Jose Rizal University

College of Science and Health Sciences

Health Economics Case Study (P)

Submitted to:

Prof. Teodora T. Macalincag, RN, MPH

Submitted by the following Members:

Andog, Zhannen

Arandia, Ma.Lyn

Mendoza, Shaira
 Case Study on Health Care Rationing

What is Health care Rationing? and Where and How is it being implemented?

Health care rationing refers to the limiting availability of medical care for certain
populations depending on the procedure and the problem of the population, with the payer in
charge of setting the rules. Health care rationing has been the most encountered problem of
the Philippine Health care system.

The health care system in the Philippines is composed of the government and private
healthcare providers paid through the government’s philhealth, the private health insurance
system or Medicards and cash payment based on the Universal Healthcare Law. According
to philhealth.gov.ph PhilHealth aims to Ensure that all people, at all stages of life, have
access to the health treatments they require without fear of financial ruin; and make the
program long-term sustainable through effective revenue collection and efficient purchasing
ability. On the other hand, the private healthcare Insurance system or MediCards provides
healthcare services based on the amount applied with the insurance companies which
services includes but are not limited to the free-standing clinics to provide laboratory tests,
diagnostic procedures, annual physical examination, executive checkup, pre-employment
exam and other medical evaluation, as well as first aid treatment in case of emergencies.
(Ferrolino, 2019). According to RA 11223 which states that Universal Healthcare Law shall
support all Filipinos that would provide access to excellent and affordable health care
services which help lower financial risk.

However, in spite of the above cited references, the current healthcare market in the
Philippines still undeniably affects the healthcare rationing due to the deregulation of health
care services and resources. While it is true that the government was able to increase the
number of hospitals or the country’s health care capacities, there are still many of these
government health care facilities that are lacking modern medical equipment, limited medical
supplies and inadequate health care professionals. The private hospitals on the other hand,
have complete modern and sophisticated medical equipment, supplies and capabilities, but,
it is obvious as well that only those who can afford financially are the ones who can avail its
healthcare services. Therefore in this instance it is clear that the healthcare rationing
regarding the quality healthcare goods and services per se are fully dependent on the
financial capability of the patient. In this regard, it is deduced that the best possible solution
to the inequitable health care rationing is to regulate the prices and fees of healthcare goods
and services. Once it is regulated, the prices and fees will be lowered, hence, may become
affordable and further eradicate inequities.

Everyone wants to live a healthy life. And, if given the option, we would prefer to live
a life without ever having to deal with a surgeon’s scalpel, the nurse’s needle, or the dentist’s
drill. However, good health does not always come easily. Achieving a long, healthy life
frequently necessitates the use of scarce resources, making it, at least in part, an economic
issue.

Healthcare is one of the most important goods and services. Learning the unique
characteristics of a market is a good starting point for us to understand why the government
plays such a big role in healthcare provision and why health policy is frequently complex and
vexing. Rationing in healthcare is accomplished through market forces and with assistance
from major government programs. Most private health insurance and non-emergency health
care rationing decisions are based on what the company or government insurance will pay
for rather than what the patient is willing to pay for.

Think about vaccinations. A person is less likely to contract a disease if she is

immunized against it. She also has a lower chance of becoming a carrier and infecting
others. Thus, getting vaccinated has a positive impact on society. However, if getting
vaccinated costs money, time, or the risk of adverse side effects, far too few people will
choose to get vaccinated because they will likely ignore the positive externalities when
weighing the costs and benefits. The government could address this problem by either
subsidizing vaccine development, manufacturing, and distribution or by mandating
vaccination.

Health care rationing decisions might be made by various organizations, groups or

individuals in several levels of health care systems. It has been argued that rationing of
health care must be implemented by three levels of health care systems: The health
systems, intermediate, and the clinical levels. At the health care systems level, government
and health authorities or health insurance companies determine the total care spending
levels, which type of services will be covered and the extent of patient cost sharing. At the
intermediate level, subunits like hospitals determine the schedules, waiting times for various
health care services. While on clinical level, the clinicians decide about the treatments
priorities of the patients, treatment approaches, as well as various conditions.
 So, as to who decides the healthcare rationing whether who will receive more and
who receive less in connection with the COVID 19 pandemic, is the DOH thru its program of
scientific and priority basis such as; the areas with high number of cases; densely populated
areas; Senior citizen; with comorbidity; front-liners and etc.

References

Keliddar I., Mosadeghrad A.M., & Sirizi M. (2017). Rationing in health systems: A critical
review. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804460/

The Economics of healthcare. (2017, August 30). Scholar Harvard.

https://scholar.harvard.edu/files/mankiw/files/economics_of_healthcare.pdf