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All for Health

towards
Health for All
THE DUTERTE HEALTH AGENDA
Lahat para sa Kalusugan tungo sa
Kalusugan para sa Lahat
ATTAIN HEALTH-RELATED SDG TARGETS
Financial Risk Protection Better Health Outcomes Responsiveness

Protect Access
from functional
TRIPLE SERVICE
BURDEN OF DELIVERY
DISEASE NETWORKS

Attain and sustain


UNIVERSAL
HEALTH
INSURANCE

Equity  Inclusiveness  Quality  Comprehensiveness  Efficiency  Sustainability  Transparency  Accountability


• Filipinos able to access services with EQUITY
least financial, cultural and geographical
INCLUSIVENESS
barriers
• Preference for the underserved

Our • Filipinos able to demand quality and QUALITY


compassionate services at par with
Values global clinical and non-clinical standards
COMPREHENSIVE

• Filipinos able to continuously get the EFFICIENCY


most health from resources allocated
SUSTAINABILITY
(cost-effective)

• Filipinos able to make informed choices


TRANSPARENCY
with respect to their health/care and
participate in holding the government ACCOUNTABILITY
accountable to the people
• Filipinos protected from health-related
impoverishment
FINANCIAL PROTECTION
Our
Vision • Filipinos attain best possible health
outcomes with less disparity
BETTER HEALTH STATUS

• Filipinos feel respected and valued in all of


their interaction with the health system
RESPONSIVENESS
What services to How to best deliver the
guarantee or services?
prioritize?

Our Protect from


TRIPLE
Access
functional

Strategy BURDEN OF
DISEASE
SERVICE
DELIVERY
NETWORKS

Attain & Sustain


UNIVERSAL HEALTH
INSURANCE

How to equitably and efficiently


finance the service?
SERVICES THAT ADDRESS THE TRIPLE BURDEN OF DISEASE
• Communicable
• Non-communicable, including malnutrition
• Diseases of rapid urbanization and industrialization (e.g. Injuries, mental
health (including suicide prevention) and alcohol /drug use)
Triple SERVICES THAT CORRESPOND TO THE FULL SPECTRUM
Burden of OF CARE FOR ALL LIFE STAGES (minimal exclusions)
• Promotive, preventive, curative, rehabilitative, palliative

Disease Emphasis on role of health promotion and primary care (annual health check)

What services INTERVENTIONS THAT MODIFY BUILT ENVIRONMENT


should be AND MOBILIZE COMMUNIITIES
• Trigger behavioral shift towards healthy lifestyle/habits
guaranteed to • Total Ban on Firecracker
protect Filipinos • AMR, ZOD, food safety & nutrition
from the triple • Adopt and scale-up community-based interventions
• Create strategic partnerships to promote healthy homes, workplaces, schools
burden threat?
and transport
NETWORKS AS CONTRACTED UNITS OF PHILHEALTH,
ACCOUNTABLE FOR ENSURING:
• Appropriate, ethical and at par with clinical and non-clinical standards
- Gate-keeping, Licensing & Accreditation, Clinical practice guidelines

Service • Physical access


- Accessible location, transport assistance, or telehealth

Delivery • Seamless continuum of services


-
-
Lower level level facilities to end referral centers and vice versa
Public (DOH, LGU, NGA) and private exchanges (patients and human resource)

Networks •
- Team-based approach
Patient/client-friendly and culturally-sensitive services
- No queues, by appointment only
How should health
care providers be
NETWORKS ENHANCED BY RELIABLE DATA & REGULAR
organized to ensure
FEEDBACK
easy access to high • Mandate online submission/data sharing and reporting to disease registries
quality services? • Obtain accurate feedback: e.g. ghost patients, surprise field visits
• Streamline monitoring and evaluation systems and create dedicated performance unit

NETWORKS RESILIENT IN TIMES OF DISASTER


• Strengthen preparedness initiatives

* To include other government agencies’ initiatives (sector wide approach)


PHILHEALTH AS GATEWAY TO FINANCIAL ACCESS TO SERVICES
and PROTECTION FROM CATASTROPHIC SPENDING
• Treat every Filipino as member unless proven otherwise
• Secure resources to enable ‘enrollment’ of remaining 8% and to sustainably
Universal •
finance remaining 92%
Strictly enforce no balance billing for poor & fixed copayment for non-poor (ceiling)
• Cover services that contribute to high out of pocket payment
Health • primary/outpatient care, outpatient drugs
• medically and financially catastrophic conditions such as cancers, rare diseases,

Insurance •
metabolic disorders, mental health drugs, nicotine replacement
Position private health insurance / HMO plans as supplementary to NHIP (benefits
complementation)
How to equitably and
efficiently finance PHILHEALTH AS MEANS TO SUSTAINABLY FINANCE
the services? GOODS AND SERVICES
• Phase-in coverage of budget-financed commodities by PhilHealth
• Facilitate pooled procurement/bulk purchasing arrangements thru PhilHealth

ALIGN ALL HEALTH FUNDS TOWARDS DHA


• DOH, PHILHEALTH, PAGCOR, PCSO, LGU, ODA and other NGA health funds
• Streamline what is considered ‘free’ or ‘charity’ services
GOVERNANCE

ATTAIN
HEALTH-RELATED
SUSTAINABLE HEALTH FINANCING
DEVELOPMENT GOAL

TRIPLE SERVICE
Financial Risk Protection BURDEN OF DELIVERY
SERVICE DELIVERY AND
DISEASE NETWORKS TRAVEL MEDICINE
Better Health Outcomes
Responsiveness
HEALTH HUMAN
UNIVERSAL RESOURCE DEVELOPMENT
HEALTH
Equity  Inclusiveness  Quality INSURANCE

Comprehensiveness  Efficiency REGULATIONS, POLICY


AND STANDARDS
Sustainability  Transparency DEVELOPMENT
Accountability

HEALTH INFORMATION
AND SURVEILANCE
BUILD CAPACITY AND ESTABLISH ACCOUNTABILITY IN
FULFILLMENT OF INDIVIDUAL & SECTORAL MANDATES
Governance • Strengthen DOH as a policy and regulatory agency and PhilHealth as the national
government purchaser
• Leverage support for and hold LGUs accountable in their role as as service
providers and local stewards of health

ENSURE EFFICIENCY, TRANSPARENCY & PREDICTABILITY AND


INTEGRITY OF GOVERNMENT TRANSACTIONS
• Reduce red tape and limit turnaround time of transactions to 3 days, where appropriate
• Make transactions client-friendly, professional and transparent
• Establish mechanisms to ensure integrity is upheld in all transactions
GENERATE MORE REVENUES FOR HEALTH
Health •

Ensure progressiveness of premium rates for the formal sector
Improve collection efficiency
Financing • Raise premium rate (by 2018)

PURCHASE HEALTH SERVICES EFFICIENTLY


• Enforce contracting arrangements with health service providers
• Set up strong monitoring mechanisms
• Set price ceilings to reduce unpredictability of out-of-pocket payments
• Reform provider payment mechanism to reflect true cost
- Short term: Adjust case rates using costing studies
- Medium term: Most appropriate contracting and provider
payment mechanism
DEFINE HEALTH ENTITLEMENTS AND STANDARDS OF CARE
• Establish transparent priority setting process to ensure equitable and fair expansion of
health insurance benefits
Service • Prioritize mental health, smoking cessation, and drug rehabilitation
entitlements

Delivery •


Incorporate patient’s rights/rights-based approach in entitlements
• Observe international commitments: Human Rights, CEDAW, Anti-Torture
Require only “unique health ID” when accessing entitlements

ESTABLISH FUNCTIONAL PRIMARY-CARE FOCUSED


SERVICE DELIVERY NETWORKS
• Define scope of services and map existing service capabilities
• Develop health facility/hospital investment plan
• Position DOH hospitals within SDNs (apices, teaching/training, equity center)

STREAMLINE BOQ FUNCTIONS AND DEVELOP TRAVEL


MEDICINE PORTFOLIO
RECONFIGURE FRONTLINE HUMAN RESOURCE COMPLEMENT
BASED ON COMPETENCY RATHER THAN PROFESSION
Health Care • Modify curriculum to make it more responsive to the needs

Workforce • Match medical schools work with geographic areas (return service program for
graduates)

ESTABLISH SUSTAINABLE RECRUITMENT AND RETENTION OF


TALENTED PROFESSIONALS
• Consolidate financing towards fair HCW compensation (salary, PhilHealth
reimbursements, other incentives)
• Actively promote opportunities for post-graduate training
• Reorient deployment programs to balance contribution
with career development
ENSURE ACCESS TO LOW-COST QUALITY ESSENTIAL
Medicines, MEDICINES and DIAGNOSTICS
• Publish prices of drugs and diagnostics
Devices •

Establish price negotiation board and mechanisms for bulk purchasing
Explore options for supply chain management (PPP or outsourcing)

& Other USE HEALTH TECHNOLOGY ASSESSMENT(HTA) TO


Technology SYSTEMATICALLY DETERMINE DRUGS AND DIAGNOSTICS
THAT WILL BE PAID BY DOH and PHIC
• Establish body and institutionalize process to conduct HTA to guide coverage
decisions
STRENGTHEN SECTOR’S CAPACITY FOR HEALTH PROMOTION
• Establish external health promotion body

Health UPHOLD CITIZEN’S RIGHTS TO INFORMATION AND


PATIENT’S RIGHTS
Information • Make health data, processes, and prices transparent & accessible

and STRENGTHEN DATA GOVERNANCE FOR NATIONAL


Information DECISION MAKING
• Streamline data and report requirements across facilities

Systems •

Harmonize health information systems and databases
Require submission of data as part of licensing and contracting
• Establish mechanisms to obtain regular feedback from all stakeholders
Zero unmet need for FP

Roll out TSEKAP+ OP Drug benefit


100 to the poorest 200
Days Days Roll out mental health and enhanced
HIV/AIDS package

Expand National Drug Rehab Program


Health in All policies in
4 key sectors

Strategic Alignment of DOH Hospitals in a


SDN
Operationalize ambulance services
(land, sea, air)

Contracting by SDN operational in 3 regions


No queues in public facilities
(by appointment and navigators)

Enroll remaining 8% of the population


Adjust rates for most
common cases

Make prices of most common drugs


affordable and diagnostics available
Enforce fixed and zero co-payment
(NBB for poorest)
A Attract the “best and the brightest”

ATTAIN
C Champion health in all settings to all
sectors HEALTH-RELATED
SUSTAINABLE
DEVELOPMENT GOAL
Harness and align private sector
H donors, non-state actors, and
deepen engagement with the people
TRIPLE SERVICE Financial Risk Protection
BURDEN OF DELIVERY
DISEASE NETWORKS Better Health Outcomes
I Instill integrity and foster
accountability in all Access
Responsiveness
Quality
Efficiency
Expand pre-payment through a
UNIVERSAL
E single national government
purchasing fund (DOH+PHIC)
HEALTH
INSURANCE
Access | Quality
ATTAIN SUSTAINABLE
DEVELOPMENT
Efficiency GOAL
| Transparency
TARGETS
Vest with resources, capacity and Sustainability | Equity
V evidence to enable key health sector
players* to fulfill their mandate/role Accountability

Empower all government health care


E providers with management and
fiscal autonomy

*DOH, PHIC, LGU, DOH Hospitals, Private sector, other NGOs


Battlecry:

Mahal Ko ang Pilipinas, simply


because it is the Land of my Birth
Duterte Marching Order
 Hire anyone you think can help basta wag lang
corrupt
 Dra. Help the poor, they are the reason why
government exist
 No queuing, kawawa ang Pilipino
 Change is coming
 All appointees undergo screening
process. No kaibigan, kamag-anak.

No junket travels