Miko L. Balisi

UHC and ZFF: Roles and Integration for Better Health The House bill 5784 or the Universal Health Coverage (UHC) bill has been passed at the 17th congress. The bill aims to strengthen the provision of health care to Filipinos by simplifying supply and demand side of healthcare and institutionalizing update at the Department of Health financing strategy. The bill also proposes changing the name of the Philippine Health Insurance Corporation (PHIC) or PhilHealth to Philippine Health Security Corporation (PHSC) signaling the new role of PhilHealth as the national purchaser of health services. The main premise of the change is that PHSC new role will provide financial security in health. Another update in the UHC Bill is the creation of the Health Technology Assessment Council which serves as the advisory council to the secretary of health and PHSC for entitlements that will be financed by the two agencies. What is UHC Act? UHC act or House bill 5784 is a move to ensure that every Filipino is entitled to healthy living conditions and access to comprehensive set of health services which will cost financial burden to the people. Achieving UHC has been a battle cry of the department of Health since 2010. During the national elections in 2010, many politicians adapted the platform of universal health coverage for the Filipinos. When President Aquino won the elections, he adapted the Universal health care or Kalusugan Pangkalahatan and included universal health coverage as one of the strategies. With the current developments and the change in the administration, there is a move to further strengthen the healthcare system and ensuring universal health care coverage. In the 17th congress alone, there were many versions of the bills which pave way to HB 5784. There were 4 initial house bills that were filed in the 17th congress, HB 159, HB 225, HB 1875, and HB 5120. A substitute bill was filed by Rep. Angelina Tan, MD consolidating the previous house bills1. Feature of the HB 5784 The house bill aims to strengthen the delivery of health service to Filipinos by having a universal health coverage. The HB 5785 simplifies the PHIC (PHSC) membership into two groups: the contributory group and the non-contributory group (subsidized by the government). It provides equity to the Filipino people by ensuring health of the people that can’t avail health services due economic circumstances. Further the bill aims to provide inpatient health services that are free from co-payment for non-contributory group. It also gives option to the people by ensuring availability of outpatient health services at zero co-payment in public facilities and fixed co-insurance in private facilities1. These may help access to health care facilities and may lesson overcrowding because people may choose to avail services based on their capacity to pay without over burdening themselves. Another important feature of the bill is the establishing a national purchaser which will be PhilHealth. It classifies the benefits into population-based and individual based health care interventions. The national purchaser will have all capacity to pool all government funds allocated to health for much efficient provision of services. While it is important to have the entitlements of UHC be delivered, the bill also ensures that the government will be able to deliver the services efficiently and effectively. Thus, it also establishes the health technology assessment council to guide the investments of DOH and decision making of PHIC. The HTAC will make a list of negative lists which will be a guide for service provisions. All health services not in the list will be available as entitlements for the Filipino. There is also a shift to provider payment mechanisms with built-in cost containment. The bill will also establish mandating income retention to the government health facilities, and submission of clinical costing price data for all health care providers. Health human resource is one of the priorities of the bill and thus ensuring there is a proper referral system is vital. The bill provides that every filipino shall have a primary health care provider which will be the main point of contact prior gaining access to higher level of care. To be able to do the mandate, there is a need to strengthen the Health Human Resource of the country. One feature of the bill is requiring return of service for at least 2 years in underserved communities of all health professional graduates of public universities. However, to protect the interest of the HRH, the bill also ensures appropriate compensation and incentives especially those who will serve in geographically isolated and disadvantage areas. Finally, the bill also seeks to ensure the role of DOH, PHIC, and LGUs in organization, financing, and delivery of health services. Given that the Philippine Health Care System is a devolve system it is apparent that the roles of key players in health service is defined. The bill also seeks to contract provincial-based networks and linked to regional referral hospitals, enforcing the share of No Balance Billing Beds with rigorous monitoring for quality. Role of Zuellig Family Foundation The Zuellig Family Foundation has been working with local governments to strengthen their leadership and governance capacity to realize their pivotal role in delivery of health services. The foundation with its partners mainstreamed its program to more than 600 Local Government Units with most are in the 4th and 5th class municipalities. The results for better health outcome using leadership and governance model has been promising as results were seen in most of the enrolled LCEs. However, given the ever-changing scale of the healthcare system, it is important to adapt the strategies to be relevant and to deliver results; adapting the primary health care model with alignment to Philippine Health Agenda. The Primary Health Care Road Map is being used by the LGU as guide and monitoring tool for their progress. One block in the road map is health financing. Health financing is very challenging especially in the 4th and 5th class municipalities because some of them are Internal Revenue Allotment (IRA) dependent. Given the new strategy in the UHC bill, it is important that the LGU will be able to adapt despite their limitation. It is good to know that UHC bill membership of non-contributory members will be allocated from the General Appropriations Act (GAA) which means that it takes away the burden of the LGU to enroll its indigent to the PHIC. ZFF should be able to adapt with these changes as it challenges the LGUs to ensure that services will be provided. ZFF should model its future programs with consideration of the changes given HB 5784 will be turned into law.