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On the road to universal health care

SPMC J Health Care Serv. 2016;2(1):5 ARK: http://n2t.net/ark:/76951/jhcs2q3yy4

Leopoldo J Vega1


1Office of the Medical Center Chief, Southern Philippines Medical Center, JP Laurel Ave, Davao City, Philippines


Correspondence Leopoldo J Vega, coh.spmc@gmail.com
Received 3 June 2016
Accepted 13 September 2016
Cite as Vega LJ. On the road to universal health care. SPMC J Health Care Serv.. 2016;2(1):5. http://n2t.net/ark:/76951/jhcs2q3yy4


The Medical Director of Southern Philippines Medical Center reports on the hospital's contributions towards attaining universal health care.



Southern Philippines Medical Center (SPMC) has gone through a positive change. We have taken the challenge of pursuing the Universal Health Care (UHC) or Kalusugan Pangkalahatan (KP) agenda of the Department of Health,1 which aims to improve access to quality health care services among Filipinos, especially those in the lower socioeconomic strata. As the Medical Director of SPMC, I have always been confident in accepting this challenge, since the agenda is perfectly aligned with our mission to provide equitable and affordable health care services.


Financial risk protection through health care insurance is the cornerstone of UHC.2 SPMC has documented a steady increase in Philippine Health Care Insurance Corporation (PhilHealth) coverage rate among the patients that we saw, from 32.02% in 2009 to 82.18% by the end of 2015. We have subsidized the health care costs of 82,719 patients through the PhilHealth no-balance-billing (NBB) scheme3 from 2014 up to mid-2016. This hospital subsidy has been increasing since 2014, with a mean annual cost of PHP 188M in 2014 to 2015, or 34% of the mean annual actual health care cost for the patients on NBB during those years. From 2012 to 2015, a total of 155 patients in SPMC have also availed of the PhilHealth Z-Benefit Packages for illnesses and procedures with exceptionally high costs of health care (i.e., breast cancer, acute lymphocytic leukemia, coronary arterial bypass graft, ventricular septal defect, tetralogy of Fallot, and kidney transplant).4 We have also implemented the PhilHealth Point of Care (POC) enrolment program5 in SPMC. So far, we have purchased the health insurance premiums of 24,472 patients since the start of the POC enrolment implementation in 2013 up to the end of 2015. Finally, through the SPMC Medical Assistance Program (MAP), we have spent a total of PHP 178M to cover the health care costs of 72,238 patients who availed of the program benefits from 2014 to 2015.


We envision for SPMC to be a “world-class, service-oriented medical center”. I believe that, in pursuing the UHC agenda, we are given the opportunity to realize the practical purpose of our vision—to play a major role in delivering world-class health services to the poor and disadvantaged.



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Acknowledgments

I would like to thank Ms Maria Levy Grace M Figura, Ms Amelita M Lorejo RN, MPA, Ms Elsa Macabingkil, Dr. Federico Fuente, Ms Lucille B De Guzman, Ms Ivy Jean M Esaga, Ms Rhialyn Dumaquita, Ms Lani P Paler, Dr Maria Elinore Alba-Concha, and Mr Clarence Xlasi Ladrero for their invaluable contributions to the contents of this article.


Article source

Commissioned


Peer review

External


Competing interests

None declared


Access and license

This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial 4.0 International License, which allows others to share and adapt the work, provided that derivative works bear appropriate citation to this original work and are not used for commercial purposes. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/


References

1. Department of Health. The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos, Department of Health Administrative Order 2010-0036 (16 Dec 2010).


2. Saksena P, Hsu J, Evans DB. Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges. PLoS Med. 2014;11(9).


3. PhilHealth. New PhilHealth Case Rates for Selected Medical Cases and Surgical Procedures and the No Balance Billing Policy, PhilHealth Circular 11-2011 (5 Aug 2011).


4. PhilHealth. Governing policies on PhilHealth benefit package for Case Type Z, PhilHealth Circular 29-2012 (14 June 2012).


5. PhilHealth. Implementation of the Point of Care Enrollment Program, PhilHealth Circular 32-2013 (7 Nov 2013).


Copyright © 2016 Vega LJ.

     

Published
September 24, 2016

Issue
Volume 2 Issue 1 (2016)

Section
Perspective