Health in the spotlight

Health received a very special mention in the fourth State of the Nation Address (SONA) of President Ferdinand “Bongbong” Marcos Jr. at the joint opening session of the 20th Congress last July 28. It was symbolic of sorts when PBBM declared that from his SONA day there will be “zero balance billing” for patients confined in all 87 government-run hospitals all over the country.

Giving flesh to the “zero balance billing” promise of PBBM, the state-run Philippine Health Insurance Corp. (PhilHealth) launched four days later its newest project, aptly dubbed Yaman ng Kalusugan Program para Malayo sa Sakit (YAKAP). This acronym is actually a Filipino word which means “embrace.” As PhilHealth explains it, YAKAP reflects the Marcos administration’s commitment to embrace all Filipinos in this government’s inclusive and accessible health care project.

Thus, it became symbolic in the sense that the “zero balance billing” was kind of a roundabout way by which PBBM reversed the transfer of PhilHealth funds back to the National Treasury that was questioned in several petitions against it. While pending its resolution, the Supreme Court (SC) issued a temporary restraining order that stopped the transfer of the remaining P29.9 billion of alleged “excess funds” of PhilHealth.

Underscoring the need for accessible health care for every Filipino, the YAKAP of PhilHealth introduced a broader range of free primary care services, including free access to 75 essential medicines, laboratory tests and cancer screenings. By doing this, YAKAP intends to enhance the existing program to bring health care services closer, especially to impoverished communities and reduce the need as much as possible for costly hospital confinement.

It’s about time. For decades, our health system has languished in a state of underinvestment and chronic neglect.

The announcement of PhilHealth’s YAKAP program and “zero balance billing” policy draws attention to the promise of much-needed relief for Filipinos, long burdened by steep health care costs. These programs were actually mandated in the letter and intent of the Universal Health Care (UHC) Act. Republic Act (RA) 11223, or the UHC Act, was signed into law by former president Rodrigo Duterte on Feb. 20, 2019.

Under the UHC Act, all citizens, including overseas Filipino workers, are automatically enrolled in PhilHealth’s national health insurance program. Since its enactment in 2019, PhilHealth has expanded coverage across outpatient, inpatient and primary care, marking progress despite various implementation challenges.

Many of the principal authors of the UHC Act in Congress have called out PhilHealth as a “failure” in carrying out its mandate, amid many Filipino families still drowning in debt paying for hospital bills of their sick loved ones. Many like-minded lawmakers deplored this is not the mandate they intended for PhilHealth. In fact, lawmakers earmarked to PhilHealth a specific percentage of proceeds from the so-called “sin tax” collections of the government.

And when resources finally do flow into the health system, they are too often diverted or misused. These are not just lapses; they are systemic failures. A case in point was the controversial Finance Department order in April this year to transfer to the National Treasury P89.9-billion “excess funds” supposedly lying idle at the PhilHealth to finance the unprogrammed programs in the Congress-approved 2024 budget.

Many of the world’s most advanced and progressive countries – Japan, Germany, Sweden, and South Korea, to name a few – have long made health a central pillar of national policy. Countries closer to home are going in the same direction, such as Singapore, Taiwan, Thailand and Malaysia. And they have the outcomes to show for it.

According to the World Bank, investments in health contribute directly to increased productivity, educational attainment and national resilience. A healthy population is a more innovative, more stable and more economically competitive one. The Philippines ought to go towards this direction.

The focus on health financing and service delivery is necessary – but it’s only one piece of the puzzle. We must begin to treat the Philippine health sector as a potential center of excellence, not just a problem to be solved. For instance, the Philippines should no longer be dependent on imported medicines, especially the essential ones, to ensure supply and hopefully bring down costs.

We should manufacture high-quality pharmaceuticals, develop new treatments through research and transform into a regional hub for ethical, affordable and innovative health care. This is not a pipe dream. It is an opportunity waiting to be seized.

To make this happen, the government must create the right enabling environment.

Consider the familiar list of woes in our country’s health sector: the mass exodus of Filipino health workers, the shortage of specialists and basic medical equipment in far-flung communities, the inadequate supply of essential medicines and the alarmingly high out-of-pocket expenses that drive millions into poverty every year.

Include also the proliferation of counterfeit drugs – a deadly consequence of weak regulation and high medicine costs – and rampant malnutrition among children, which continues to rob future generations of their full potential. Mental health services remain grossly insufficient and misunderstood.

Yet despite this bleak landscape, the recent policy shifts signal a chance to turn the tide. Aside from political will, however, we also need strategic vision to emulate these economies of our neighboring countries.

Traditionally, health does not occupy a prominent spot in the national discourse. Perhaps it is because accomplishments in this sector are not readily visible, such as when factories or infrastructure are built. This attitude must change. For arguably, there is no better measure of a country’s progress than the state of health of its populace.

These goals demand long-term thinking. We cannot be content with short-term deliverables that only look good in term-end reports. The vision for Philippine health care must go beyond 2028. It must be institutionalized, defended and constantly improved.

Thanks to PBBM’s SONA, for the first time in years, health appears to be earning its rightful place in the national spotlight. These should not just be about bureaucratic adjustments. It has been a long-standing promise of the UHC Law that is long overdue and highly sought-after.