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Student Number
Name of School
LESSON II
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
HEALTH SYSTEM
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
Lesson 3
Lesson 4
Lesson 5
Lesson 6
Lesson 7
Lesson 8
Lesson 9
Lesson 10
Lesson 11
Lesson 12
Lesson 13
Lesson 14
Lesson 15
 DEFINITION OF HEALTH CARE SYSTEM

Health system is “the combination of resources, organization, financing, and

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management that culminate in the delivery of health services to the population”
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(Roemer, 1991). This system consists of many parts such as the community,
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department or ministries of health, health care providers, health service
Lesson 1
1.1organizations,
Definition of Vision, pharmaceutical companies, health financing bodies, and other
Mission, Goals and
organizations related to the health sector. Each plays a role in the system such as
Objectives
1.2governance,
Comparison of Visionhealth service provision, and financing and managing resources.
and Mission
1.3 Purpose and Inclusion
InMission
of Vision and the World
Health Organization (WHO) Report (2000), health system is
defined
Lesson 2 as “all the organizations, institutions, resources, and people whose primary
Lesson 3
purpose
Lesson 4 is to improve health.” Thus, a well-performing health system provides
Lesson 5
direct
Lesson 6 health-improving activities whether in personal health care, public health
services,
Lesson 7 or intersectoral initiatives, to achieve high health equity.
Lesson 8
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 GOALS AND FUNCTIONS OF A HEALTH SYSTEM

WHO identifies three (3) main goals of health systems:

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Student Number the health of populations
(1) Improving
Name of School
Lesson 1 Improving health of the population is the overarching goal of a health system.
1.1 Definition of Vision,
Health
Mission, status should thus be measured over the entire population and across
Goals and
Objectives
different socioeconomic groups. Populations must be protected from existing and
1.2 Comparison of Vision
andemerging
Mission health risks. Intensive preparations for resilience to impending but still
1.3 Purpose and Inclusion
unknown
of Vision health risks must be executed to ensure the safety of populations. Health
and Mission
systems
Lesson 2 should strive for equity in health by minimizing inequitable disparities
Lesson 3
which may be caused by certain factors such as income, ethnicity, occupation,
Lesson 4
gender,
Lesson 5 geographic location, and sexual orientation, among others. There are
Lesson 6
significant
Lesson 7 variations in health outcomes across the world, within regions, and
Lesson 8
within countries. Countries and regions with relatively similar socioeconomic status
Lesson 9
may
Lesson 10 have quite disparate health outcomes. The way health systems are organized
Lesson 11
contributes
Lesson 12 to this disparity. These disparities are most effectively reduced when
Lesson 13
they are recognized and their minimization becomes an explicit national goal.
Lesson 14
Lesson 15
 (2) Improving the responsiveness of the health system

Responsiveness refers to providing satisfactory health services and engaging

people
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confidentiality,
Student Number autonomy, quality, and timeliness in the delivery of health services.
Health
Name systems also have an obligation to respond to the legitimate non-health
of School
needs
Lesson 1 and expectations of populations. Responsive health systems maximize
1.1 Definition of Vision,
people’s autonomy and control, allowing them to make choices and placing them at
Mission, Goals and
the center of the health system.
Objectives
1.2 Comparison of Vision
and Mission
1.3(3) Providing
Purpose and Inclusion fair health financing
of Vision and Mission
Lesson 2
Lesson 3 An ideal health system provides social and financial risk protection in health.
Thus,
Lesson 4 all health systems must be adequately funded to provide essential services to
Lesson 5
all 6citizens. WHO defines a fairly financed health system as one that does not deter
Lesson
Lesson 7
individuals
Lesson 8 from receiving needed care due to payments required at the time of
service,
Lesson 9 and one in which each individual pays approximately the same percentage
Lesson 10
of 11
Lesson their income for needed services. A health financing system that dissuades
Lesson 12
people
Lesson 13 from seeking needed services or impoverishes individuals and families
worsens
Lesson 14 health outcomes.
Lesson 15
 There are 4 vital health system functions are:

(1) Health service provision

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The most visible product of the health system is public and private health
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service provision. A health service is any service, not limited to clinical services,
aimed
Lesson 1 at improving the health of populations. Preventive measures as well as
1.1 Definition of Vision,
promotion
Mission, Goals and of a healthy way of living to avoid illnesses also form part of the best
Objectives
1.2systems. Thus, the system has to perform a wide range of activities
Comparison of Vision to cater to
andthese
Mission various demands.
1.3 Purpose and Inclusion
of Vision and Mission
(2)2 Health service inputs
Lesson
Lesson 3
Lesson 4
Lesson 5 Health service inputs, or managing resources, means generating the essential
Lesson 6
physical resources for the delivery of health services which include medications,
Lesson 7
human
Lesson 8 resources, and medical equipment. Resources such as trained doctors and
Lesson 9
medical
Lesson 10 staff and supply of medications often take time to be produced; hence, the
Lesson 11
health system policymakers have to respond and use the available resources to
Lesson 12
address
Lesson 13 short-term population needs.
Lesson 14
Lesson 15
 (3) Stewardship

Stewardship, or the overall system oversight, is the main responsibility of the

government.
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Student
overallNumber
health system.
Name of School
Lesson 1
1.1 Definition of Vision,
The core of the stewardship function includes:
Mission, Goals and
Objectives
a. Identifying
1.2 Comparison of Vision health priorities for allocation of public resources;
and Mission
1.3 Purpose and Inclusion
b.Mission
of Vision and Identifying an institutional framework;
Lesson 2
Lesson 3 c. Coordinating activities with other systems related to external health care;
Lesson 4
Lesson 5
Lesson 6 d. Analyzing health priorities and resource generation trends and their
Lesson 7 implications; and
Lesson 8
Lesson 9
Lesson 10 e. Generating appropriate data for effective decision-making and policymaking
Lesson 11 on health matters.
Lesson 12
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 (4) Health financing

Health system financing includes raising and pooling resources to pay for
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health services.
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Name of School
A. Revenue collection
Lesson 1
1.1 Definition of Vision,
Revenue
Mission, Goals and is earned from payments for health care services. The mechanisms
Objectives
1.2for revenue
Comparison of Vision collection include general taxation, direct household out-of-pocket
andexpenditures,
Mission mandatory payroll contributions, mandatory or voluntary risk-rated
1.3 Purpose and Inclusion
contributions,
of Vision and Mission donor financing, and other forms of personal savings.
Lesson 2
Lesson 3 Each source of health financing is associated with a specific manner of
Lesson 4
organizing
Lesson 5 and pooling of funds and purchasing services. Public health systems rely
Lesson 6
on 7general taxation for its financing, while social security organizations are funded
Lesson
through
Lesson 8 the mandatory payroll contributions from workers and employers.
Lesson 9
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 B. Risk pooling

Financial risk pooling is a form of risk management which aims to spread

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financial risks from an individual to all pool members (WHO, 2000). It is considered
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a core function of health insurance companies. This mechanism prevents outright
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payment for health services which discourages patients belonging to the poor
Lesson 1
1.1sector from
Definition of Vision,seeking health care. Participation in effective risk pooling helps families
Mission, Goals and
from financial losses due to health shocks, thus ensuring financial protection.
Objectives
1.2 Comparison of Vision
and Mission
Each country has its own approach to managing its financial risk to finance its
1.3 Purpose and Inclusion
health
of Vision care system. Multiple and fragmented forms of risk pooling arrangements
and Mission

exist
Lesson 2 in most developing countries. Most high-income countries follow one of the
Lesson 3
two4 main models: the Bismarck model and the Beveridge model.
Lesson
Lesson 5
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 BISMARCK MODEL (Bismarck’s Law on Health Insurance of 1883)

This
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model is named after the Prussian
Chancellor,
Student Number Otto von Bismarck, known for inventing
the welfare state in the 19th century as part of the
Name of School
Lesson 1
1.1unification
Definition of Vision, of Germany. The Bismarck model uses an
Mission, Goals and
insurance system where the sickness fund finances
Objectives
1.2 Comparison of Vision
both the employers and the employees through
and Mission
1.3 Purpose and Inclusion

payroll deduction. But unlike the U.S. insurance

of Vision and Mission
Lesson 2
industry,
Lesson
Lesson 4
3 the Bismarck-type health insurance plan
covers
Lesson
Lesson 6
5 everybody, thus collecting no profit. This is
considered
Lesson 7
Lesson 8 a multi-payer model with tight regulation
giving
Lesson 9
Lesson 10 the government the cost-control clout. This
model is widely used in Germany, France, Belgium,
Lesson 11
Lesson 12
Lesson 13
Netherlands,
Lesson 14
Lesson 15
Japan, Switzerland, and, to a degree, in
Latin America.
 BEVERIDGE MODEL (Beveridge Report or the Social Insurance and Allied
Services of 1942)
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Student This
Numbermodel is named after William Beveridge, the
social
Name reformer
of School responsible for designing Britain’s
Social of Vision, Security System and the National Health
Lesson 1
1.1 Definition
Mission, Goals and
Service. In the Beveridge model, health care is
Objectives
1.2 Comparison of Vision
and provided
Mission and funded by the government through
1.3 Purpose and Inclusion
tax payments. The government owns many, but not
of Vision and Mission
Lesson 2
all,
Lesson
Lesson 4
3 hospitals and clinics in the country. Doctors may
be
Lesson
Lesson 6
5 government or private employees who collect
their professional fees from the government. This
Lesson 7
Lesson 8
results
Lesson 9
Lesson 10 in low cost per capita since the government
controls
Lesson 11
Lesson 12 the health care services. Countries using
the Beveridge plan include Hong Kong, Great
Lesson 13
Lesson 14
Lesson 15
Britain, Spain, most of Scandinavia, New Zealand,
 C. Strategic purchasing

In strategic purchasing, risk-pooling organizations use collected funds and

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pooled financial resources to finance the health care services of the members. The
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purchaser defines the substantial part of the provider's external incentives to
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develop the provider-user interaction and the health service delivery models.
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
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 WHO HEALTH SYSTEM FRAMEWORK

In its World Health Report 2000, WHO released a single framework (Figure 2.1)
with
Emil six clearly defined building blocks and priorities which are necessary in
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strengthening
Student Number health systems and improving the overall health outcomes.
Name of School
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
Lesson 3
Lesson 4
Lesson 5
Lesson 6
Lesson 7
Lesson 8
Lesson 9
Lesson 10
Lesson 11 Figure 2. 1 The WHO Health Systems Framework
Lesson 12 (Figure by World Health Organizaion (2007), licensed under CC BY-SA 4.0
Lesson 13
Lesson 14
Lesson 15
 One building block is service delivery which refers to the timely delivery of
quality and cost-effective personal and non-personal health services. Another is
health workforce which includes individuals and groups working towards the
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achievement of the best health outcomes by being responsive, fair, and efficient.
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The of
Name number
School of staff should be sufficient and fairly distributed to ensure
competency, responsiveness, and productivity. Information (health information
Lesson 1
1.1system) which analyzes, disseminates, and uses reliable and relevant information
Definition of Vision,
Mission, Goals and
on health status, determinants, and systems performance is also a valuable
Objectives
1.2 Comparison of Vision
building block. Another important building block is that of health products,
and Mission
1.3vaccines and technologies which are made accessible through uninterrupted
Purpose and Inclusion
of Vision and Mission
supply, well-managed pharmaceutical services, and education on proper use of
Lesson 2
medication.
Lesson 3 Financing (health financing system) is a building block which takes care
Lesson 4
of the funding for health care services to guarantee that people can use health
Lesson 5
services
Lesson 6 when needed without fear of having not enough resources to pay for them.
Lesson 7
Lastly,
Lesson 8 leadership and governance involves the task of ensuring effective
Lesson 9
stewardship of the entire health system. This building block also covers the
Lesson 10
monitoring
Lesson 11 of the accountability of private and public health agencies, proper
Lesson 12
system
Lesson 13 design, and appropriate regulation of health systems.
Lesson 14
Lesson 15
 PHILIPPINE HEALTH SYSTEM

Historical Background
EmilThe
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health reform initiatives carried out over the years in the Philippines were
Student Number
primarily focused on these areas of concern: health service delivery, health
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regulation, and health financing. These health reforms aimed at addressing issues
such
Lesson 1 as poor accessibility, inequity, and inefficiency of the Philippine health system.
1.1 Definition of Vision,
Mission, Goals and
1. 1979: Adoption of Primary Health Care Strategy (LOI 949) – promoted
Objectives
participatory
1.2 Comparison of Vision management of the local health care system
and Mission
2. and
1.3 Purpose 1982:InclusionReorganization of DOH (EO 851) – integrated the components of
of Vision andhealth
Mission care delivery into its field operations
Lesson 23. 1988: The Generics Act (RA 6675) – ushered the writing of prescriptions
Lesson 3
Lesson 4 using the generic name of the drug
Lesson 5
4. 1991: Local Government Code (RA 7160) – transferred the responsibility
Lesson 6
Lesson 7 of providing health service to the local government units
Lesson 8
Lesson 95. 1995: National Health Insurance Act (RA 7875) – instituted a national
Lesson 10 health insurance mechanism for financial protection with priority given to the
Lesson 11 poor
Lesson 12
Lesson 13
Lesson 14
Lesson 15
 6. 1999: Health Sector Reform Agenda– ordered the major organizational
restructuring of the DOH to improve the way health care is delivered,
regulated, and financed
7. 2005:
Emil Gatus FOURmula One (F1) for Health – adopted an operational framework
Student to undertake reforms with speed, precision, and effective coordination and to
Number
Name ofimprove
School the Philippine health system
Lesson 18. 2008: Universally Accessible Cheaper and Quality Medicines Act (RA
1.1 Definition9502)
of Vision, – promoted and ensured access to affordable quality drugs and
Mission, Goals and
Objectives medicines for all
1.2 Comparison of Vision
9. 2010: Kalusugang Pangkalahatan or Universal Health Care (AO 2010-
and Mission
0036)
1.3 Purpose and Inclusion– provided universal health coverage and access to quality health care
of Vision andfor all Filipinos
Mission
Lesson 2
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Lesson 7
Lesson 8
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Lesson 13
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Lesson 15
 Leadership and Governance

The Department of Health (DOH) is mandated to provide the appropriate

Emil Gatusfor the nation’s healthcare industry. Its other tasks include (1) the
direction
Student Number
development of plans, guidelines and standards for the health sector; (2) technical
Name of School
assistance; (3) capacity building; (4) advisory services for disease prevention; and
Lesson 1
1.1(5) control
Definition of medical supplies and vaccines.
of Vision,
Mission, Goals and
Objectives
DOH
1.2 Comparison coordinates its national health programs through the local government
of Vision
and Mission
units (LGUs). LGUs take care of their own health services and are given autonomy
1.3 Purpose and Inclusion
under
of Vision the Local Government Code (LGC) of 1991 (R.A. 7160). 78 provincial
and Mission

governors,
Lesson 2 138 city mayors and 1496 municipal mayors, and 42,025 barangay
Lesson 3
chairpersons
Lesson 4 compose the local government units of the country (NSCB, 2010).
Lesson 5
Lesson 6
Lesson 7
Lesson 8
Lesson 9
Lesson 10
Lesson 11
Lesson 12
Lesson 13
Lesson 14
Lesson 15
 In terms of administration, LGUs are grouped into 17 regions. Although they
operate in a decentralized system, LGUs are under the supervision of the DOH
regional health offices. The provincial government is tasked to provide health
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services through provincial and district hospitals. The city and municipal
Student Number
governments
Name of School rely on public health and primary health care centers (BHCs) for their
primary care. (For a detailed organizational structure of the Philippine health sector,
Lesson 1
1.1see The
Definition Philippines Health System Review (2011) published in Health System in
of Vision,
Mission, Goals and
Transition, vol. 1, no. 2.)
Objectives
1.2 Comparison of Vision
and Mission
DOH is duty-bound
1.3 Purpose and Inclusion
to:
of Vision and Mission
Lesson 2 1. develop policies and programs for the health sector;
Lesson 3
Lesson 4 2. provide technical assistance to its partners;
Lesson 5
Lesson 6
Lesson 7
3. encourage performance of the partners in the priority health programs;
Lesson 8
Lesson 9 4. develop and enforce policies and standards;
Lesson 10
Lesson 11 5. design programs for large segments of the population; and
Lesson 12
Lesson 13
Lesson 14 6. provide specialized and tertiary level care.
Lesson 15
 Figure 2. 2 The Philippine Health System
(Alliance For Improving Health Outcomes, Inc. 2017)

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Student Number
Name of School
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
Lesson 3
Lesson 4
Lesson 5
Lesson 6
Lesson 7
Lesson 8
Lesson 9
Lesson 10
Lesson 11
Lesson 12
Lesson 13
Lesson 14
Lesson 15
 Under the decentralized or devolved structure, the state is represented by
national offices and LGUs, with provincial, city, municipal, and barangay or village
offices. DOH, LGUs, and the private sector participate, cooperate, and collaborate
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in the care of the population. Before devolution, the national health system
Student Number
consisted
Name of School of a three-tiered system under the direct control of the DOH: (1) the
tertiary hospitals at the national and regional levels; (2) the provincial and district
Lesson 1
1.1hospitals and city and municipal health centers; and (3) the barangay (village)
Definition of Vision,
Mission, Goals and
health centers.
Objectives
1.2 Comparison of Vision
and Mission
1.3 PurposeWith the
enactment of the LGC of 1991, the government health system now
and Inclusion
of Vision and Mission
consists of basic health services—including health promotion and preventive units
Lesson 2
—provided by cities and municipalities, provincial and province-run district
Lesson 3
hospitals
Lesson 4 of varying capacities, and mostly tertiary medical centers, specialty
Lesson 5
hospitals,
Lesson 6 and a number of re-nationalized provincial hospitals managed by the
Lesson 7
DOH.
Lesson 8
Lesson 9
Lesson 10
Lesson 11
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Lesson 13
Lesson 14
Lesson 15
 Directions of the Philippine Health Sector

(1) The Philippine Health Agenda 2016 – 2022 (DOH Administrative Order
2016-0038)
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Student Number
This agenda adopts the slogan “All for Health Towards Health For All” as the
Name of School
rallying point for its vision of a Healthy Philippines by 2020. It expanded the
Lesson 1
scope
1.1 Definition of the Universal Health Care (UHC) directions, particularly through a
of Vision,
Mission, Goals and
whole-of-government approach. With this agenda, the health system
Objectives
guarantees:
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
a. population- and individual-level interventions for all life stages that
of Vision and Mission
Lesson 2 promote health and wellness, prevent and treat the triple burden of
Lesson 3
Lesson 4 disease, delay complications, rehabilitation, and provide palliation for both
Lesson 5
Lesson 6 the well and the sick;
Lesson 7
Lesson 8 b. access to health interventions through functional service delivery
Lesson 9
Lesson 10 networks (SDNs); and
Lesson 11
Lesson 12
Lesson 13
c. financial freedom when accessing these interventions through Universal
Lesson 14 Health Insurance.
Lesson 15
 (2) The Philippine Developmental Plan 2017-2022

This is the first of the four key medium-term plans to translate the vision of
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a “matatag,
Student Number maginhawa, at panatag na buhay” for the Filipinos and the country.
Name of School
(3) NEDA AmBisyon Natin 2040
Lesson 1
1.1 Definition of Vision,
A product of the Philippine Development Plan 2017–2022, this collective
Mission, Goals and
Objectives
long-term
1.2 Comparison of Vision plan envisions better life for the Filipinos and the country in the next
25 years by formulating policies and implementing programs and projects to
and Mission
1.3 Purpose and Inclusion
of Visionattain
and Missionthis AmBisyon. This plan focuses on four areas: building a prosperous,
Lesson 2predominantly middle-class society where no one is poor; promoting a long and
Lesson 3
Lesson 4healthy life; becoming smarter and more innovative; and building a high-trust
Lesson 5society.
Lesson 6
Lesson 7
(4)8 Sustainable Developmental Goals 2030
Lesson
Lesson 9
Lesson 10
Lesson 11 This is a compilation of 17 developmental goals that targets to end poverty,
Lesson 12
fight inequality and injustice and confront issues involving climate change and
Lesson 13
its effects.
Lesson 14
Lesson 15
 KEY POINTS TO REMEMBER:
EmilHealth
Gatussystem combines resources, organization, financing, and management to
Studentdeliver
Number health services to the population. According to the World Health
Name of School
Organization (WHO) Report in 2000, health system is defined as “all the
Lesson 1organizations, institutions, resources, and people whose primary purpose is to
1.1 Definition of Vision,
Mission,improve
Goals and health.”
Objectives
1.2 Comparison of Vision
The primary goals
andMission of the health system are improved health outcomes (attaining
1.3 Purpose and Inclusion
of Visionthe best average
and Mission level health care for the entire population by minimizing
Lesson 2disparities), more responsive health system (meeting the people’s expectations
Lesson 3of and satisfaction from health service delivery), and more equitable health care
Lesson 4
Lesson 5financing (protecting each individual from financial risks).
Lesson 6
Lesson 7
 8The four functions of the health system are health services provision
Lesson (for
Lesson 9
appropriate and cost-effective health delivery); health service inputs
Lesson 10 (for
generating human resources, technology, and capital); health financing
Lesson 11 (by
Lesson 12
revenue collection, risk pooling, and strategic purchasing); and stewardship
Lesson 13 and
Lesson 14
initiatives (to strengthen governance, accountability, and responsiveness).
Lesson 15
  A health system can be analyzed in its totality by using a framework consisting
of six building blocks, i.e., leadership and governance, health financing, health
workforce, medical products, vaccines, and technologies, health information,
andGatus
Emil service delivery.
Student Number
 The
Name Department of Health (DOH) is the lead agency for Philippine health care.
of School
Lesson 1According to its mandate (E.O. No. 119, Sec. 3), the DOH shall be responsible for
1.1 Definition of Vision,
the (1) formulation and development of national health policies, guidelines,
Mission, Goals and
standards, and manual of operations for health services and programs; (2)
Objectives
1.2 Comparison of Vision
issuance of rules and regulations, licenses, and accreditations; (3) promulgation
and Mission
1.3 Purpose and Inclusion
of national health standards, goals, priorities, and indicators; and (4)
of Vision and Mission
development of special health programs and projects, and advocacy for
Lesson 2
Lesson 3legislation on health
policies and programs. the ability to pay rather than the
Lesson 4
Lesson 5risk of illness).
Lesson 6
Lesson 7
Lesson 8
Lesson 9
Lesson 10
Lesson 11
Lesson 12
Lesson 13
Lesson 14
Lesson 15