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The Health System We Aspire For Filipinos, especially the poor, marginalized, and vulnerable are protected from high cost of health care FINANCIAL PROTECTION Filipinos attain the best possible health outcomes with no disparity BETTER HEALTH OUTCOMES Filipinos feel respected, valued, and empowered in all of their interaction with the health system RESPONSIVENESS GOALS 2 2000 Every year, around 2000 mothers die due to pregnancy-related complications. Persistent Inequities in Health Outcomes Three out of 10 children are stunted. A Filipino child born to the poorest family is 3 times more likely to not reach his 5th birthday, compared to one born to the richest family. 5 Restrictive and Impoverishing Healthcare Costs Every year, 1.5 million families are pushed to poverty due to health care expenditures Filipinos forego or delay care due to prohibitive and unpredictable user fees or co-payments Php 4,000/month healthcare expenses considered catastrophic for single income families Tiisin ko na lang ito.. 6 Poor quality and undignified care synonymous with public clinics and hospitals Long wait times Less than hygienic restrooms, lacking amenities Poor record-keeping Overcrowding & under-provision of care Privacy and confidentiality taken lightly Limited autonomy to choose provider 7 Goals: Attain Health-Related SDG Targets Financial Risk Protection, Better Health Outcomes, Responsiveness Values: Equity, Efficiency, Quality, Transparency A C H I E V E ATTAIN HEALTH-RELATED SDG TARGETS Financial Risk Protecti n | Bett r Health Outcomes | Responsiveness Values: Equity, Quality, Efficiency, Transparency, Accountability, Sustainability, Resilience 3 Guarantees UNIVERSAL HEALTH INSURANCE SERVICE DELIVERY NETWORK ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE GUARANTEE #1 Services for Both the Well & the Sick Guarantee 1: All Life Stages & Triple Burden of Disease COMMUNICABLE DISEASES DISEASES OF RAPID URBANIZATION & INDUSTRIALIZATION NON- COMMUNICABLE DISEASES & MALNUTRITION Pregnant Newborn Infant Child Adolescent Adults Elderly First 1000 days | Reproductive and sexual health | maternal, newborn, and child health | exclusive breastfeeding | food & micronutrient supplementation | Immunization | Adolescent health | Geriatric Health | Health screening, promotion & information 12 Guarantee 2: Services are delivered by networks that are ENHANCED BY TELEMEDICINE AVAILABLE 24/7 & EVEN DURING DISASTERS PRACTICING GATEKEEPING COMPLIANT WITH CLINICAL PRACTICE GUIDELINES LOCATED CLOSE TO THE PEOPLE (Mobile Clinic or Subsidize Transportation Cost) FULLY FUNCTIONAL (Complete Equipment, Medicines, Health Professional) 15 UNIVERSAL HEALTH INSURANCE GUARANTEE #3 Financial Freedom when Accessing Services •No balance billing for the poor/basic accommodation & Fixed co-payment for non-basic accommodation • Expand benefits to cover comprehensive range of services • Contracting networks of providers within SDNs Guarantee 3: Services are financed predominantly by PhilHealth PHILHEALTH AS MAIN REVENUE SOURCE FOR PUBLIC HEALTH CARE PROVIDERS SIMPLIFY PHILHEALTH RULES PHILHEALTH AS THE GATEWAY TO FREE AFFORDABLE CARE • 100% of Filipinos are members • Formal sector premium paid through payroll • Non-formal sector premium paid through tax subsidy 17 1. Raise more revenues for health, e.g. impose health- promoting taxes, increase NHIP premium rates, improve premium collection efficiency. 2. Align GSIS, MAP, PCSO, PAGCOR and minimize overlaps with PhilHealth 3. Expand PhilHealth benefits to cover outpatient diagnostics, medicines, blood and blood products aided by health technology assessment 4. Update costing of current PhilHealth case rates to ensure that it covers full cost of care and link payment to service quality 5. Enhance and enforce PhilHealth contracting policies for better viability and sustainability C Cover all Filipinos against health-related financial risk H Harness the power of strategic HRH development 1. Revise health professions curriculum to be more primary care-oriented and responsive to local and global needs 2. Streamline HRH compensation package to incentivize service in high-risk or GIDA areas 3. Update frontline staffing complement standards from profession-based to competency-based 4. Make available fully-funded scholarships for HRH hailing from GIDA areas or IP groups 5. Formulate mechanisms for mandatory return of service schemes for all heath graduates 1. Mandate the use of electronic medical records in all health facilities 2. Make online submission of clinical, drug dispensing, administrative and financial records a prerequisite for registration, licensing and contracting 3. Commission nationwide surveys, streamline information systems, and support efforts to improve local civil registration and vital statistics 4. Automate major business processes and invest in ware- housing and business intelligence tools 5. Facilitate ease of access of researchers to available data I Invest in eHealth and data for decision-making 1. Harness and align the private sector in planning supply side investments 2. Work with other national government agencies to address social determinants of health 3. Make health impact assessment and public health management plan a prerequisite for initiating large-scale, high-risk infrastructure projects 4. Collaborate with CSOs and other stakeholders on budget development, monitoring and evaluation E Elicit multi-sectoral and multi-stakeholder support for health ATTAIN HEALTH- RELATED SDGs UNIVERSAL HEALTH INSURANCE SERVICE DELIVERY NETWORK Financial Risk Protection Better Health Outcomes Responsiveness ALL LIFE STAGES & TRIPLE BURDEN OF DISEASE