Professional Documents
Culture Documents
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by Leo Miguel Vergeire, Jereme Paolo K. Syling, and Kim Patrick Tejano, MD
AHEAD Fellows, Health Policy and Systems Research Track
The UHC Bill is set for first plenary hearing this May 2018.
FINANCING PILLAR
1. Simplifying PhilHealth membership into
two groups: direct contributory (premium Legend: Medical
Amenities X-Factor Total Bill
Package
contributions from payroll) and all others as PHIC
OOP/PHI
indirect contributory (fully subsidized premium A B C A+B+C
from tax collections)
3600* +
Class C 9,300 18,600
15,000 1800 29,700
2. Ensuring full PhilHealth cost coverage for medical (Private) [50%*(A+B)] 11,100
(50% * B)
package + basic amenities, and private insurance
/ OOP to cover for all additional amenities as fixed Class B 3600* +
3,720 18,600
co-payment / co-insurance, and co-regulating (Semi- 15,000 720 23,040
[20%*(A+B)] 4,440
Private) (20% * B)
private health insurance and health maintenance
organizations (HMOs) to ensure benefit
Class A
complementation (see table on right) (Ward)
15,000 3600* N/A 18,600 18,600
REGULATION PILLAR
1. Developing preferential licensing and contracting mechanisms to encourage establishment of facilities in
underserved areas, and expanding the DOH regulatory mandate to determine bed capacity and bed ratios for
all facilities
2. Requiring return service of at least 2 years in an underserved SDNs for all health professional graduates
of public universities, establishing a National Health Workforce Support Pool that will ensure equity in the
distribution of human resources particularly to underserved areas
GOVERNANCE PILLAR
INTERVENTION EXAMPLE PAYER
1. Classifying entitlements and clarifying
purchasing roles (see table on the right) Fumigation, bed
Population-based nets, mass drug DOH & LGU
administration
2. Institutionalizing Health Technology Assessment PhilHealth,
Ambulatory,
to guide policy and program development of Private Insurance,
Individual-based Inpatient care,
DOH and coverage decisions of PhilHealth, and HMO, Household
Medicines
Out-of-Pocket
mandating Health Impact Assessments for any
Halfway house,
projects, programs, and/or policies that are health- Non-Direct
Transporation
DSWD
related or may have impact on the health sector
EXPENDITURE CLASS PAYER
3. Streamlining of PhilHealth Board of Directors BASIC PhilHealth
with better entry criteria and reorganization Accommodation (as as prospective payments)
How do F1+ for Health and UHC Bill complement each other?
Advancing Health through Evidence- To access the full text of this article or other research Advisory Board
Assisted Decisions with Health Policy projects funded by the DOH, contact: Usec. Mario Villaverde, MD, MPH, MPM, CESO I
and Systems Research (AHEAD-HPSR) Dir. Kenneth Ronquillo, MD, MPHM, CESO III
operationalizes F1+ for Health’s Research Center for Health System Development
commitment to instill a culture of (RCHSD) Editors
research and strengthen internal analytic rlc.rchsd.doh@gmail.com Beverly Lorraine Ho, MD, MPH
capacity in the Department of Health 651-7800 loc 1326 Barbara Michelle de Guzman, MSN, RN
and build health policy systems research
capacity within the sector. Research Division - Health Policy Development and Publication Manager
Planning Bureau Juanita Valeza
AHEAD is a collaboration between the Department of Health
Department of Health and the Philippine Building 3 2/F San Lazaro Compound, Creative Director
Council for Health Research and Rizal Avenue, Sta. Cruz, Manila Jake Matthew Kho
Development