Interview: Paulyn Jean B Rosell-Ubial
In what ways can the Philippine health agenda serve to bridge accessibility gaps in the country?
PAULYN JEAN B ROSELL-UBIAL: The Philippine Health Agenda 2016-2022 was crafted to address the gaps in the current health care system to ensure universal access to quality services across the continuum of care and all life stages. Our agenda also looks at disparities in the health system between geographic locations and prioritises areas where the most disadvantaged populations are located. Looking at several health indicators, we have identified three major interventions to address existing disparities in the Philippine health care system.
First is ensuring and strengthening universal health insurance coverage through the Philippine Health Insurance Corporation, or PhilHealth. Being a Filipino will be synonymous with being a PhilHealth member. We aim to change the current benefit structure by crafting packages that contain a list of guarantees or services that every Filipino can conveniently access for free. Health financing structures and mechanisms will also be streamlined, and resources augmented to gain leverage and strengthen the purchasing power of PhilHealth. The goal is to make the social health insurance scheme more efficient and equitable, to provide true financial risk protection through either strict enforcement of the “No Balance Billing” for guaranteed packages or fixed co-payment for non-basic accommodation Second, we will strengthen the service delivery networks and improve access by bringing services closer to the people. This will facilitate early diagnosis and treatment of diseases at the barangay (village) level, and consequently allow for the referral of more complex diseases to hospitals for timely management. We are also considering the employment of patient navigators to accompany patients through the referral system, as well as tapping PhilHealth or the Department of Social Welfare and Development to cover the transportation costs of patients to the health facilities. Third is achieving better health outcomes by protecting Filipinos from the triple burden of disease: communicable diseases, non-communicable diseases and emerging or re-emerging diseases. This goal will be attained by ensuring that all primary care facilities are sufficiently equipped and capable of providing what are identified as the basic set of services for all life stages. We have developed benefits packages for essential health services at every level of delivery. The Department of Health also knows the importance of health promotion and the impact of the social determinants of health.
How can the imbalance of human capital between Metro Manila and the provinces be addressed?
ROSELL-UBIAL: Our health agenda aims to expand access to the provinces and disadvantaged groups, while also striving to develop human resources to meet the ideal health worker-to-population ratio. We have studied the Cuban health system and found that in terms of infrastructure and facilities, our countries are not far apart. The key advantage of Cuba is that they have one doctor for every 1000 citizens, and it is this ratio that allows for early detection and management of diseases in the community. In the Philippines, the current ratio of rural health care workers to the population is 1:33,000. The target for the country will be to have one health worker in every barangay. To entice more doctors and health practitioners to render services in geographically isolated and disadvantaged areas, greater compensation or incentives will be offered should they choose to work in these areas compared to those who opt to practice in urban centres.
Moreover, as we do not produce enough doctors to meet demand, we are looking to rely on other health professionals, such as nurses and midwives, who have proper training in providing adequate primary care to communities. We are also planning to fund scholarships in medicine and are considering shortening the medical curriculum to six years, as well as scholarships for allied medical professionals based on need in the rural areas.
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