1. Healthcare Innovation Forum:
Philippine Healthcare
Teodoro J. Herbosa MD FPCS
College of Medicine,
University of the Philippines, Manila
Undersecretary, DOH (2010-2014)

2. Objectives
History of the Philippine Health care system
Health Reforms: Universal Health Care
Health Financing
Health Systems Strengthening
Health Partnerships
Intended Health Outcomes

3. Philippine Health Care
Prehispanic era
Spanish Era
American Era
Golden Era 50’s
Diaspora
Two Systems: Public vs
Private

7. Health Reforms
Government owned Corporate Hospitals
Local Government Code/decentralization/devolution
Reforms from private healthcare vs social protection scheme
National Health Insurance Act 1994 Philippine Health
Insurance Corporation
Universal Health Care funded through Sin Tax
Governance Reform for Public Hospitals

9. Background
3

10. Universal Health Care
Building Blocks
Governance
Financing
Health Goods and Materials
Health Services
Information System
Health Workforce

11. THE AQUINO HEALTH AGENDA
Universal Health Care or Kalusugan Pangkalahatan, has three
strategic thrusts:

12. Universal Health Care / Kalusugan Pangkalahatan
Improved Health
especially for the
Poor and
Vulnerable
Secure access
to quality
care at
facilities
Achieve the
public health
MDGs
Provide
financial risk
protection
INTERVENTIONS OF
CARE
Prim
ary
Prevention
and
H
ealth
Prom
otion
Curative
H
ealth
Care
Secondary
Prevention and
Primary Care

13. Universal Health Care
Kalusugan Pangkalatan
Health Risk Financing and Payment schemes reforms
Access to quality and affordable health care -
modernization
Improved Public Health Outcomes focused on Maternal
and Child Health
eHealth National eHealth Strategic Plan and Framework

14. Health Financing
Premium based health insurance system
Targetting the poorest
Using Sin Tax revenues for sustainable financing
Increased Health expenditure by government
Catastrophic Illness packages
Primary Care Benefit
Case Payment scheme/Capitation payments

15. SUBSTANTIAL INCREASE IN THE
DEPARTMENT OF HEALTH BUDGET
Budget (in billion pesos)
BillionPesos
0
22.5
45
67.5
90
Year
2008 2009 2010 2011 2012 2013 2014
Budget (in billion pesos)
18.91 23.67 24.65 31.83 42.08 50.44 89.7

16. 23 Case Rates (No balance billing for
Sponsored Program beneficiaries in
government hospitals)

17. Health Systems
Strengthening
Health Leaders Program ZFF
MMCF Strategic Thinking for Hospital Directors
Hospital governance reform; ISO Certification
Hospital Accreditation Commission

18. Health Systems
Strengthening
Focus on GIDA
Preventive Health approach expanding EPI, rotavirus,
Pneumococcal vaccines
NCDs
Local health systems/Interlocal health zones

19. IMPROVED ACCESS TO QUALITY
HOSPITALS AND FACILITIES
3,576:Total health
facilities upgraded
and rehabilitated as
of Feb 2013
1,049 hospitals
Another 2,487 health facilities will
be upgraded this 2013.
2,751 (91%) came from the 609
priority municipalities listed by the
National Anti-Poverty Commission
Result: Increase in deliveries of
mothers in hospitals. 719,552
mothers (38.8%) (2009) vs
1,014,613 mothers (57.1%) (2011)

20. Health Partnerships
Public Private Partnerships PPPs
Social Marketing and buy in
Name calling by certain sectors
Success in Emergencies and Disasters
Protracted planning and feasibility studies

21. Performance Comparison: Existing & MPOC
EXISTING POC
MODERNIZED POC
534 beds utilized out
of 700 sanctioned
beds, sub capacity
operation at 55%
-60% levels
Ideal Staff to Bed
Ratio not being
effectively
achieved
Lower than average
period of Avg. Length
of Stay (ALOS) &
discharge times for
admitted patients
Only primary and
secondary medical
services, Limited allied
services, medical tourism
& private patients due to
poor competitive
advantage
Private sector
efficiency in
operations to
ensure atleast 70%
capacity utilization
Expected Ideal
Staff to Bed Ratio
of 2.25 persons/
bed
Possible reduction
in ALOS, discharge
period to reduce
from 22 days to 8
days
Super specialty tertiary care
with increased private
patients, medical tourists,
allied medicine due to
internationally competitive
services & facilities

22.
Criteria For Selection Of Pilot Hospitals
22

23. Health Outcomes
Longer Life Span
Increase in Average height
Lower Maternal and Child Mortality
Correcting undernutrition
Decerease childhood obesity
Decrease smoking related mortalities NCDs

24. OUTCOMES
3

25. ATTAINMENT OF THE HEALTH-RELATED
MILLENNIUM DEVELOPMENT GOALS

26. Disaster Risk Reduction
Capacity and Capability
Incident Command Systems
Emergency Operations Center
Communications and Coordination
Logistics management system

27. eHealth
Enterprise architecture/Common platform
Standards and Nomeclature
Security and Privacy
Risk management
Health Information Exchange
Analytics and Big Data

28. eHealth Component Map
(Based on the DOH Philippine eHealth Framework and
Development Plan 2013-2016)

29. Health Information ExchangeOPENHIE

31. Private Sector
Health systems development: Corporate networks
Procure and Improve Model
Ambulatory services to a greater number
Market segment capture
HMO and Health Insurance
Health Industry; Pharma, Equipment, Supplies, Design and
construction

33. Threats to UHC
Sec. AG Romualdez
•Emphasis on profit in the private health sector
•Health goods and services as commodities
•*Globalization – ASEAN Harmonization of
Health Services
•*Public-Private Partnerships
•Medical Tourism
•Two-tiered health care system

34. – Dr. S.T.Han, WHO Regional Director for the Western Pacific: Hiscock
Memorial Lecture, University of Hawaii, 1991
““You may have the best infrastructures, the most
modern and up to date technology, and the best
management and finance systems, but without a
well-motivated and skilled workforce none of these
will have beneficial impacts on the health of
people.””

35. –Randy Pausch, The Last Lecture
“The brick walls are there for a reason. The brick
walls are not there to keep us out. The brick walls
are there to give us a chance to show how badly we
want something. Because the brick walls are there
to stop the people who don't want it badly enough.
They’re there to stop the other people.”