MANILA (UPDATED) - Human resource is considered the “most important aspect” but a “challenge” for the implementation of the Universal Health Care Law, according to a national scientist.
“If you don’t have the human resource, you don’t have the health professional there…nothing will happen,” said National Scientist, Ramon Magsasay Awardee and UP Manila Professor, Dr. Ernesto Ochoa Domingo in a webinar.
The law, signed by President Rodrigo Duterte in 2019, mandates that all Filipinos have the right to equitable access to quality and affordable heath goods and services and protection against financial risks.
To do that, the law aims to provide “primary health care” to Filipino communities, which is now more significant due to the pandemic.
“Primary health care is an approach to providing health care services, making sure that the social determinants of health are addressed, making sure that the health services are provided equitably, adequately and comprehensively,” DOH Disease Prevention and Control Bureau Chief Health Program Officer Christian Edward Nuevo said.
Nuevo added, the DOH is now going towards a “people- centered primary care”, where “every Filipino is matched to a primary care provider, who ensures they receive appropriate services in facilities within healthcare provider networks without experiencing financial hardships.”
The advantage to this approach is it can address more than “80% of people’s common health needs throughout their lives”.
“To prevent and manage people’s illness before they become expensive and complicate to treat,” Nuevo said.
“We don’t want people getting into very, very sickly situations but address their needs right at the onset so that they don’t progress into something more serious," he added.
But for Domingo, providing human resource for the UHC implementation is a “challenge”, since this requires reforming the current health systems so it can address needs of primary health care facilities.
“There is a disproportionate focus on specialists, tertiary care often referred to as ‘hospital- centrism’. When I was chairman of the department of Medicine of UP-PGH, out of 150 faculty members I have, no one is a generalist. All are generalist,” Domingo said.
“You have to develop other health professionals, short of having a doctor. It is unrealistic to expect to have a doctor for every barrio,” he added.
Nuevo in a statement admitted, this is not an easy requirement to implement.
“It will probably need push and pull across various aspects. For one, the payments (i.e. benefit packages) for primary care should be increased to make it a viable space of practice. Second, establishing that relationship across networks where primary care acts as a gatekeeper, will also put premium and value to primary care as the crucial first step. Third, infrastructure expansion will also help open up opportunities for professionals to actually make the choice to primary care, and practice at that level. Imagine, seeing a primary care facility built in your community, and in need of a doctor. That can be a good incentive for our health professionals to practice within their community,” Nuevo said.
Financing the implementation of the UHC should also be through taxes, and not through PhilHealth.
“You can never finance UHC by PhilHealth. Impossible, no matter what you do. You can’t be financed simply by health premium. Remember, PhilHealth.. is not for UHC, that is for health protection,” Domingo said.
“The primary thing to finance UHC is it must be placed on tax money. And that what the law is saying. The law says the tax will come from sin tax, from the gaming taxes, and all sorts of taxes that is incorporated into a fund, entrusted in this case to the provincial people for them to budget according to plan of action or the coming year," Domingo added.
The implementing rules and regulations of the UHC were finalized in October 2019.
(Editor's note: This article has been updated to clarify that the statements/ quotes in the second and third to the last paragraphs of this article were made by Dr. Ernesto Ochoa Domingo, and not by DOH Disease Prevention and Control Bureau Chief Health Program Officer Christian Edward Nuevo.)