Finland, France, Germany, Hungary and Iceland, just to name some.
While we may not have a very rich or wealthy government as compared to these countries, Duque cites, the Philippine UHC program will be as good, if not better than those offered even in the Obamacare health insurance coverage in the United States. Beaming with obvious pride, Duque announced this in our Kapihan sa Manila Bay last Wednesday, or on the eve of the signing of the IRR.
As provided for by RA 11223, the UHC will be principally implemented and administered by the Philippine Health Insurance Corp., or PhilHealth for short. Directly attached to the DOH, the PhilHealth is currently headed by retired military general Ricardo Morales as president and chief executive officer (CEO). Being the Health Secretary, Duque sits as ex officio chairman of the PhilHealth Board of Directors.
While the new PhilHealth president/CEO has no medical background, Duque noted the experience and background of Morales. Upon retirement from active military service in 2009, Morales joined the AFP General Insurance Corp. and was president and CEO of the AFP Mutual Benefit Association Inc. from 2011 to 2013.
Morales replaced Dr. Roy Ferrer as PhilHealth chief who, along with several other officials in June this year, was told by President Duterte to resign. This will enable the agency to start with a “clean slate” following the reported loss of some P300 million to bogus insurance claims by a dialysis clinic and other reported shady deals that seriously affected its financial operations.
When he was named to PhilHealth, President Duterte gave Morales the marching orders to “fix the organization and eliminate corruption” at a crucial period when the UHC Law is to be launched.
Duque looks forward to the full implementation of the landmark law on UHC that expands access to health services of all Filipinos across the country. Speaking in our Kapihan sa Manila Bay, Duque disclosed the IRR spells out how they will implement the automatic enrolling of all Filipinos in PhilHealth’s National Health Insurance Program (NHIP). It seeks to ensure that up to 98% of Filipinos will have access to a comprehensive set of health services without financial hardship.
Duque himself once served as president and CEO of PhilHealth from 2001 to 2005, or before he was first appointed by former president Gloria Macapagal-Arroyo and served as DOH Secretary until 2010. Thus, Duque wants to make sure the implementation of the expanded UHC Law will be fully funded in the first-year rollout of the program.
The implementation of the UHC Law for its first year needs P257 billion, Duque said. According to him, this will be sourced from the “sin” tax collections of the national government and partly from the income generated by the Philippine Amusement and Gaming Corp. (PAGCOR) and the Philippine Charity Sweepstakes Office (PCSO).
Through these recent years, the annual UHC funding has been sourced from the “sin” taxes on cigarettes and alcohol products. Of the projected “sin” tax collections, P160 billion was allocated for next year to PhilHealth’s premium subsidy for the indigent, senior citizens, and sponsored members.
With a required budget of P1.5 trillion of the expanded UHC until 2024, Duque admitted the government will implement the full package coverage “progressively,” increasing incrementally by about 10 to 15 percent per year.
The DOH, in consultation with the Department of Budget and Management and the local government units (LGUs), are mandated by the UHC Law to come up with guidelines for the use of the special health fund. All income from PhilHealth payments will go to the special health fund, which will be allocated by LGUs exclusively for the improvement of local health systems.
The crafting of the IRR will operationalize provisions in the law, such as budget allocations, health financing, improvements in the benefit packages, among others. The same law provides for a transition period (i.e., Section 41) for LGUs and concerned government agencies for the full implementation of the law.
During our Kapihan sa Manila Bay, Duque took the opportunity to pitch for his initiative to “re-nationalize,” or to return to the national government public health service units that were devolved to LGUs since 1991 under the Local Government Code. According to him, the DOH is now looking for “champions” at the 18th Congress to help him push for the re-nationalization of health services back to the DOH.
Re-nationalization, Duque pointed out, complements the UHC in bringing together and connecting the primary health care from barangay level, municipal/city health centers, district health centers to provincial hospitals all the way to the specialized hospitals of the national government like the Heart Center of the Philippines, National Kidney Center, etc. Thus, Duque called for the support of Sen. Christopher “Bong” Go and Rep. Angelita Tan, respective chairpersons of the Senate and the House health committees.
However, Duque rued, some mayors “do not want to lose their power over their health workers and their facilities.”
For obvious reasons, public health services have been a rich source for patronage politics not only among LGUs but also for those in Congress. Health is wealth, euphemistically speaking, of course.