Towards a Shared Understanding of the Philippines’ Universal Healthcare Law and Its Opportunities and Challenges for the Private Sector

03 June 2020

Recognizing the critical yet untapped potential of the private sector in ensuring the health of Filipinos, the ThinkWell Philippines team helped to facilitate a session in the Private Sector in Public Health (PSPH) Monthly Series. The Series convenes stakeholders from the private sector to converse about pressing health system issues, explore innovative solutions, and influence policy discourses. The Asian Institute of Management (AIM) of Stephen Zuellig Graduate School of Development Management and the ISPOR Philippines Chapter also helped to facilitate the event.

The event was titled, “Our Common Ground: Towards a shared understanding of the UHC Law and its opportunities and challenges for the private sector in the Philippines.” The session aimed to uncover opportunities that the country’s Universal Health Coverage (UHC) Law provides for the private sector. The discussion was attended by twenty-five stakeholders representing fourteen private sector organizations. Representatives from the Department of Health (DOH) and PhilHealth also participated in the discussion that Dr. Marife Yap and Dr. Gelo Apostol of ThinkWell Philippines led.

ThinkWell initiated the discussion with the question: Does the Philippine private sector have a strategic role in implementing the UHC Law? Everyone agreed that the private sector does have a role, but the more important question is what is that role? Participants shared confusion about little guidance on the role from the DOH and PhilHealth, as well as about the law’s implementation schedule. Ultimately, the private sector recognizes the importance of the UHC Law in democratizing health care and strengthening public health. They are willing to assist in addressing health system gaps, but they need to have a clear understanding of what the government expects from them, especially when it comes to interfacing with local governments that will handle the management and financing of province or city-wide health systems and health care provider networks (HCPNs).

The following main topics were discussed during the session:

• The roles of and expectations from the private sector are not laid out in the Implementing Rules and Regulations (IRR) of the UHC Law
• The government’s priority initially is to organize public facilities into networks, but it does not prevent private facilities from participating as well. There is confusion as to how private facilities can be part of a network.
• The important role of local government units (LGUs) as managers of HCPNs was recognized, but issues on financing and extent of coordination with LGUs were raised

Participants also discussed the extent to which private facilities would have to coordinate with local governments:

• Private institutions can offer the latest primary care benefit package, Konsulta, as long as they reach the indicated requirements. However, there was a concern that the private sector has not yet been fully engaged in the development of the new primary care benefit package. There was also confusion as to whether Filipinos will have the freedom to choose a primary care provider or they will be assigned.
• Considering that the private education sector contributes significantly to the production of the human resources for health in the country, the government needs to engage with them more.
• How can providers work with the government on initiatives on development of software applications?

The DOH and PhilHealth recognize the important contributions of the private sector to implement the UHC Law, especially when it comes to service provision. The government aims to address the mistrust coming from the private sector and also develop a comprehensive strategy on how the private sector can be more actively included. It was also noted that all sectors and stakeholders should be actively involved in consultations to ensure that all voices are heard and included. Ultimately, the government wants to ensure that the public and private sectors will have equal footing, especially when it comes to the delivery of quality services.

The private sector’s role in public health service requires a few critical principles: building trust, creating a dynamic relationship, and holding a shared value of better health services. There is an expectation that transactions and policy be made with less ambiguity. The group asks for clarity with the current UHC law’s Implementing Rules and Regulations on government reforms to deliver UHC services. This clarity is necessary to enable the private sector to meaningfully participate.

Written by Geminn (Gelo) Louis Apostol, MD, MBA, Private Sector Specialist, ThinkWell Philippines and Kenneth Hartigan-Go, MD, Associate Professor, Department of Strategic Management Head, Stephen Zuellig School of Development Management, Asian Institute of Management, Makati City, Philippines