Community

Medicine:
Week 5
PGI BEKP
PGI presentation
Here is where your JAJ begins
 TABLE OF CONTENTS
01 02 03
UN Declaration on Primary Health Philippine Medical
Human Rights Care Approach Act of 1959

04 05 06
Practice of Physicians’ Code of Universal Health
Medicine Ethics Care Law
 01
UN Declaration
on Human Rights
 UN Declaration on Human Rights

the Declaration was proclaimed by the United Nations General

Assembly in Paris on 10 December 1948 (
General Assembly resolution 217 A)

as a common standard of achievements for all peoples and all

nations
 Preamble

Whereas recognition of the inherent dignity and of the equal and inalienable rights of
all members of the human family is the foundation of freedom, justice and peace in
the world,

Whereas disregard and contempt for human rights have resulted in barbarous acts
which have outraged the conscience of mankind, and the advent of a world in which
human beings shall enjoy freedom of speech and belief and freedom from fear and
want has been proclaimed as the highest aspiration of the common people,
 Preamble

Whereas it is essential, if man is not to be compelled to have recourse, as a last resort, to

rebellion against tyranny and oppression, that human rights should be protected by the
rule of law,

Whereas it is essential to promote the development of friendly relations between

nations,

Whereas the peoples of the United Nations have in the Charter reaffirmed their faith in
fundamental human rights, in the dignity and worth of the human person and in the
equal rights of men and women and have determined to promote social progress and
better standards of life in larger freedom,
 Preamble

Whereas Member States have pledged themselves to achieve, in co-operation with the
United Nations, the promotion of universal respect for and observance of human rights
and fundamental freedoms,

Whereas a common understanding of these rights and freedoms is of the greatest

importance for the full realization of this pledge
 Preamble

Now, therefore, The General Assembly,

Proclaims this Universal Declaration of Human Rights as a common standard of

achievement for all peoples and all nations, to the end that every individual and every
organ of society, keeping this Declaration constantly in mind, shall strive by teaching
and education to promote respect for these rights and freedoms and by progressive
measures, national and international, to secure their universal and effective recognition
and observance, both among the peoples of Member States themselves and among the
peoples of territories under their jurisdiction.
 Article 1
All human beings are born free and equal in
dignity and rights. They are endowed with
reason and conscience and should act towards
one another in a spirit of brotherhood.
Article 2
Everyone is entitled to all the rights and freedoms
set forth in this Declaration, without distinction of
any kind, such as race, colour, sex, language,
religion, political or other opinion, national or
social origin, property, birth or other status.
Furthermore, no distinction shall be made on the
basis of the political, jurisdictional or international
status of the country or territory to which a person
belongs, whether it be independent, trust, non-self-
governing or under any other limitation of
sovereignty.
 Article 3 Article 4
Everyone has the right to life, liberty and No one shall be held in slavery or servitude;
security of person. slavery and the slave trade shall be prohibited in
all their forms.
 Article 5 Article 6
No one shall be subjected to torture or to Everyone has the right to recognition everywhere
cruel, inhuman or degrading treatment or as a person before the law.
punishment
 Article 7
All are equal before the law and are entitled
without any discrimination to equal protection of
the law. All are entitled to equal protection
against any discrimination in violation of this
Declaration and against any incitement to such
discrimination.
Article 8
Everyone has the right to an effective remedy by the
competent national tribunals for acts violating the
fundamental rights granted him by the constitution or
by law.
 Article 9 Article 10
Everyone is entitled in full equality to a fair and public
No one shall be subjected to arbitrary arrest, hearing by an independent and impartial tribunal, in the
detention or exile. determination of his rights and obligations and of any
criminal charge against him.
 Article 11 Article 12
1. Everyone charged with a penal offence has the
right to be presumed innocent until proved guilty No one shall be subjected to arbitrary interference with
according to law in a public trial at which he has his privacy, family, home or correspondence, nor to
had all the guarantees necessary for his defence. attacks upon his honour and reputation. Everyone has
2. No one shall be held guilty of any penal offence the right to the protection of the law against such
on account of any act or omission which did not interference or attacks.
constitute a penal offence, under national or
international law, at the time when it was
committed. Nor shall a heavier penalty be
imposed than the one that was applicable at the
time the penal offence was committed.
 Article 13 Article 14
1. Everyone has the right to freedom of
movement and residence within the borders 1. Everyone has the right to seek and to enjoy in
of each State. other countries asylum from persecution.
2. Everyone has the right to leave any country, 2. This right may not be invoked in the case of
including his own, and to return to his prosecutions genuinely arising from non-political
country. crimes or from acts contrary to the purposes and
principles of the United Nations.
 Article 15 Article 16
1. Everyone has the right to a nationality. 1. Men and women of full age, without any limitation
due to race, nationality or religion, have the right to
2. No one shall be arbitrarily deprived of his
marry and to found a family. They are entitled to
nationality nor denied the right to change his
equal rights as to marriage, during marriage and at its
nationality. dissolution.
2. Marriage shall be entered into only with the free and
full consent of the intending spouses.
3. The family is the natural and fundamental group unit
of society and is entitled to protection by society and
the State.

.
 Article 17
1. Everyone has the right to own property alone as well as in association with others.
2. No one shall be arbitrarily deprived of his property.

Article 18
Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to
change his religion or belief, and freedom, either alone or in community with others and in public or
private, to manifest his religion or belief in teaching, practice, worship and observance.
 Article 19
Everyone has the right to freedom of opinion and expression; this right includes freedom to hold
opinions without interference and to seek, receive and impart information and ideas through any
media and regardless of frontiers.

Article 20
1. Everyone has the right to freedom of peaceful assembly and association.
2. No one may be compelled to belong to an association.
 Article 21
1. Everyone has the right to take part in the government of his country, directly or through freely chosen
representatives.
2. Everyone has the right of equal access to public service in his country.
3. The will of the people shall be the basis of the authority of government; this will shall be expressed in
periodic and genuine elections which shall be by universal and equal suffrage and shall be held by
secret vote or by equivalent free voting procedures.

Article 22
Everyone, as a member of society, has the right to social security and is entitled to realization,
through national effort and international cooperation and in accordance with the organization and
resources of each State, of the economic, social and cultural rights indispensable for his dignity and
the free development of his personality.
 Article 23
1. Everyone has the right to work, to free choice of employment, to just and favourable conditions
of work and to protection against unemployment.
2. Everyone, without any discrimination, has the right to equal pay for equal work.
3. Everyone who works has the right to just and favourable remuneration ensuring for himself and
his family an existence worthy of human dignity, and supplemented, if necessary, by other
means of social protection.
4. Everyone has the right to form and to join trade unions for the protection of his interests.

Article 24
Everyone has the right to rest and leisure, including reasonable limitation of working hours and
periodic holidays with pay.
 Article 25
1. Everyone has the right to a standard of living adequate for the health and well-being of
himself and of his family, including food, clothing, housing and medical care and
necessary social services, and the right to security in the event of unemployment,
sickness, disability, widowhood, old age or other lack of livelihood in circumstances
beyond his control.
2. Motherhood and childhood are entitled to special care and assistance. All children,
whether born in or out of wedlock, shall enjoy the same social protection.
 Article 26
1. Everyone has the right to education. Education shall be free, at least in the elementary and fundamental
stages. Elementary education shall be compulsory. Technical and professional education shall be made
generally available and higher education shall be equally accessible to all on the basis of merit.
2. Education shall be directed to the full development of the human personality and to the strengthening of
respect for human rights and fundamental freedoms. It shall promote understanding, tolerance and
friendship among all nations, racial or religious groups, and shall further the activities of the United
Nations for the maintenance of peace.
3. Parents have a prior right to choose the kind of education that shall be given to their children.

Article 27
1. Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to
share in scientific advancement and its benefits.
2. Everyone has the right to the protection of the moral and material interests resulting from any scientific,
literary or artistic production of which he is the author.
 Article 28
Everyone is entitled to a social and international order in which the rights and freedoms set forth
in this Declaration can be fully realized.

Article 29
1. Everyone has duties to the community in which alone the free and full development of his
personality is possible.
2. In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are
determined by law solely for the purpose of securing due recognition and respect for the rights and
freedoms of others and of meeting the just requirements of morality, public order and the general
welfare in a democratic society.
3. These rights and freedoms may in no case be exercised contrary to the purposes and principles of
the United Nations.
 Article 30
Nothing in this Declaration may be interpreted as implying for any State, group or person any
right to engage in any activity or to perform any act aimed at the destruction of any of the rights
and freedoms set forth herein.
 “The right to the highest attainable standard of
health”
● The WHO Constitution (1946) envisages “…the highest attainable standard of health as a
fundamental right of every human being.”
● Acknowledging health as a human right recognizes a legal obligation on states to ensure
access to timely, acceptable, and affordable health care.
● A state's obligation to support the right to health – including through the allocation of
“maximum available resources” to progressively realize this goal - is reviewed through
various international human rights mechanisms.
 “The right to the highest attainable standard of
health”
The right to health, as with other rights, includes both freedoms and entitlements:
1. Freedoms include the right to control one’s health and body and to be free from
interference.
2. Entitlements include the right to a system of health protection that gives everyone an equal
opportunity to enjoy the highest attainable level of health.
Primary Health Care
Approach

02
 Primary Health Care (PHC)
● Primary Health Care (PHC) is the health care that is available to all the people at
the first level of health care.
● According to World Health Organization (WHO)
○ ‘Primary Health Care is a basic health care and is a whole of society approach
to healthy well-being, focused on needs and priorities of individuals, families
and communities.’
● Primary Health Care (PHC) is a new approach to health care which integrates at the
community level all the factors required for improving the health status of the
population.
 Primary Health Care (PHC)
● Primary health care is both a philosophy of health care and an approach to
providing health services.
● It addresses the expansive determining factor of health and ensures whole person care
for health demands during the course of the natural life.
● It is developed with the concept that the people of the country receive at least the basic
minimum health services that are essential for their good health and care.
 History of Primary Health Care (PHC)
● a joint WHO-UNICEF international conference was held in 1978 in Alma Ata
(USSR), commonly known as Alma-Ata conference.
● The conference included participation from government from 134 countries and
other different agencies.
● ‘The existing gross inequality in the health status of people particularly between
developed and developing countries as well as within countries is politically, socially
and economically unacceptable’.
 History of Primary Health Care (PHC)

● called for acceptance of WHO goal of ‘Health for All’ by 2000 AD.
● proclaimed Primary Health Care (PHC) as a way to achieve ‘Health for All’.

● October 19, 1979 – Letter of Instruction (LOI) 949, the legal basis of PHC was signed
by Pres. Ferdinand E. Marcos, which adopted PHC as an approach towards the design,
development and implementation of programs focusing on health development at
community level.
 Primary Health Care (PHC)

Rationale for Adopting Primary Health Care

● Magnitude of Health Problems
● Inadequate and unequal distribution of health resources
● Increasing cost of medical care
● Isolation of health care activities from other development activities
 Primary Health Care (PHC)
Importance of Primary Health Care
● Focuses more on quality health service and cost-effectiveness.
● Focuses on “Health for all”
● Integrates preventive, promotive, curative, rehabilitative and palliative
health care services.
● Encourages new connection and community participation.
● It includes services that are readily accessible and available to the
community.
● Can be easily accessible by all as it includes services that are simple and
efficient with respect to cost, techniques and organization.
 Primary Health Care (PHC)
Importance of Primary Health Care
● Promotes equity and equality.
● Improves safety, performance, and accountability.
● Advocates on health promotion and focuses on prevention,
screening and early intervention of health disparities.
● Perceived as an integral part of country’s socio-economic
development.
 Primary Health Care (PHC)

Goal of Primary Health Care

● HEALTH FOR ALL FILIPINOS by the year 2000 AND HEALTH IN
THE HANDS OF THE PEOPLE by the year 2020.
● An improved state of health and quality of life for all people attained
through SELF RELIANCE.
 Primary Health Care (PHC)

Key Strategy to Achieve the Goal:

● Partnership with and Empowerment of the people
○ permeate as the core strategy in the effective provision of
essential health services that are community based, accessible,
acceptable, and sustainable, at a cost, which the community and
the government can afford.
 Primary Health Care (PHC)
Objectives of Primary Health Care
● Improvement in the level of health care of the community
● Favorable population growth structure
● Reduction in the prevalence of preventable, communicable and other disease.
● Reduction in morbidity and mortality rates especially among infants and children.
● Improvement in Basic Sanitation
● Development of the capability of the community aimed at self- reliance.
● Maximizing the contribution of the other sectors for the social and economic
development of the community.
 Primary Health Care (PHC)
Five (5) Principles of Primary Health Care (PHC):
● Social equity
● Nationwide coverage/wider coverage
● Self- reliance
● Intersectoral coordination
● People’s involvement (in planning and implementation of programs)
 Primary Health Care (PHC)
Pillars of Primary Health
Care

1. Community Participation
2. Inter-sectoral Coordination
3. Appropriate Technology
4. Support Mechanism Made
Available
Primary Health Care (PHC)
 Philippine
Medical Act of
1959 (RA 2382)
03
● The Regulation of Medical Practice (PRC)
● Republic Act no. 2382 (Philippine Medical Act
of 1959)
● Summary: Practice of Medicine
 THE REGULATION OF MEDICAL
PRACTICE
(NOCHE, 2016)

“the maintenance of peace and order, the protection of life, liberty and property, and the
promotion of the general welfare are essential for the enjoyment by all of the blessings
of democracy”
- 1987 Constitution, Article II, Section 5
 LEGAL
BASIS
“ The State shall protect and promote the right to health of the
people and as a policy instill health consciousness among them”
- 1987 Constitution, Article II, Section 15
 PROFESSIONAL REGULATORY BOARD
OF MEDICINE: LEGAL BASIS
The Medical Act of 1959 (RA 2382)

Article I, Section 1. Objectives - This Act provides for and shall govern:
(a) the standardization and regulation of medical education
(b) the examination for registration of physicians
(c) the supervision, control and regulation of the practice of medicine
in the Philippines
 RA 8981:
THE PRC MODERNIZATION ACT OF 2000
Section 9. Powers, Functions and Responsibilities of the Various Regulatory
Boards
A. To regulate the practice of the profession
B. To monitor the conditions affecting the practice… adopt such measures as may
be deemed proper for the enhancement of the profession… maintain high
professional standards
 PRC AND THE PROFESSIONAL
REGULATORY BOARDS
A. Only bodies expressly created
by law to regulate the
professions
B. the Professional Regulatory
Board of Medicine:
supervision, control and
regulation of the practice of
medicine
REGULATION OF MEDICAL PRACTICE

Powers and functions of the PRC and the PRB’s

REGULATION OF MEDICAL PRACTICE

Powers and functions of the PRC and the PRB’s

QUASI-
LEGISLATIVE QUASI-JUDICIAL

Make rules / policies / Hear and investigate

resolutions violations
REGULATION OF MEDICAL PRACTICE

Main Goal: ensure high quality of care for the protection of the
public; maintain high professional standards

Methods:
Before entry: licensure exams
In practice: requiring credentials
requiring CPE
continuing assessment
enforcing regulatory laws
 04
Practice of
Medicine
 QUALIFIED TO PRACTICE
● Those who can have “LIMITED PRACTICE WITHOUT ANY CERTIFICATE
OF REGISTRATION” in accordance with SEC 12, ART III MEDICAL ACT
OF 1959 as amended;
○ Exclusive consultation in specific and definite cases
○ Attached to international bodies to perform certain definite work in the
Philippines
○ Commissioned medical officers stationed in the Philippines in their own
territorial jurisdiction. EMBASSIES are also considered EXTENSION OF
THEIR COUNTRIES
○ Exchange professors in special branches of medicine
 QUALIFIED TO PRACTICE
● “BALIKBAYAN” PHYSICIANS pursuant to PD 541, “ALLOWING FORMER FILIPINO
PROFESSIONALS TO PRACTICE THEIR RESPECTIVE PROFESSIONS IN THE
PHILIPPINES”.
○ Without having to renounce their foreign citizenship provided that they have a good
standing prior to their departure from the Philippines and in their adopted country
○ Need to renew your license. Prior to the practice of their professions, they shall have
first registered with the Professional Regulation Commission and have paid the proper
professional license fee.
○ Must be willing to pay income tax here in the Philippines
 QUALIFIED TO PRACTICE

● ROAD CIRCUITING SURGEONS are foreign doctors who

came to operate and would leave their patient in the care of
other surgeons.
 QUALIFIED TO PRACTICE

● As to the SCOPE OF THE PRACTICE: ● As to NUMBER:

A. General practice A. Individual practice
B. Specialist practice B. Group practice
Forms of group practice:
● As to VENUE OF PRACTICE: - Employer-employee relationship
A. Clinic practice - Partnership
B. Hospital practice - Corporation
 Physicians’
Code of Ethics
05
 ARTICLE I
GENERAL PRINCIPLES
● Section 1. The primary objective of the practice of medicine is service to mankind
irrespective of race, age, disease, disability, gender, sexual orientation, social standing,
creed or political affiliation. In medical practice, reward or financial gain should be a
subordinate consideration.
● Section 2. On entering the profession, a physician assumes the obligation of maintaining
the honorable tradition that confers the well deserved title of a “friend of mankind”.
The physician should cherish a proper pride in the calling and conduct himself/herself in
accordance with this Code and in the generally accepted principles of the International
Code of Medical Ethics.
● Section 3. Physicians should fulfill the civic duties of a good citizen, must conform to the
laws and cooperate with the proper authorities in the application of medical knowledge for
the promotion of the common welfare.
 ARTICLE I
GENERAL PRINCIPLES
● Section 4. Physicians should work together in harmony and mutual respect.
● Section 5. Physicians should cooperate with and safeguard the interest,
reputation and dignity of paramedical and other health professionals.
● Section 6. Physicians should be upright, diligent, sober, modest and well
versed in both the science and the art of the profession.

● Section 7. The promotion and advancement of the health of the patients

should be prioritized over the benefits of the physicians and the health
products industries.
 ARTICLE II
DUTIES OF PHYSICIANS TO THEIR PATIENTS

● Section 1. A physician should be dedicated to provide competent medical care with full
professional skill in accordance with the current standards of care, compassion,
independence and respect for human dignity.
● Section 2. A physician should be free to choose patients.
● Section 3. In an emergency, provided there is no risk to his or her safety, a physician
should administer at least first aid treatment and then refer the patient to the primary
physician and/or to a more competent health provider and appropriate facility if necessary.
 ARTICLE II
DUTIES OF PHYSICIANS TO THEIR PATIENTS

● Section 4. In serious/difficult cases, or when the circumstances of the patient or the family
so demand or justify, the attending physician should seek the assistance of the
appropriate specialist.
● Section 5. A physician should exercise good faith and honesty in expressing opinion/s
as to the diagnosis, prognosis, and treatment of a case under his/her care. A physician shall
respect the right of the patient to refuse medical treatment.
 ARTICLE II
DUTIES OF PHYSICIANS TO THEIR PATIENTS

● Section 6. The physician should hold as sacred and highly confidential whatever may be
discovered or learned pertinent to the patient even after death, except when required in the
promotion of justice, safety and public health.

● Section 7. Professional fees should be commensurate to the services rendered with due
consideration to the patient’s financial status, nature of the case, time consumed and the
professional standing and skill of the physician in the community.
 ARTICLE III
DUTIES OF PHYSICIANS TO COMMUNITY

● Section 1. A physician should cooperate with the duly constituted health authorities in
the education and enforcement of laws and regulations for the promotion of health.
● Section 2. A physician shall assist the government in the administration of justice in
accordance with law.
● Section 3. A physician is encouraged to expose and report to the proper authorities
unlicensed medical practitioners, charlatans and quacks in as much as their nefarious
practices may cause injury to health and life.
 ARTICLE III
DUTIES OF PHYSICIANS TO COMMUNITY

● Section 4. A physician shall not employ agents in the solicitation and recruitment of
patients. For the promotion of medical practice, a physician may use professional cards,
classified advertising, publications, internet, directories and signboards. Signboards shall
not exceed one by two (1x2) meters in size. Except in internet web sites, only the name of
the physician, field of specialty, office hours or office or residential addresses may appear.
● Section 5. A physician involved in multi media must be well informed of the matter
under discussion. Only the name of the physician and membership to a society or
institution may be mentioned or posted.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION
● Section 1. A physician shall waive his professional fees to a colleague, his or her spouse,
children and parents who are financially dependent on him.
● Section 2. When necessary, the attending physician should always seek consultation from an
available appropriate specialist.
● Section 3. The primary and consultant physicians should always observe the proper protocol of
the referral system. The consultant may make another referral but should seek permission from
the primary physician.
● Section 4. With the consent of the patient, in cases where a physician has to suspend service
during temporary absences, the substitute physician shall treat the patient with the same
dedication and quality of care extended to his/her own patient.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION
● Section 5. Whenever a physician makes a social or business call on a patient under the care of another,
making comments pertaining to the case is unethical unless if an emergency arises.
● Section 6. Whenever there is an irreconcilable difference of opinion in the management of a case, the
matter should be referred to the Philippine Medical Association or the specialty society concerned.
● Section 7. Members of the editorial board of medical journals should possess adequate qualifications.

● Section 8. A physician shall not receive any commission for referring patients to a colleague, third
person or institution.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION
● Section 9. A physician is encouraged to report to the Philippine Medical Association or the Board of
Medicine personal knowledge of any corrupt or dishonest conduct of the members of the profession.
● Section 10. Continuing medical education conferences and professional meetings must contribute to
improve and optimize patients care or address the educational needs of the targeted medical audience.
They must be organized by a medical society on its own or in cooperation with sponsoring entities.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION

● Section 11. Funds from commercial sources may be accepted for the benefit of the association or
society.
● Section 12. Physicians may accept reasonable subsidies from health and other industries to support
their participation in CME events.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION

● Section 13. The faculty/speaker/consultant of conferences or meetings is allowed to accept from

health industries honoraria and reimbursement for reasonable transportation, lodging and meal
expenses.
● Section 14. Scholarships for physicians and medical students are permissible as long as the selection
of scholars are made by the organizers or academic institutions concerned.
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES
AND TO THE PROFESSION

● Section 15. Generic names shall be used during the course of CME activities. However, after the
lectures, the sponsoring entity may promote or indicate their branded products.

● Section 16. When commercial exhibits are part of the overall program, arrangements for these should
not influence the planning nor interfere with the CME activities. Only relevant information of the
product should be included in the exhibit area.
 ARTICLE V
DUTIES OF PHYSICIANS TO ALLIED PROFESSIONALS

● Section 1. Physicians should never pay nor receive commission to or from any allied health
worker for cases referred.
 ARTICLE VI
RELATIONSHIP OF PHYSICIANS WITH THE HEALTH
PRODUCT INDUSTRY

Section 1. The physician shall not derive any form of material gain from product
samples.

Section 2. Physicians may participate in post-marketing or similar activities where they

are asked to try new products on patients provided that the patients are properly informed
and have given their informed consent.
 ARTICLE VI
RELATIONSHIP OF PHYSICIANS WITH THE HEALTH
PRODUCT INDUSTRY
● Section 3. Only gifts of reasonable value that primarily entail benefit to patient care or
related to physicians’ work may be accepted by a physician from a health product company.
● Section 4. Physicians may request donations for a charitable purpose for as long as it does
not redound to his or her personal benefit.
● Section 5. Research activities shall be ethically defensible, socially responsible, and
scientifically valid.
● Section 6. Research trials conducted by physicians for an industry should be done in
accordance with the national or institutional guidelines for the protection of human subjects.
 ARTICLE VII
AMENDMENTS

● Section 1. The Board of Governors of the Association, upon

recommendation of the Commission on Ethics may amend or repeal
this code by a 2/3 vote of the members of the Board. Amendments
shall be subsequently ratified by the General Assembly following the
approval by the Board.
Universal Health
Care Law 06
Philippine 1987 Constitution

“Health is a right of every Filipino citizen and

the State is duty-bound to ensure that all
Filipinos have equitable access to effective
health care services”
 “Deliberate attention to the
needs of millions of poor
Filipino families which
comprise the majority of our
population”
THE PHILIPPINES HEALTHCARE
SYSTEM
● Public Sector:
○ Service devolved to local government units
● Private Sector:
○ More doctors are in the private sector
○ Almost the same number of hospitals and hospital neds
between public and private sectors
 UTILIZATION OF HEALTH FACILITIES

Health Facility Type %

Government 50%
Private 42%
Traditional Healer 7%

Common health seeking reasons:

● Illness or Injury 68%
● Medical Check-up 28%
● Dental Care 2%
● Medical Requirement 1%
 Strategy #1
Ensure that each family has assigned competent primary health care
provider

Strategy #2
Produce health professionals that are responsive to the current needs
of the health sector

Strategy #3
Manage the exit or re-entry
Health Coverage in the Philippines
● 1960s: Medical Care Commission, implemented for the employed
and their families, hospitalization benefits only

● 1995: National Health Insurance Program with Philippines Health

Insurance Corporation as implementing agency, Phase 1 for the
employed and their dependent, Hospitalization initially, the with
selective outpatient package: plus sponsored members
Distribution of Health Expenditure by Source of Funds
National Health Insurance Program and
the Philippine Health Insurance
Corporation

SONA-July 26,2010

“According to the National Statistics Office, 38% of

Filipinos have Philhealth coverage”
● Improved public health service such as Philhealth for all
within three years

–President Aquino’s Inaugural Speech

● To enroll the poorest 5,000,000 Filipino families with

Philhealth
–President Aquino’s State of the Nation Address
 UNIVERSAL HEALTH CARE

● Improve financial risk protection through improvements in NHIP benefit

delivery
● Achieve health-related Millennium Development Goal-Max (MDGmax)
target
● Improve access to quality health care facilities
● Attain efficiency by using information technology
● More aggressive promotion of healthy lifestyle
 Best Practices for Health Human Resource
Development Initiatives

● University of the Philippines Manila School of Health Sciences

(1976)
○ Ladderized curriculum-student can become midwife, nurse, doctor with
service leave in between
○ Students nominated by the communities
○ Do not pay tuition fees, given allowance
○ To serve for 2 years for every year of education
○ Retention rate of 85-90% Now with 3 campuses
Best Practices for Health Human Resource
Development Initiatives

Department of Health
○ Doctor to the Barrios Program (1995)-doctors recruited for underserved,
doctorless communities, serve for 2 years, with financial incentives and
CME activities
○ Pinoy MD-scholarship for doctors who are required to serve for two years
for every year education
○ Midwifery Students Scholarship Program-midwives to serve for two
years for every year of education
○ RNHeals-10000 nurses to be fielded to train community health teams
 KALUSUGANG PANGKALAHATAN

● KP as an Operational Solution

● Convergence of Three Strategic

Thrusts to serve poor families
 KALUSUGANG PANGKALAHATAN

● Analysis Problem
○ Neither Government subsidy nor the NHIP have
adequately protected the poor from financial risk
○ The poor have limited access to quality outpatient (RHUs)
or Inpatient (Hospital) Facilities
○ Current public health effort may not meet MDG
commitments by 2015, especially those related to maternal
and child health
 THE DOH GOALS

● Financial Risk Protection

○ Enroll 5.2 million families (Q1) identified by NHTS-PR under
the PhilHealth Sponsored Program—DONE
○ Train and deploy 10,000 RNHeals nurses as trainers and
supervisors to capacitate community-level health workers—
ONGOING
○ Secure drugs, medicines and supplies for DOH-retained
hospitals serving NHTS-PR families for implementation of
NBB policy—ONGOING
 THE DOH GOALS

● Health Facilities Enhancement

○ Upgrade DOH-retained hospitals, provincial hospitals, district
hospitals and RHUs to ensure access to better-quality inpatient
and outpatient care for NHTS-PR families—ONGOING
○ Procure and distribute treatment packs for hypertension and
diabetes to RHUs for the use of 4Ps beneficiaries —DONE
 THE DOH GOALS

● Attaining Health-related MDGs

○ Procure and distribute health commodities to RHUs serving
4Ps beneficiaries— ONGOING
○ Deploy Community Health Teams—ONGOING
 PHILHEALTH MEMBERSHIP

● Aim for 100%

● Sponsored Program Coverage to be sustained
● Coverage of the Rest of the Informal Sector
○ Revive organized group enrollment
● Educating the Sponsored and Informal Sector Members
○ RNHeals
○ Family Development Seminar with DSWD
 HEALTHCARE PROVIDERS

● Facilitate accreditation of Autonomous Region of Muslim

Mindanao facilities and MDG benefit provider
● Incentive package for health providers
● Facilitaite investments in innovative health care providers such
as specialty surgical hospitals
● Maximize use of information technology with POLICIES on
Health data dictionaries, AND security and privacy of health
data dissemination
 BENEFITS FOR MEMBERS
● Total Shift to Case Payment
● CONSIDER Differential case payments based on facility type,
remoteness, incentive for quality
● Intensify implementation of No Balance Billing for the SPONSORED
PROGRAM in GOVERNMENT HOSPITALS
● Improved OPB now to be called the PRIMARY CARE BENEFIT
○ Gate-Keeping!
○ Continue support for innovative models like the Bukidnon model
○ Open to all types of healthcare providers complying with accreditation
requirements
 BENEFITS FOR MEMBERS

● Supplemental health insurance benefits for government

employees
● Catastrophic fund in collaboration with President’s social fund,
PCSO, PAGCOR etc.
● Closer collaboration with HMOs to simplify PhilHealth
availment of Philhealth members who are also HMO members