Interview: Hector Thomas Navasero
In terms of data privacy, how well protected is the industry against cyberattacks on medical devices?
HECTOR THOMAS NAVASERO: There is a significant lack of adequate data privacy infrastructure in the Philippines. As a result, many companies keep their databases and cloud storage systems in Singapore. However, most government hospitals do not even have proper electronic medical record platforms, but rather physical files.
Thus, there is not enough data to store in the cloud because the data is not digital. Hospitals could easily use business process outsourcing to digitise their data, but we have not seen that happen. Once hospitals digitise, they can begin to use more advanced devices, saving the health care industry a lot of time.
What should be the investment priorities for the Department of Health (DOH) in 2018, given that they just received their highest ever budget?
NAVASERO: The DOH should focus on improving primary care, as this would lower the total cost of the sector. Hospitals have quotas, so if a patient shows up the hospital will try to get them in a room and then charge their insurance company. This often leads to overcharging because the patient is beholden to the hospital. For example, it only costs eight pesos ($0.16) to conduct a haematology reagent test, but hospitals are charging 150 pesos ($2.97) to poor farmers.
There are also not nearly enough outpatient primary care facilities or general primary care doctors. If you get sick you will go straight to a specialist, which is expensive. The DOH should also focus on rural areas: while it is easy to build infrastructure there are simply not enough doctors in the countryside. However, telemedicine could give immediate assistance to rural patients, as could mandating that medical students complete part of their residencies in the provinces. Lastly, the country has a great need for genetics research, as this can give way to more specific low-cost drugs, which can reduce the costs for end users across all socio-economic classes.
In what ways can the market be made more open and attractive to foreign investment?
NAVASERO: In the area of pharmaceuticals, the Philippines should actually put up a barrier to foreign participation to help Filipino companies improve their drug manufacturing capacities. Currently, the Philippines is very open to foreign pharmaceutical companies. This could be a big problem because most of these drugs are not manufactured in the Philippines, whereas countries such as Thailand, Indonesia and Vietnam have foreign manufacturing plants in their country. Also, it is currently much cheaper for the Philippines to import generic drugs, particularly from India.
This poses a national security issue, if a natural disaster strikes and we cannot import pharmaceuticals, we will not have sufficient access to medicine. Furthermore, the Food and Drug Administration does not have enough funding to regulate foreign pharmaceuticals, so we can never be certain that imported drugs are completely safe or within their expiration date.
How effective have micro-insurance plans been in providing universally affordable coverage?
NAVASERO: Micro-insurance plans are a good shortterm fix, but they are just small monthly payments. If the companies providing these plans are small, they will not survive, whereas large companies have a better chance because they can take more risk. Under the leadership of Francisco Duque, the DOH is focusing heavily on improving the Philippine Health Insurance Corporation (PhilHealth). As it stands now, PhilHealth cannot truly provide all the needs of the average worker. As a result, many private insurance companies are coming into play, but this is very difficult to regulate. PhilHealth gets better every year, but it still needs a lot more money. Hopefully we will see more preventive medicine so that the PhilHealth budget does not have to increase dramatically. The real solution is to improve primary care, rural health care provision and hospice care.
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