Commentary: Reforming Philippines’ healthcare system to meet challenges of pandemic

Last May, the Social Weather Stations (SWS) released a survey that found out at least 87.0% of Filipinos are worried that anyone in their immediate family might catch coronavirus infection.

For most of us, worrying about catching COVID-19 infection is greater than worries about acquiring other deadly virus, such as Ebola in 2014 (82%), swine flu in 2009 (82%), bird flu in 2006 (83%) and in 2004 (80%), and Severe Acute Respiratory Syndrome in 2003 (78%).   

It has been two months since that survey was conducted and more than four months since the government imposed strict quarantine restrictions, but the Philippines is still struggling to control the spread of the pandemic. Apparently, many of us still hope and pray that our beloved ones will not be infected by the dreadful virus from Wuhan.

This only shows that “staying healthy and avoiding illness” remains the top personal concern among us Filipinos. In this time of pandemic, being sick is foreseen by many as an event that will entail several enduring challenges for the family and community as well.

Two landmark health laws, the Universal Health Care (UHC) Act and the National Integrated Cancer Control (NICC) Act, were simultaneously approved by the president in February 2019. The main objective of these laws is to ensure access to the needed health services without exposing patients to financial hardships.  

For the current year, a combined allocation of P172.37 billion was allocated to the Department of Health and Philippine Health Insurance Corporation mainly to progressively realize UHC. Though, the NICC Act was signed into law a few days prior to approval of UHC, legislators still failed to include a separate line item in the health department’s budget for this year. 

In 2018 alone, there were 141,021 new cancer cases recorded, and the sad part is 86,337 died due to the disease. In the same year, breast cancer ranked at the top spot in terms of new cases detected, while lung cancer is the leading cause of mortality.

In the recent report published by the Economist Intelligence Unit, entitled “Cancer preparedness in Asia-Pacific: Progress toward universal cancer control,” the Philippines ranks last for cancer preparedness in the Asia-Pacific region with an overall score of 42.6 out of 100, well below the regional average of 66.5, while Australia (92.4), South Korea (83.4), and Malaysia (80.3) lead the region.

Many health experts have pointed out that the country should invest enough to improve the current health systems. Now that the country is facing the pandemic, the needed reforms in our public health system have been exposed. Even the secretary of health himself mentioned that “the UHC is crafted to address this very gap that has plagued our system for many years. Hence, it is a critical moment to fast track the transition to universal healthcare.” 

Looking into the proposed national budget for 2021, economic managers originally set a P4.64- trillion allocation. That was before the pandemic struck, then in May 2020, it was reduced to P4.33 trillion after it became clearer that revenues will decrease due to reduction in the economic activity brought by the coronavirus shutdowns. 

Based on the recommendations of the World Health Organization, at least 5% of this total budget should be implemented on health-related programs. However, it was mentioned in the last joint Congressional oversight committee hearing on the UHC Law that the DOH only proposed a budget of around P182-billion for next year. 

The said amount is still less than the health allocation as recommended by the WHO. It is hoped that this will be further increased to facilitate the implementation of health laws, such as the NICC Act. 

As the president is expected to present his administration’s recovery plan during the State of the Nation Address scheduled on July 27, Filipinos are indeed expecting that he will be able to discuss his plans for the overall health spectrum, and not to only focus on the COVID-19 response. 

Afterwards, the Congress will resume and at the top of its priorities is to discuss the national budget for next year. However, it was earlier announced that the submission of the budget for 2021 will be delayed until August, which will give legislators less time to deliberate its contents.

Though, for this year, the virus has derailed some of the plans in terms of the implementation of the relevant health laws, stakeholders are vigilant and consistently remind the government not to disregard these. Ensuring the implementation of these health programs through enough appropriation will help the country regain its momentum and will support the gradual but stable revival of the economy. 

Health is wealth; but investment and financing should be a priority in the years to come so that government could reform and improve the healthcare system, and also prevent the recurrence of any pandemic. 

The ongoing crisis underlines the extensive consequences of an inadequate public health system. Government must act decisively to guarantee that quality health services are accessible to all. This is the mandate provided by the Universal Health Care Act and the National Integrated Cancer Control Act that now requires our legislators to ensure adequate funding for fast implementation.

Alvin Manalansan is a non-resident fellow of think tank Stratbase ADR Institute and convenor of CitizenWatch Philippines.