UCHP experts push reforms amid out-of-pocket health spending

Unilab Center for Health Policy (UCHP) – a program of Unilab Foundation (ULF) -- recently released two research papers which indicated the need for reforms in public health expenditure, including the state insurer’s benefit payments system, to lower the Filipinos’ out-of-pocket medical expenses.

In the first study conducted by Prof. Orville Solon, former Dean of the UP College of Economics, former Prof. Alejandro Herrin, and Dr. Michael Mo, the experts looked into the Philippine National Health Accounts (PNHA) from 1991 to 2022 to see the trends and impacts of government reforms to improve health spending.

The PNHA is being collected annually since 1991, although this is the first instance where a time-analysis for 30 years (1991-2022) is made.

“The National Health Accounts is a rich resource of information; and seeing how our actions and decisions impact the Filipino household is important in calibrating policies and programs”, said Dr. Enrique Ona, Chairman of the Advisory Council of the UCHP and a former Health Secretary.

The results of the 30-year health data were unveiled in an executive symposium attended by representatives from the national government, local governments, Congress, health care providers, patients’ groups, and other key stakeholders in the health sector last August 2 at the Sheraton Manila Bay.

This is part of UCHPs commitment to provide the forum for an exchange of ideas for better implementation of the country’s Universal Health Care policy.

The review showed that total health expenditure (THE) increased in nominal terms from only P40.3 billion pesos in 1991 to P1.1 trillion pesos in 2022, or an average yearly growth of 10.95 percent, which is comparable with other economies in the ASEAN.

“However, after correcting for inflation or what we call real terms, health spending grew by an average of 5.84 percent per year. But considering that the population grew from 62 million in 1991 to 112 million in 2022, health spending for every Filipino increased by an average of 3.90% every year,” the researchers said.

The study showed that the increase in spending is indicative that reforms such as earmarking of sin tax revenues contribute to the steady rise in government spending. The national and local governments contribute about 30 percent to the THE.

Still, private out-of-pocket payments (OOP) have been consistently the biggest component of healthcare spending through the years.  In 2022, for instance, OOP accounts for 45 percent of the country’s total health expenditure. Studies indicate that Filipinos spend more for inpatient care than outpatient services. Thus, efforts to decreasing OOP should be directed at reducing expenses for inpatient care.

A step toward the right direction in addressing this is the DoH’s initiatives of opening Bagong Urgent Care at Ambulatory Centers (BUCAS) across the country, as this will not only address physical accessibility but financial accessibility as well.

The government also intends to open several Super Health Centers to augment the health delivery system.