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An Approach to Financing Universal Health Care

An Approach to Financing Universal Health Care. Orville Solon UP School of Economics June 29, 2010. Key Arguments. The money already being spent in the health system is sufficient to pay for a critical package of health services for all Filipinos.

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An Approach to Financing Universal Health Care

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  1. An Approach to FinancingUniversal Health Care Orville Solon UP School of Economics June 29, 2010

  2. Key Arguments • The money already being spent in the health system is sufficient to pay for a critical package of health services for all Filipinos. • The challenge is to be able to pool and manage the funds to: (a) address inequities, and (b) remove inefficiencies

  3. How Much is Being Spent for Health (2006 Philippine National Health Accounts) • Total health care spending is at least P225 billion • Health spending by national and local government units total P52.4 billion • Social health insurance accounts for P19.1 billion • Family out-of-pocket spending is P128 billion

  4. Sources and Uses of Health Expenditures – Health Reform Targets

  5. Reliance on Family Out-of-Pocket Spending Perpetuates Inequities

  6. Addressing Inequities – Progressive NHIP Premium Contributions

  7. Addressing Inefficiencies – Raising Value for Money in the NHIP • Family out-of-pocket must be converted to additional premium payments of roughly P6 billion per year in premium payments • But value for money from existing expenditures must be raised before pouring in additional premium payments

  8. Target = 100 Fully Protected Filipinos 53 eligible to file claims 53 22 22 avail of services covered in accredited facilities 8 The 22 who availed of benefits is only equivalent to 8 fully protected Filipinos Leakages in NHIP Implementation

  9. A Performance Yardstick for NHIP Implementation: Benefit Delivery Rate • Only 8% of Filipinos are fully protected by the NHIP. They are: • Eligible to claim (registered, paid contributions) • Knows entitlements, able to access and avails health services from accredited providers • Total health care expenditures fully reimbursed • This is what we refer to as the PhilHealth Benefit Delivery Rate

  10. BDR, All Population, 2008 Potential BDR: 77% * 91% * 42% = 29%

  11. BDR by component: Sponsored, non-Sponsored, and by age group Note: BDR for the SP owes to higher support value while that for the elderly is due to higher availment.

  12. BDR by special benefit package Direct estimate for OPB BDR is 0.3%

  13. Re-organizing the Financing of Health Care • National Government: coordination, regulation, surveillance, and national public health threats • Local Government (preferably provincial): localized public health threats and basic clinical care • National Health Insurance: critical personal health care • Individual family finances: preference driven health services

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