Everything you need to know about Universal Healthcare Bill

In a special ceremony in Malacañang, President Rodrigo Duterte signed a law that seeks to provide health care for all Filipinos.

Speaking to members of the Philippines’ House of Representatives after signing the bill, Duterte said, “By automatically installing our citizens into the National Health Insurance Program and expanding health coverage to include free medical consultations and laboratory tests, the Universal health care law that I signed today will guarantee equatable access to quality and affordable healthcare services for all Filipinos.”

How do Filipinos benefit?

Filipinos will now be considered to possess “immediate eligibility” for and have access to the full spectrum of health care, which includes preventive, promotive, curative, rehabilitative, and palliative care for medical, dental, mental, and emergency health services.

Patients would be registered with a primary health care provider of their choice, for outpatient care, medicines, and laboratory tests. These will also be included in PhilHealth’s primary care benefits package.

Direct contributory members would also get more benefits as premiums increase. This is intended to encourage those who pay higher premiums and those who are voluntarily paying.

Membership rates would also gradually increase by .5% yearly, while income ceilings for contributions would go up by P10,000 per year.

Meanwhile, PhilHealth payments for local government unit (LGU) hospitals would be set aside in a special fund to improve the health facilities in LGUs.

Frequently Asked Questions for Universal Health Care (UHC)

1. What is UHC?
When we talk about UHC, we mean a system that inherently protects and saves all Filipinos – healthy, with risk factors, and already sick:

• That every Filipino has a healthy home, school or workplace, which allows him or her to choose a healthy lifestyle
• That every Filipino is matched to a primary care provide team -consisting of nurses, dieticians, midwives, and physicians alike -who ensures that health care services are delivered at the right place (outpatient, hospital setting), right time
• That every Filipino’s health spending is predictable and will not force them into financial ruin because adequate and effective safety nets are in place.

2. How does UHC Law help improve health care in the Philippines?

• The UHC Law will promote a shift to a primary care-focused health system for every Filipino. Thus in the next 3 years, the DOH will be stepping up public health programs and prioritizing investments in primary care facilities and health workers rendering primary care services. PhilHealth meanwhile will be expanding its primary care benefits program – increasing reimbursements for primary care services.

3. What do we mean when we say primary care-focused?
A primary care-focused health system means a system with trusted first and continuing point of contact (can be a physician or nurse) for Filipinos. The primary care provider will ri1nd1r needed general outpatient services and, if needed, refer them to the appropriate levels of care when needed. Over time, this will gradually address the problem of congestion in hospitals and will allow shorter waiting time for those who are in need of care

4. What is the significance of signing the UHC Law?
The UHC law is a historic landmark legislation. It took almost 30 years and many health secretaries to get to this point. The signing of the UHC Law proves that with strong political will, all sectors can collectively work towards a comprehensive legislation that will catalyze the much needed reforms of the Philippines health sector.

5. Who is covered by the UHC Law?

• As long as you are a citizen of the Philippines, you are covered by the UHC Law. The law also mandates that all FIiipino citizens be automatic members of the PhilHealth or National Health Insurance Program.

6. Will all health services be free through UHC?

• A key objective of the law is to decrease out-of-pocket expenses for Filipinos who seek health services and to make the health care costs more predictable.
• As a PhilHealth member, outpatient services in public clinics will be free while those in private clinics will have corresponding co-payments. The law requires all providers to make information on prices of services available to patients.
• For inpatient services, costs will be fully shouldered by Phil Health ( 100% support value, zero co-payment) if admitted in basic accommodation. There will be a fixed, predictable or set co-payment if admitted in non-basic accommodation (semi private, private wards).

7. What are the next steps after the UHC Law signing?

• The signing of the UHC Law is just the first step! DOH and Phil Health will have 180 days to complete the Implementing Rules and Regulation, in consultation with different stakeholders. All stakeholders are encouraged to participate in the IRR development of this important health reform.

8. How will the UHC Act affect the public health care delivery system?

• The law incentivizes consolidation of municipal health systems into a province­wide and city-wide health system in the next 6 years. This means that the rural health units and barangay stations that are now under the purview of the municipal mayors will be establishing a formal network with the other facilities within the province, including hospitals. The network is expected to have patient-centered processes, and will exhibit clinical integration (effective referral among facilities within the network), management integration (shared vision among all facilities), and financial integration (shared risk and gains among all facilities). All of these are expected to help

9. Do we need to pay for monthly premium? How much is the monthly contribution to Phil Health?

• Yes, existing PhilHealth members will continue to pay their premiums every month so that they can avail Philhealth benefits when they need it. Under the law, the PhilHealth membership will have two types: (1) direct and (2) indirect contributory members.
  1. Direct contributors are those with capacity to pay for their premiums. Existing PhilHealth members who are paying their monthly premiums, including their dependents, will belong to this type of membership.
  2. Indirect contributors are those who are deemed without capacity to pay and so, their premiums will be subsidized by the government.
• Details will be further fleshed out in the IRR.

10. Why would I opt to be a direct contributor if the government will subsidize the premium for indirect contributors?

• PhilHealth shall provide additional program benefits for direct contributors where applicable and indirect contributors will be assured to get basic benefits.

11. Where will the funding for the implementation of UHC come from?

• Current fund sources for UHC include: DOH budget, PhilHealth subsidy, and direct Philhealth contributory collections. Funds from PCSO, PAGCOR, and DOH MAIP will also be pooled to PhilHealth to leverage government’s position in purchasing health services.

12. Do we have enough funds to implement UHC?

• We need to ensure enough funds to sustain the implementation of UHC especially in the next 10 years. This is why the Department of Health is actively advocating for increase in alcohol and tobacco taxes. More importantly, these have direct health benefits by curbing the incidents of smoking and alcohol related illness. It’s a win-win