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HERDIN Record #: PCHRD080407040856 Submitted: 05 August 2007 Modified: 16 November 2017

Social health insurance in a developing country: The case of the Philippines.

Konrad Obermann,
Maria Ofelia O. Alcantara,
Claude Bodart,
Matthew R. Jowett,
Eduardo P. Banzon

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Very little is known about the Philippine health care system, and in particular its experience with social health insurance (SHI). Having initiated an SHI programme 35 years ago, the Philippines hold many lessons for the development of such schemes in other low and middle-income countries. We analyse the challenges currently facing PhilHealth, the national health insurer. PhilHealth was formed in 1995 as a successor to the Medicare programme and was given a mandate to achieve universal coverage by 2010. To date, PhilHealth has been quite successful in some areas (e.g. enrollment), but lags behind in others (e.g. quality and price control). We conclude that SHI in the Philippines has been a success story so far and provides lessons for countries in a similar situation. For example: (i) SHI is based on value decisions and the clear statement of societal goals can give guidance in the technical execution, (ii) SHI is a financing institution and needs to be treated accordingly, (iii) SHI can be implemented independently of the current economic situation and might actually contribute to economic development, (iv) community-based health care financing schemes should be merged with the national SHI in the long run, and (v) there is a strong need to push for high quality care and improved physical access. No clear suggestions can be given with respect to the benefit catalogue and the balance between economies of scale and decentralisation. Although riddled with many inadequacies, PhilHealth was set up as a strong and largely politically independent institution for the development of SHI. SHI can act as a stabilizing institution in a politically and economically volatile environment. (Author)

Publication Type
Journal
Publication Sub Type
Others
Title
Social Science and Medicine
Frequency
Bimonthly
Publication Date
June 2006
Volume
62
Issue
12
Page(s)
3177-3185
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Fulltext pdf (Request Document)
Philippine Council for Health and Research Development Fulltext Print Format (Request Document)

Citation

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