Gov't aims to reduce citizens' out-of-pocket share in health spending

Vivienne Gulla, ABS-CBN News

Posted at Sep 23 2022 02:34 AM

Medical personnel at the Cagayan Valley Medical Center in Tuguegarao City temporarily take care of the patients at the hospital's conference room on August 24, 2022, in the aftermath of tropical storm Florita's onslaught. Jonathan Cellona, ABS-CBN News/file
Medical personnel at the Cagayan Valley Medical Center in Tuguegarao City temporarily take care of the patients at the hospital's conference room on August 24, 2022, in the aftermath of tropical storm Florita's onslaught. Jonathan Cellona, ABS-CBN News/file

MANILA—The government targets to reduce citizens’ out-of-pocket share in health spending from the current 44% to 30% in five years, according to Marikina 2nd District Rep. Stella Quimbo.

She, however, is not optimistic that the Philippines will be able to provide free healthcare services to all Filipinos in the future.

“Gaano tayo kalayo o kalapit sa free health services para sa mamamayan?” ACT Teachers Party List Rep. France Castro asked.

“Palagay ko hindi siguro mangyayari ‘yung sitwasyon na lahat ng ating healthcare will be provided for free. Hindi talaga mangyayari yan. Hindi kakayanin. Kahit pumunta tayo sa pinakamayaman na bansa sa mundo, there’s no such thing as free healthcare for everyone. But sa ngayon, of course, ang aspiration is to provide free healthcare for those in need,” Quimbo, the Department of Health’s budget sponsor at the House of Representatives, replied.

“Sa PhilHealth, mayroong indigent program, kung saan libre ang PhilHealth premium contributions ng ating 4Ps. Having said that, the goal really is not for all to have free healthcare, but rather, ang goal is to lower our out of pocket payments from 44% to 30%. Baby steps tayo. From now, 2022 to 2027, 5-year goal, pababain naman sana natin ang ating out of pocket payments to 30%,” she said.

“Hindi po naman imposible na magkaroon tayo ng free healthcare services. Kung ita-target talaga natin, kung pagtutuunan natin ang health services para sa mamamayan. Pwede nating magawa ‘yun,” Castro countered.

Quimbo said the Philippine Health Insurance Corporation shoulders only 14% of the total health spending,

“Napakaraming problema sa PhilHealth. May problema halimbawa sa disenyo ng programa, gumagamit tayo ng case rates… pero ang case rates na ‘yan, sa maraming illnesses napakababa. Therefore, hindi talaga niya kayang magbigay ng sapat na financial risk protection,” she said.

Castro proposed to give government funds for health expense subsidies directly to public hospitals, instead of having hospitals reimburse these expenses from PhilHealth. But Quimbo disagreed.

(5:58PM) “With due respect, I will have to disagree with you. Una sa lahat, ang isang health insurance scheme is certainly more efficient than a direct subsidy. Kung piso ang inilagay mo sa ospital, ang makukuha mo out of that is also P1 worth of services. Ang dahilan kung bakit sa isang health insurance scheme, pag maglagay ka ng piso ang makukuha mo is much more than P1 is because of what we call risk pooling," Quimbo explained.

"'Pag pinagsasama-sama mo lahat ng Pilipino sa isang scheme, may Pilipinong malusog, may Pilipinong sickly at kailangan ng hospitalization, kumbaga nagkakaroon ng subsidization between your health population and your sick population."

The two lawmakers, however, agree that the country’s 2023 budget for the health sector is not enough. The proposed budget for the DOH and its attached agencies next year is P301 billion.

“Nasa 1.39% ito sa projected nominal GDP ng bansa. So napakalayo po ito kumpara sa recommended 5% ng GDP o P1.08 trillion kung ibabatay sa national government fiscal program for 2023,” Castro said.

“Bitin na bitin ang ginagastos ng ating bansa para sa kalusugan. Ang pinropose nila sa DBM ay P500 billion total, ang nakuha lang na approved amount ay P301billion. If we had more fiscal space, ay mapapataas sana natin ang budget. That’s a challenge we all face today,” Quimbo admitted.


The DOH expects to increase its budget utilization rate for the year to 95% in December from the current 46%. The agency has the remaining 21,000 unfilled positions.

The House of Representatives terminated on Thursday the plenary debates on the proposed 2023 budget for the DOH. Basilan Rep. Mujiv Hataman earlier moved to defer consideration of the agency’s budget, after he slammed the slow upgrade of the Basilan General Hospital. But it did not push through after the DOH committed to facilitate the hospital’s application for license to operate at 100-bed capacity by November.


Camarines Sur 3rd District Rep. Gabriel Bordado, meanwhile, expressed concern over the lifting of mask mandate outdoors, as Christmas celebrations near. 

Quimbo assured fellow lawmakers the agency is closely monitoring the number of COVID cases in the country. But she stressed, it is necessary to administer booster shots to more eligible individuals.

The Philippines has administered a total of 19 million booster shots, according to data from the National COVID-19 Vaccination Dashboard. DOH record, meanwhile, shows that of its PinasLakas vaccination campaign target, 2.7 million or 11.36% received a booster since it was launched last July 26.

"Around late December of 2021 up to early January 2022, we experienced a high surge of COVID-19 cases, most probably exacerbated by Christmas celebrations and other holiday activities. With December fast approaching and the mask mandate easing up, how is the Department of Health ensuring that we don’t experience a similar surge again?” Bordado asked.

"It’s our second week of implementing this policy of optional mask wearing. Nakamanman ang ating ahensya kung tataas ba ang numbero, ang bilang ng COVID cases dahil dito. Sila po ay actively monitoring that possibility. But in the medium term, ang talagang makapagpapababa ng cases in a sustainable way is really the vaccination program, pagpapalawak ng booster program,” Quimbo replied.


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