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Health Issues
Attendees: Niacinth Loredo

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0:00 Niacinth Loredo: Or Republic. Act one one, two, two three. The landmark law expands
access to health services. Health is one of the most important is not the most important topic
for any population or individual.

0:36 Niacinth Loredo: In 2019, our legislators passed the Universal Health Care Act or
Republic of 11223. The landmark law expands access to health services by automatically
enrolling.

0:49 Niacinth Loredo: All Filipinos in Philhealth National Health Insurance program. It seeks
to ensure that all Filipino citizens have access to a comprehensive set of health services.

1:00 Niacinth Loredo: Without financial hardship. According to our, Social media. Our
medium-term plan, recognizes human development, not just as a means of economic
development, but as an end in itself, that is why the signing of the uhc.

1:17 Niacinth Loredo: Law is a victory scored for the health sector. We are glad that we have
reached this milestone, And President Duterte on signing, the law said.

1:29 Niacinth Loredo: By automatically enrolling our citizens into the National Health
Insurance Program and expanding PHILHEALTH coverage to include free medical
consultations.

1:40 Niacinth Loredo: And laboratory tests the u80 law will guarantee equitable access to
quality and affordable healthcare services to all Filipinos.

1:47 Niacinth Loredo: After almost a year, the implementing rules in regulations, were finally
written and signed by the Secretary of Health, Dr.

1:55 Niacinth Loredo: Francisco T Duke In this episode of health issues, we will explain
what universal health care. Law, really means.

2:02 Niacinth Loredo: This is Dr. Teddy Herbosa, and we'll be talking to Dr. Emeritofarad
about the salient features of the Uhc, law, and the issues and concerns regarding the
progressive attainment of universal health, care for all Philippines, Our guest today is Dr.
2:18 Niacinth Loredo: Amirito, Josefara on MD MBA is an assistant Professor of the College
of Public Health, former assistant to the Dean for Academic Affairs, and former chair of the
Department of Health Policy and Administration.

0:01 Niacinth Loredo: In the College of Public Health of the University of the Philippines.
Manila, he teaches former assistant to the Dean for Academic Affairs and former chair of the
Department of Health Policy and Administration.

0:14 Niacinth Loredo: In the College of Public Health of the University of the Philippines
Manila, He teaches courses in hospital administration, public health administration, held
economics and research methods in Health Informatics, Emma, Welcome Back to Health
Issues and Good afternoon.

0:25 Niacinth Loredo: It is an honor again to be here. I guess we have a very exciting
afternoon. Yes, let's start with the basic question.

0:37 Niacinth Loredo: What is universal health coverage or universal health care as we call it
in the Philippines? I in the Philippines.

0:46 Niacinth Loredo: Actually there is still a debate on the chair part in the coverage part.
It's actually universal health care for us, but I think there was a long debate on the care and
the coverage.

1:00 Niacinth Loredo: Organization sees it has coverage. So the for the Philippines, its
universal meaning, all Filipinos are covered They will not suffer for financial catastrophe.

1:18 Niacinth Loredo: And these services are all accessible affordable and of quality. Very
good definition. How to what if the universal health care law?

1:24 Niacinth Loredo: Philippines, the Universal Health Care law, ensures and ensures that
everyone from the barangay to the national level will be following certain framework on how
it is going to be delivered.

1:41 Niacinth Loredo: So, it was fast. One minute. It was discussed a long time for a long
time, it was just an advocacy. And now after years, I think, even before it was just a journal
article.

2:00 Niacinth Loredo: So, propagated by the Universal Health Care Study Group and it I
think spent Study group. And I think spent at least two administration to presidents before it
was finally signed into law by this administration.

2:36 Niacinth Loredo: And I think it was it is described by the website of the Department of a
progressively. Policy that progressive a payment of universal.

2:49 Niacinth Loredo: Healthcare is not an endpoint yet. Yeah, so it's a progressive working
progress. It's working progress.
2:56 Niacinth Loredo: Yes. So, when you say universal help, Care or universal health
coverage. Poor we trying to cover all Filipinos.

3:05 Niacinth Loredo: So basically all Filipino. So if I'm a foreigner I'm not covered. I don't
think so. It is the resources, our resources for Filipinos because before you still have to show
your card, you have to be a member.

3:20 Niacinth Loredo: But now I think just a slow as you are and that is what the universal
there means as far as the country is concerned.

3:30 Niacinth Loredo: So that our Constitution actually provides, that healthcare is right and
that right is supposed to be provided by government, but this kind of right is a progressive,
right?

3:41 Niacinth Loredo: It's not like right to life elegant you're alive here actually alive. But the
right to health care or access to equitable.

3:53 Niacinth Loredo: Affordable healthcare is a progressive one. Correct because it's an
imperfect way of delivering it. There's a it's dependent on how the government will give it to
you and government.

3:58 Niacinth Loredo: This is too types locally national and there is a complexity in the local
because we have a different way of interpreting the law much like the Bible, everybody
interprets it differently so let's talk about that.

4:13 Niacinth Loredo: It seems that universal health care The law is actually about tweaking
or reforming the health system.

4:25 Niacinth Loredo: Yes. Can you describe the health system prior to the law and where
we plan to bring this health system in the future with the presence of the law?

4:35 Niacinth Loredo: I think before, will depends when you, where you start before, it was
actually before the payment law, which was the revolution was So all services stem from our
lead health system, which is the Department of Health like centralized.

4:53 Niacinth Loredo: Yes. All schools are under their heads and are run by and employed
by teachers from their pet. But what happened during the payment alone?

5:01 Niacinth Loredo: Payment, the lawyer referred to the local government code, local
government out 1992 and 92 food. Yes, what happened there?

5:10 Niacinth Loredo: So now, it's just like the parent, having children, the children already
selves. So you fight. So these are the mayors, These are the local government units.

5:20 Niacinth Loredo: So they decided to give parts of the health system to the local
government decision, making decisions employment.
5:29 Niacinth Loredo: Yes, all of those things. So, after that, what happened Department of
Health Care of, like, seven hospitals, right?

5:40 Niacinth Loredo: And regional centers. Yes, sir. And then the local government, the
governor's took care of of the local primary health hospitals.

5:49 Niacinth Loredo: The provincial hospital in the mayor Took care of the health centers,
the health centers in the health districts are very interesting.

5:55 Niacinth Loredo: So we fragmented our help system in a way or we decentralized there.
Some people say fragmented. Some people say it's centralized and closer to the people.

6:05 Niacinth Loredo: It depends on the perspective. So I think it has advantages. It also has
its disadvantages if you're a very efficient with Germany Area, Administrative Pro is in the
local setting, then it will work.

6:18 Niacinth Loredo: So we have to define a term that comes out of it in universal health
coverage, it's called equity another another.

6:30 Niacinth Loredo: This law, this local government created inequity for the poor. Yes,
because all municipalities not all local government units and rich first class, you know,
municipalities first class second class.

6:47 Niacinth Loredo: Special express. The fish are six, plus are the poorest fresh glasses,
more world. So the income resources are not the same and with the income because that's
the primary thing comes human, resources equipment, even the skills needed and there's
always the tendency of course to go to the more populist areas.

6:59 Niacinth Loredo: So when I, when I say, you go for universal healthcare or universal
health coverage. Yes, I agree with you.

7:19 Niacinth Loredo: In principle? Yes, I do. What that if I'm the mayor. What Make capacity
my skills my resources. I can't I don't think I can do it the way you envisioned it.

7:30 Niacinth Loredo: So I think there is that the Soviet divide the divine individually so
equity. Well, equity will will be there in equity.

7:45 Niacinth Loredo: The drive for equity is there as the principle of the law. But inequity will
exist because matches I if I was the mayor would like to deliver the services you envisioned
it.

8:00 Niacinth Loredo: I cannot. Because I'm limited by what I have. So but also came in the
time where in the government did that end up fight for help to help budget was a tie.

8:14 Niacinth Loredo: So the private sector continued to develop you can get access to
healthcare but you will have to pay a private hospital for all the modern care medicine, but
the poor were left with Minimal the government.
8:26 Niacinth Loredo: The government, yes, it was minimal and the meager budget had to
be divided to, and there's larger population.

8:39 Niacinth Loredo: And there's also the question of quality because of that the quality will
always. And so, They say that there's this study, I haven't found it yet but it sounds logical.

8:47 Niacinth Loredo: So word association between government hospitals and a private
hospital. They say that the people go to the private hospitals for quality, but it is expensive.

8:57 Niacinth Loredo: Then they go to the government hospitals. Not so expensive but
affordable but it's affordable or probably free or comes with this.

9:06 Niacinth Loredo: So can you define that? So what is affordable healthcare? So we've
defined inequity as the divide between the economics of the health services delivered.

9:15 Niacinth Loredo: So what is affordable? Affordable is something that will not drive you
into financial catastrophe. Affordable is something that after getting say I will not be very
poor afterwards.

9:26 Niacinth Loredo: I will not be able to pay the tuition fear My children. I'll be able to pay
the rent of my, whatever we can describe to the viewers like some of the health systems in
other countries like the Scandinavian countries, or even the Where there is a national
Health Service?

9:37 Niacinth Loredo: As long as you're a citizen, you will get health care cover you are
covered with from the time, you're born to the time, you're in the tomb.

9:50 Niacinth Loredo: You are covered by the government, and if you need open, heart
surgery, the government will take care.

9:59 Niacinth Loredo: Yes. So, I think in, in those countries, they're very, I mean, they were
ahead of us in interpreting it.

10:09 Niacinth Loredo: And we are not as you said, fragmented, as we are, so they might be
also subdivided. But there is that centralized notion of if they give money, you said, single
payer or a pool of money.

10:28 Niacinth Loredo: Good percentage of that really goes to help so that if it's curative
preventative, everything, all those services will be delivered to the person's concern.

10:38 Niacinth Loredo: So, this positive, the Universal Health Care law is like, by the
approval, that the government does value health and life of its Human of its people, that is
population.

10:51 Niacinth Loredo: The fact that now they are creating a framework. Of a system of the
disaffordable and equitable to the Filipino.
10:59 Niacinth Loredo: Yes, but it's a progressive. Okay? So let's talk about progressive.
What services? Can be delivered as of now, right?

11:09 Niacinth Loredo: Like Now when I ask people about field health field, health will cover
only like 30% of your expenses when your hospitalized and it doesn't cover your outpatient
diagnostic and your outpatient care what changes with the law.

11:25 Niacinth Loredo: What change with the law is that I think the primary focus now I
mean, it's like educating the people at the same time the beard from the curative.

11:36 Niacinth Loredo: Yeah. From the massive treatment, which as you know, entails more
cost for the government and for the people that's why out of pocket is also increasing so
more on the primary healthcare services.

11:49 Niacinth Loredo: So this is part of the, you know, there's NCVS. We have the triple
burden already of the disease so that's it.

12:03 Niacinth Loredo: These communicable diseases, infectious diseases, and, of course,
diseases of people. Hope, I hope people call the concentrate.

12:12 Niacinth Loredo: Not only on primary health care, but also on health promotion and
prevention. Yes, maybe we can define that to the people.

12:19 Niacinth Loredo: So what is primary care? What is health promotional? What is
primary prevention? Okay, well, We start first with primary health care.

12:31 Niacinth Loredo: I think that's the basis. I think this was their long before help for all
the year 2000. 1974. Yes and so 2010 came and there was no helping equity, the whole
world and if you get the sorrows, probably use good.

12:38 Niacinth Loredo: See that help for all? It's actually universe that's still universal health
care. So it's I think it's just a rolling progressive thing but that primary helps here never
happened.

12:55 Niacinth Loredo: But for so many reasons, of course, it could be said that it creates
jobs because if it's business the revenue earn more money so it gives this corporations more
money, more jobs, you create more jobs, but the notion of universal health care is prevent
him so that you do not determinal illness and you get to catch the symptoms first.

13:05 Niacinth Loredo: So that's the primary. That's why it's primary. So secondary
internationally. You probably end up in hospital getting confined.

13:16 Niacinth Loredo: Of course, there are those cases as well, but nipping it in the but I
think it's the so let me when the PHILHEALTH law was created or the National Health
Insurance app.

13:43 Niacinth Loredo: Of 1994 when it was created to feel help was designed so that it
would take care of the people's hospitalization needs.
13:52 Niacinth Loredo: And that continued on but it's a support value or money was only a
small proportion. So the people still had to pay a lot for hospitalization what changes now
because I think in the UHC law they're saying that field help will pay for consultation in the
primary health care clinic and laboratory death in the healthcare clinic.

14:01 Niacinth Loredo: What changes now and how will this be implemented? As I said, As
long as you are Filipino, you are covered.

14:23 Niacinth Loredo: So patience when they come and they consult they have different
businesses. The chronic. So it could be a primary element.

14:32 Niacinth Loredo: So, Feel health as the financial arm of the universal health care
would be able to deliver both kinds of services.

14:41 Niacinth Loredo: So the whole spectrum with primary be its secondary and be it
tertiary. So the but the emphasis, again, It's in ily size towards is primary.

14:54 Niacinth Loredo: So, I'm also winning away the patients from thinking, chronic
because education and help promotion, but we delivering it through the financing, right?

15:06 Niacinth Loredo: So I will not, so they not decided to focus on primary prevention,
Even secondary prevention. Yes. If you have none communicable disease, they prevent
hypertension.

15:14 Niacinth Loredo: Make sure they control your hypertension so that you don't get a
stroke or heart attack. Another key to that is the reference system.

15:27 Niacinth Loredo: So it's like hospitals, level, three hospitals, those are tertiary hospitals
are for those with Making this so your barangay health station, your rural health unit.

15:44 Niacinth Loredo: Probably anything that is in the municipal area would be towards
preventive and primary any describes to me how that will happen.

15:49 Niacinth Loredo: So, I was, I am thinking about the headache, so you come to that the
first notion of a Filipino is Go to my doctor and it's very short doctor and hospital.

16:02 Niacinth Loredo: So that will be kind of remedy or tweak it. Will you will be referred
back to where you are. So it's something like that you will be in that service delivery network.

16:16 Niacinth Loredo: That's how they turn it. Where you belong. And if you have gone
there already, you have this certification that you have been seeing.

16:25 Niacinth Loredo: And, of course, if the diagnostic show that you really indeed need
tertiary care. Then that is the time that you will go there.

16:29 Niacinth Loredo: So I think that that referral system that financing part is really tailored
to go into preventive and you go if you're yeah chronic or terminal, you go to the right.
16:46 Niacinth Loredo: Mechanic Shop. If you're a car, how does that work? I have, I have,
let's say, A diabetes. I cannot go to my endocrinologist.

16:57 Niacinth Loredo: I have to go to a primary healthier. Yes, you have to go before I marry
network to the endocrinology and they usually notion of course is where you live.

17:06 Niacinth Loredo: So what is near to you? So where's your place of residence? So
everyone will have a service delivery network so that's very different from the way people.

17:16 Niacinth Loredo: Success healthcare today because the way people access
healthcare to this Dr. Bosa. Do you know anyone who is a good endocrinologist?

17:25 Niacinth Loredo: And then I referred them to the endocrinologist and they go straight
to them. So you mean that cannot happen anymore or it can still happen if you know.

17:33 Niacinth Loredo: No there's this slow education through that kind of upset up that you
will that doctor probably or that expense whatever consultation that was, will not get the
correctly investment or will not be reversed totally unless you the referral system, Okay?

17:54 Niacinth Loredo: Now I'll ask you. We have a lot of doctors. Most of our doctors are
specialists because med school, everybody wanted to become a specialist.

18:09 Niacinth Loredo: I'm asserted. So, it took me years Who will take care, where will we
get the primary physicians, or we call that family and community medicine, right?

18:18 Niacinth Loredo: So, where are we going to get all these family physicians that will
take care of a hundred million Philippines in the International exist right now?

18:29 Niacinth Loredo: Correct, at this point. So yes, I said before it is a work in progress. So
the Department of Health, I think, is making talking to a primary care, physicians building,
that network primary healthcare strengthening that.

18:46 Niacinth Loredo: So our schools produce the doctors. I think there's has been changes
in the curriculum. Now to orient, our medical, not like the ones we did before we're in, you
enter school.

18:58 Niacinth Loredo: And of course, after medical school, enter into a residency program
where you are expected to become a specialist now.

19:06 Niacinth Loredo: So our country, our Filipinos are have a certain discrimination toward
the generalist. And primary care.

19:15 Niacinth Loredo: They prefer to see the specialty because the thinking is especially is
good because they had more years of training and that is a mindset, that needs to be
changed to be changed up because my friend from the UK, they cannot access a specialist
without going to their assigned GP.
19:25 Niacinth Loredo: They call it in the UK, GP GP, actually is a general practitioner, but
they can diagnose and without his referral, without his gatekeeping.

19:42 Niacinth Loredo: You cannot access an orthopedic surgeon and endocrinologist. A
surgeon, like me. And we don't have that yet now.

19:47 Niacinth Loredo: Yes. How do we build that? That's the big question. So it's a working
progress. I've told you the Department of Health right now is trying to beef up.

20:00 Niacinth Loredo: Its primary healthcare approach. Ing with of course the universities,
the universities who produce the health professionals and orient them into more family
community.

20:14 Niacinth Loredo: Approaches primary healthcare. How, of course my changing? The
curriculum. Because in the University of the Philippines, we have talks already of changing
the curriculum.

20:27 Niacinth Loredo: And, you know, that and in the College of Medicine where I teach,
yes of the goal is community oriented medical education.

20:30 Niacinth Loredo: Yes. So this is not the curriculum where we were oriented to before,
so. But as I said, it will not happen overnight.

20:38 Niacinth Loredo: Correct. And so, the education would begin with the educator's. Who
are the doctors facing the patient?

20:45 Niacinth Loredo: So the university and other medical schools have a big role to play.
Yes, in shifting, the focus of the young doctors, the medical students to understand universal
healthcare systems and primary care systems.

20:57 Niacinth Loredo: They are the first ones to have contact with the patients. So I think
they also play a role in being educator to the patient on how to ship that mindset that if I
have already I should go to my specialist doctor in the hospital.

21:09 Niacinth Loredo: But you know, I'll tell you that. Very hard. Because as a medical
student, when the person that came in to lecture in our class was a surgeon, he was driving
a Mercedes-Benz.

21:27 Niacinth Loredo: He was wearing a nice signature tie and signature felt and shoes. So
I said, I want to be like him, you know, he has lots of money Then the person from family to
visit and he was more wearing jeans and T-shirts, his hair was crappy so he didn't mice.

21:36 Niacinth Loredo: A model that I wanted to be as a doctor. How can we Shift that role
modeling for our young people. I guess we have to go back to the basics.

21:59 Niacinth Loredo: Our model doctor is actually Jose, Rizal, Jose Rizal. I think, didn't
care for Mercedes Benz, didn't care for 2020 Germany, because there was no nothing at that
point during that time.
22:08 Niacinth Loredo: So I think the model would be service service. Yes, you can still get
interested in c. Yes, you can still be a specialist but serve and and observe the countryside.

22:27 Niacinth Loredo: First serve this community where primary healthcare is supposed to
be delivered. So yeah, second your motion because I became a serger and I started
operating in remote villages and the gratification is actually great.

22:41 Niacinth Loredo: In fact, I'm flying off to Mindanao again in a couple of days to do free
surgical mission to offer to the people who have no access to specialists.

22:50 Niacinth Loredo: So I think there's a gratification as well to be what you're describing
and it is just not communicated to the medical to that.

22:58 Niacinth Loredo: Offering of service to the poor and to make because the mindset is
just like an internship. You get to rotate all disciplines.

23:06 Niacinth Loredo: Now you get to rotate to the countryside. Yes. And then choose your
residency if you still would like to go into family medicine or a specialist like a cardiologist.

23:17 Niacinth Loredo: So but that is I'm stating it very fast. But actually, it's A yearly, It's a
slow progress. So from the university to the doctor's out there, practice out there practice to
the patient patient.

23:32 Niacinth Loredo: Now knows the reference is there, I think it will come in faces before.
You will really know the notion that right universally when we pass the law and there's more
money in the help system, our government hospital became more overcrowded.

23:40 Niacinth Loredo: Because every Filipino with or without Phil help can now go to the
hospital and access health services because before they will not go, I would see patients in
the ER, and I would ask them.

23:54 Niacinth Loredo: Why didn't you go, um, to the, ER, last week when you were feeling
bad, I didn't have money. But now money is no longer an issue because there is a provided
for that they cannot be denied healthcare and strengthening the local health system.

24:06 Niacinth Loredo: Before you go to the hospital. Okay. So now you've described the
word. The word is health system. We've talked about manpower and professionalizing,
creating more GPS and family physicians and community doctors.

24:27 Niacinth Loredo: So that's going to be a struggle, the University of the roles and that.
So let's talk about the health system.

24:34 Niacinth Loredo: What will be the role of the Department of Health? The role of the
local government hospitals, the low role of medical centers or what I call apex hospitals, How
will the whole architecture look like?
24:44 Niacinth Loredo: Because it's a fragmented system, They will now create near perfect
networks to deliver this because it's so many more perfect.

25:01 Niacinth Loredo: Is perfect. So it's near perfect. So it's still a work in progress as we go
on. So under the Universal Healthcare law, there will be service delivery being maybe
effective in the local health system, Local health system as they define it.

25:18 Niacinth Loredo: In the implementation sites would be composed of course the
barangay Health Stations and Municipal Health Office, the Provincial Health Office with a tie
up with either the district hospital, the provincial health hospital acting as the part answering
for the therapeutic treatment part.

25:28 Niacinth Loredo: While that local where you will begin, your navigation should be the
primary health care so you cannot go directly to the hospital without being cleared.

25:48 Niacinth Loredo: First, may your either your municipal health officer, your rural health
position, your public health associates there.

25:56 Niacinth Loredo: It's a team that is really focused on primary healthcare before. Week.
So you could have a terminal illness but still, you would probably be seen first in that primary
healthcade setting before being ever, I see that as a implementable and doable in the public
health system in the government, but our healthcare system is also composed of the private
sector and the private sector.

26:13 Niacinth Loredo: Trucks paying people that will jump the gun, we pride themselves of
specialists. The two, you know, they have they advertised their new, CT scan, their new
pepscan, the latest ultrasound.

26:42 Niacinth Loredo: So how do we that is the mind? Changes. That is the mindset that
we're trying to break and educate the people with.

26:50 Niacinth Loredo: So you said that in the Constitution, health is a human, right? And the
Universal Healthcare law tries to guarantee that.

26:58 Niacinth Loredo: But it comes also the education that they should be involved in the
decision-making of their own health.

27:06 Niacinth Loredo: So it should begin again in the Say things. So how do you How do
you say that the marketing of the first class?

27:14 Niacinth Loredo: CT scan, It doesn't necessarily translate into getting well so so I think
it should be the doctor underneath It's advertising.

27:24 Niacinth Loredo: It's marketing. It's basically we have the best and most modern
machine. So it doesn't translate to better health care for you.

27:32 Niacinth Loredo: Trying to win that perspective, the Department of Health I think will try
or is already trying to shake hands with the private sector.
27:41 Niacinth Loredo: So they're trying now to involve even those physicians with private
practices. So you're probably rich Coming from a rich family.

27:50 Niacinth Loredo: So you have this family-owned clinic, you will also be accorded that
offer to join that network. Because that is the network that is composed both of the public
and the private.

28:03 Niacinth Loredo: So the network will be a geographic network, and people will will be
what the public hospitals, and private sector hospitals, should be inclusive.

28:14 Niacinth Loredo: Yes, and they know and they know the navigation system and they
know the network. So if you're the one with the all the super technology you will say, Hey, did
you go with the rural health unit first for the barangel station?

28:29 Niacinth Loredo: Because you probably do not need this. So that is the ideal notion of
how the navigation and the network should work.

28:40 Niacinth Loredo: So that's a local health system, a local health, apex hospital with
different spokes of hub and spokes model.

28:47 Niacinth Loredo: Yes. So you have at the very free primary healthcare and then they
refer to an apex or the either the private or the Medical Center Public Medical Center to
provide tertiary care that you have to help them.

29:00 Niacinth Loredo: Also, learn that tertiary is different from primary so that that because
there is this city's kind will not heal the headache.

29:11 Niacinth Loredo: So yes more experience that if you shall not being money, you get
cured. Correct. So we're trying to to improve on that mindset and tell these people that that's
helped literacy help literacy.

29:31 Niacinth Loredo: That's another Scott, nothing overnight Thinkrest. The current will
happen because we have to make our people literate about what is vital in healthcare and
what is just an icing on the case but I see it's probably 20 years from now.

29:42 Niacinth Loredo: It is really a very, very good system functioning and this universal
healthcare law which we started.

29:54 Niacinth Loredo: Now has a I have a few minutes left and I'd like to ask you about
issues and concerns about Nice picture that you're painting.

30:08 Niacinth Loredo: Going to this abatement of universal healthcare. I think we will have
many pumps because the way you describe it is we have the human capital development to
do.

30:18 Niacinth Loredo: We have health systems and improvement to do, we have education
and we need primary care and we need help promotion and it's a lot of work.
30:26 Niacinth Loredo: And as an asymmetry, what I call an asymmetry of information, what
it really is, what universal health care?

30:34 Niacinth Loredo: No. So, what is asymmetry of information, there is an imbalance of
what the patient knows and what the doctor knows.

30:43 Niacinth Loredo: So there is also an imbalance of what the Department of Health tries
to say. And what the patient knows, it is always the patient because that is our client, who
should know what it is really?

30:56 Niacinth Loredo: So in the second part, is the governance part. The ones in the first,
we need to put the patient in the center of the system.

31:04 Niacinth Loredo: Yes. So he's he's the one being served by the system. Yes, we must
be able to address his needs and must be able to make him satisfied.

31:12 Niacinth Loredo: Yes. And the second one is the leadership and governance part of
the health system. So these are local government.

31:23 Niacinth Loredo: So, they are very, very vital partners. They are not doctors, some
probably are doctors, and that makes it easier for them to implement uhc.

31:30 Niacinth Loredo: So, I call that leadership and governance leadership and
governance. Next part is really making sure that this systems they don't work by themselves.

31:38 Niacinth Loredo: Yes, they must be let and they must have a governance system. That
is not corrupt. That is not. That is efficient.

31:46 Niacinth Loredo: That is efficient very idea. Yes. And another I think Miss Point is
health information. So, health information, I did not see it in the highlights.

32:02 Niacinth Loredo: In IRS, even in the law I did. Let's see being highlighted like service
delivery leadership talking about health information, digital health, or talking about a
centralized system, even knowledge management knowledge, probably better.

32:16 Niacinth Loredo: So, our knowledge management in that local health system, such
that Mayor who probably is not health-oriented.

32:24 Niacinth Loredo: It's not a doctor would probably be able to allocate his resources for
her resources more efficiently towards the end goal.

32:33 Niacinth Loredo: I know what you're talking about. I've seen this with my classmates
who studied in Canada because Canada has this Ottawa rules on knee, playable head injury
rules.

32:42 Niacinth Loredo: So, who goes to the next airtel of care? Is decided by
evidence-based guidelines, the primary care physician.
32:50 Niacinth Loredo: And To develop those because we cannot get Canadian and apply it
in the Philippine healthiest step, but if you don't have an information infrastructure, it will.

33:03 Niacinth Loredo: You know, when you you when you decide, when you make a
decision, especially this authority, you need good information.

33:09 Niacinth Loredo: You cannot decide just on a whim, so you cannot decide just
because that person voted for me. It's not a good decision.

33:16 Niacinth Loredo: So you need updated reliable information and that is electronic
probably, so that it would be better.

33:24 Niacinth Loredo: So that is the part that will also help promotion health education,
navigating the system, making it work from primary healthcare to the tertiary level of care.

33:35 Niacinth Loredo: Very interesting, any final words to our viewers out there about
universal health care, we will hold your hand but bear with us.

33:46 Niacinth Loredo: I am from academia so bear with us in the education part. Will be
made perfect soon. Well with that, I'd like to thank you all for covering health issues and
concerns regarding the Universal Health Care.

34:01 Niacinth Loredo: Law. It seems, this is work in progress. We continue to strive for and
achieve universal health, care for all Filipinos and we do hope that this law will succeed and
will benefit each and every Filipino out there.

34:09 Niacinth Loredo: But I mean, Salama good. Thank you very much.

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