UHC Powerpoint Presentation (Secretary Ona)

7/31/2019 UHC Powerpoint Presentation (Secretary Ona)

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Demographic

Characteristics

Population, total (millions) 94,013,200 (projected, NSO2007)

Population < 25 years(% of total population)

52.8 % (projected, NSO 2007)49,617,400 M Filipinos

Population > 60 years(% of total population)

6.7% (projected, NSO 2007)6,637,100 M Filipinos

Birth rate(births per 1,000population)

23.4 (NDHS 2008)2,162,303 live births per year

Death rate 5.48 (NSO 2007)


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Top Ten Causes of Mortality

Cause Total Rate1. Diseases of the heart 70, 861 84.8

2. Diseases of the vascularsystem

51,680 61.8

3. Malignant Neoplasms 40,524 48.9

4. Accidents 34,483 41.3

5. Pneumonia 32,098 38.4

6. Tuberculosis 26,770 31.0

7. Unclassified 21,278 25.5

8. Chronic lower respiratorydiseases

18,975 22.7

9. Diabetes mellitus 16,552 19.8

10. Conditions originating

from the perinatal period

13,180 15.8

Philippine Statistical Yearbook, 2009


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UN Millennium DevelopmentGoals

Source:MDG Monitor: Quick Facts(accessed 10/11/2010)
http://www.mdgmonitor.org/country_progress.cfm?c=PHL&cd=608http://www.mdgmonitor.org/country_progress.cfm?c=PHL&cd=608


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6

INDICATORS 2015 Target ACCOMPLISHMENT

MDG 6

Prevalence of HIV/AIDS among high risk groups


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Mortality Trend: Communicable Diseases,

Malignant Neoplasms & Diseases of the HeartRate/ , Population111111

Philippines, -11111111

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Year

Communicable Diseases

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Malignant Neoplasms &

Diseases of the Heart

Communicable Diseases

Malignant Neoplasms

Diseases of the Heart

Source: Philippine Health Statistics, 2005


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Despite the gains inprevious health

reforms, disparities inhealth outcomes

persist


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IMR and U5MR by Region, 2008

NDHS, 2008


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IMR and U5MR by WealthQuintile, 2008

NDHS, 2008


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Maternal Mortality Rate by Region,Philippines, 2005

1 11 111 111 111

NCRCAR

IlocosCagayan Valley

Central LuzonCALABARZON

MIMAROPABicol

Western VisayasCentral VisayasEastern Visayas

ZamboangaNorthern Mindanao

DavaoSOCCSKSARGEN

CaragaARMM

Philippines

Mortality Rate

Source: PHS, 2005Source: PHS, 2005


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Inequities in access and

utilization of healthservices remain.


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Filipino Income Quintiles

Monthlyincome

Families perquintile

Q1

3,460 5,218,267

Q2 6,073 4,094,164

Q3 9,309 3,912,443Q4 15,064 3,707,494Q5 38,065 3,485,067

Source: National Health and DemographicSurvey, 2008


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Who takes care of the poor?

Sources: NSO and ORC Macro, 2003


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Births by wealth quintile, 2008


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These inequities inhealth can be explained

by insufficient financialresources directed

towards health.


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Year

Share of health expenditure

per GNP

Source: Philippine National Health Account, 2005-2007

Total health expenditure = P234.3 B or 3.2 percent of GNP


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ppine National Health Accounts, 1997

Total Health Expenditure is

PhP 87.1B (3.6% of GDP)

Philippine National Health Accounts,

Total health

expenditure is P234.3B (3.2 percent of GDP)

National

Governme

nt

%11

Local

Governme

nt

%11

Social

Health

Insurance

%1

Out-of-

Pocket

%11

Others

%11

Sources of Funds

Source of funds for Health,1997 and 2007


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Social health insurance

has yet to providesignificant financial riskprotection


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PhilHealth

Article 2, Section 2, R.A. 7875 asamended: Compulsory Coverage All citizens of the Philippines shall

be required to enroll in the NationalHealth Insurance Program in order toavoid adverse selection and social

inequity


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PhilHealth

Adequate enrolment of the governmentand private sector employed sectors

Insufficient effort in the enrolment of theindividually paying members

Sponsored program used as tool ofpolitical patronage with mixed results: Increased awareness among the indigents

of social health insurance

Erratic and unsustainable coverage (mostly1 year)

Difficulties in data gathering for coverageand entitlement


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Health Insurance coverageby wealth quintile, 2008


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Shortcomings in healthfinancing have resulted in

out of pocket expenses asthe primary source of

health expenditure.Out of pocket expenditure

has been the rate limiting

step of many of ourcountrymen in availinghealth services


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Due to scarcity of

financial resources andfragmentation of health

services as aconsequence ofdevolution, our healthfacilities have suffered

neglect


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Universal Health Care

Deliberate attentionto the needs ofmillions of poor

Filipino familieswhich comprise themajority of our

population


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Comprehensive Reforms inHealth


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Better health

outcomes

Responsive health

system

Equitable health

financing

Health Financing ServiceDelivery

Policy, standards andregulationHealth Human

Resource

Health

Information

Governance for Health


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Priority Health Policy


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Priority Health PolicyDirections of the Aquino

Administration1. A roadmap towards universal health carethrough a refocused PhilHealth;

2. Particular attention to the construction,rehabilitation, and support of health facilities:

LGU/regional hospitals, rural health units barangay health stations

1. Attainment of Millennium Development Goals 4,5, and 6 Reduction of maternal, neonatal, and infant mortality Support to contain/eliminate age old pubic health

diseases (malaria, dengue, TB)


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1. Redirecting PhilHealth

operations towards theimprovement of the nationaland regional benefit delivery

ratios2. Expanding enrollment of the

poor in the NHIP


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3. Promoting the availment of

quality outpatient and inpatientservices through reformedcapitation and no balance

billing arrangements forsponsored members

4. Increasing the support value of

health insurance for the poor


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3. Fiscal autonomy and incomeretention schemes for

government hospitals and healthfacilities;

4. Unified and streamlined DOH

licensure and PhilHealthaccreditation for hospitals andfacilities; and

5. Regional clustering of referral


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Deploying Community HealthTeams;

Utilizing the life course approach inproviding needed services

family planning

ante-natal care

delivery in health facilities

essential newborn and immediatepostpartum care; and

Garantisadong Pambata package for


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Redirecting PhilHealth

Paradigm shift in the implementation of NHIP: Expansion of NHIP coverage

Enrollment of the poorest of the poor

Enforce mandatory enrolment of the informal

sector (as per the National Health Insurance Act,R.A. 7875 as amended)

Improvement of membership services toincrease awareness of PhilHealth benefits

and entitlements Access to inpatient and outpatient services

through PhilHealth

Zero co-payment/No balance billing for health

care costs incurred for the poorest in


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Every Link in PhilHealthEvery Link in PhilHealth

Value Chain must work toValue Chain must work to

achieve financial riskachieve financial risk

protectionprotection

FINANCIALPROTECTION

PROVIDED TO THEPOPULATION

AccreditationEnrollmentClaims

AvailmentandProcessing

Insurance

Payments

Source: Joint DOH-PhilHealth Benefit Delivery Review (2010)


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Redirecting PhilHealth:Enrollment

Enforce mandatory PhilHealth coveragefor all Filipinos: Automatic enrollment of indigents

identified by the DSWD (lowest quintile)

Compulsory enrollment of members of theinformal sector, especially those who canafford to pay the premium

National government to pay for the

entire premiums of the poorest quintile National government local governmentsharing for the second poorest quintile


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Redirecting PhilHealth:Enrollment

Work with other government agencies toenforce mandatory PhilHealthmembership for all Filipinos:

School enrollment Licensing of business

Renewal of drivers license

Other government transactions

Work with the private sector to launchinnovative schemes in paying premiums(e.g. payment premium through SMS)


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Redirecting PhilHealth:Accreditation

Licensing and accreditation shall beunified to fast track accreditation ofmore health facilities in the country

Provisional accreditation for allgovernment health facilities toensure access of PhilHealth members

to health services Monitoring teams to check on needs

of health facilities for improvement


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Redirecting PhilHealth: ClaimsAvailment and Processing

PhilHealth IT upgrade to accelerateprocessing of claims


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Redirecting PhilHealth:Insurance Payments

Improve significantly support value from20% to 70% for all illnesses

Increase significantly the support valuefor catastrophic illnesses

Zero balance billing in all governmenthospitals for the identified indigents

Promote cost effectiveness: case-payment registration of the indigents under one GP National standard treatment guidelines in

all levels of health care

di i hil l h


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Redirecting PhilHealth:Insurance Payments

Determine realistic cost of care andmedical services in cooperation withthe medical community and other

stakeholders in health, guided byfairness and equity

Members shall have immediate

access to PhilHealth benefits uponregistration

Expand and roll-out outpatient

benefit package

R di i PhilH l h O h


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Redirecting PhilHealth: OtherSteps

Work with private healthmaintenance organizations (HMOs)and private health insurance in

complementing PhilHealth benefits

H lth F iliti


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Health FacilitiesEnhancement

Upgrading of health facilities: ruralhealth units, district hospitals,provincial hospitals, DOH Retained

hospital Improved facility preparedness for

trauma (4th leading cause of death)

Improved capacity of clinical/hospitalcare for the most common causes ofmortality and morbidity

Improve access to quality affordable

medicines


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H lth F iliti


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Health FacilitiesImprovement

Immediate repair and rehabilitationof selected DOH hospitals across thecountry in the next 6 months

Creation and deployment ofmonitoring teams for health facilitiesevaluation and improvement


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Public-Private Partnerships

Proposed projects:

IT system for DOH and PhilHealth

Philippine Orthopedic Center as Center

for Bone Diseases and Trauma Air ambulance project

Research Institute for Tropical Medicinefor commercial production of vaccines

San Lazaro Hospital as Center forInfectious Diseases


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Public-Private Partnerships

Commercial utilization of vacanthospital land assets

Establishment of Multi-SpecialtyCenters in selected regions (3) inNorthern Luzon, Visayas, andMindanao


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Regional Clustering

Clustering of health facilities composedof regional, hospitals and districthospitals as well as rural health unitsand health centers, to addressfragmentation of health services at locallevels by.

Establishment of Clustered Health

Boards composed of the Secretary ofHealth or his representative, local chiefexecutives, private partners, civilsociety/NGO for clustered health

facilities

Composition of Advisory


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Composition of AdvisoryBoard of Clustered Health

FacilitiesChairman: the Secretary of Health or hisrepresentative

Vice Chairman: Regional CHD or Hospital

DirectorMembers:

Local chief executives: Governors and

mayorsLegislators: Congressmen

Local health officials: PHOs and MHOs

Private Sector: civic and business leaders,

NGOs


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Attaining the MDGs

Ensure that poorest families arereached by priority public healthprograms

Deployment ofCommunity HealthTeams:

Packaging of services using the LifeCycle Approach Pre-pregnancy: Family Planning services

Pregnancy: Four ante-natal careservices and delivery in health facilities

(Emergency Obstetric and Neonatal


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Attaining the MDGs

Packaging of services using the LifeCycle Approach

Post partum: Essential newborn care

and immediate post partum care

Infancy/early childhood:Garantisadong Pambata


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Strategies for Public Health

More aggressive promotion ofhealthy lifestyle to prevent noncommunicable diseases: heart

disease, stroke, diabetes, obesity

Attention to emerging diseases

(Superbug, nosocomial diseases,A(H1N1), diseases brought about byclimate change)


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Strategies for Public Health

Inter-agency and inter-sectoralapproach for addressing publichealth concerns such as dengue:

DILG DepED

DENR

UP-NIH

RITM

Medical societies (PMA, PCP, PPS)


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ICT Tools for Health

Information and Communications Technologywill play a major part in ensuring universalhealth care is achieved as it can providequality and timely information to guide

decision making at all levels. Improvement of PhilHealth services will not

be attained with out efficient IT Tool support

Access of health to public health programs

as well as clinical services can be augmentedby ICT e.g. Telemedicine

Regional Clustering will be dependent oninformation sharing


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Human Health Resources

With reasonable compensation,adequate facilities and opportunitiesfor career growth most of our human

health resources will opt to remain inthe Philippines

Deployment and capacitating of

nurses to areas with high MMR, incoordination with the Department ofLabor and Employment and the local

government units


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Thank you

UHC Powerpoint Presentation (Secretary Ona)

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