Presented to:

Dr Julie Tiu
RA-11223 Dr Annabelle Pabilona Tiu

Presented by
PGI: REJI, JEWEL ELIZABETH
 RA 11223
Its an act instituting Universal Health Care for all Filipinos, prescribing
reforms in the health care system, and appropriating fund transfer.
 Section 2. Declaration of Principles and
policies
• It is the policy of the State to protect and promote the right to health of all
Filipinos and instill health consciousness among them.
Towards this end, the state shall adopt; (Pursuant to Section 15, Article 11 of the 1987 Constitution
the State)

• An integrated and comprehensive approach to ensure that all Filipinos are

health literate, provided with healthy living conditions, and protected from
hazards and risks that could affect their health;
• A health care model that provides all Filipinos access to a comprehensive set of
quality and cost-effective, promotive, preventive, curative, rehabilitative and
palliative health services without causing financial hardship and prioritizes the
needs of the population who cannot afford such services;
• A framework that fosters a whole-of-system, whole-of-government, and
whole-of-society approach in the development, implementation, monitoring,
and evaluation of health policies, programs and plans; and,
• A people-oriented approach for the delivery of health services that is centered
on people's needs and well-being, and cognizant of the differences in culture,
values, and beliefs.
Section 3: General Objectives
• This act seeks to:
• 1. Progressively realize universal health care in the country through a systemic
approach and clear delineation of roles of key agencies and stakeholders
towards better performance in the health system; and,
• 2 Ensure equitable access to quality and affordable health care goods and
services, and protected against financial risk.
• Population Coverage: Every Filipino citizen shall be automatically included into the National Health
Insurance Program.

• Service Coverage:
vImmediate Eligibility and access to preventive, promotive, curative, rehabilitative and palliative care for
medical, dental, mental and emergency health services.
v Comprehensive Outpatient Benefits- outpatient drug benefit and emergency medical services.
vProvision of Primary Care Providers- DOH and LGU shall endeavor to provide a health care delievery
system that will afford every filipino a primary care provider that would act as the navigator, coordinator,
and initial and continued point of contact.
vRegistration of Filipinos to Primary Care Provider Networks- register with a public or private care provider
of choice
Financial Coverage:
vPopulation based health services shall be financed by National Govt through DOH and provide free at point
of service.
vIndividual based health services through prepayment mechanisms ( social and private health
insurance,HMO)
Chapter iii: National Health Insurance
Program- All Filipinos automatically enrolled in NHIP
• Program membership is simplified into 2 types,
• Direct Contributors-
v All Filipinos aged 21 years and above who have the capacity to pay premiums.
vGainfully employed – and are bound by an employer- employee relationship. Or are Self
earning individuals, professional practitioners
v Migrant workers including their qualified dependents
• Indirect contributors- those whose premium subsidized by the national
government.
vSenior citizens who are not currently covered by the Program.
v Persons with disability.
vAll Filipinos aged 21 years old and above without the capacity to pay premiums
Entitlement to benefits package of health services provided to
filipinos for the purpose of improving health

• Philhealth id card shall not be required to avail the health services.

• Failure to pay premiums shall not prevent the enjoyment of any Program benefits. However,
employers and self-employed direct contributors shall be required to pay all missed
contributions with an interest, compounded monthly.
• At least three percent (3%) for employers of private and government sector, sea-based migrant
workers;
• (1.5%) for self-earning individuals, professional practitioners, land-based migrant workers,
Filipinos living abroad; and Filipinos with dual citizenship.
• No co-payment shall be charged for services rendered in basic or ward accomodation.
• Co-payments and co-insurance for amenities outside the basic or ward accommodation shall be
regulated by DOH and Philhealth.
Chapter iv: Health Services Delivery
Population-based Health Services
• DOH shall endeavor to contract province-wide and city-wide health systems for the delivery of
population-based health services. Province-wide and city-wide health systems shall have the
following minimum components:
• Primary care provider network with patient records accessible throughout the health system
• Accurate, sensitive, and timely epidemiologic surveillance systems
Individual-based Health Services
PhilHealth shall endeavor to contract public, private, or mixed health care provider networks for
the delivery of individual-based health services:
● service quality
● co-payment/co-insurance
● data submission
Chapter v: ORGANIZATION OF LOCAL HEALTH
SYSTEMS
• The local health system refers to all health offices, facilities and services, human resources,
and other operations relating to health under the management of the LGUs to promote, restore
or maintain health
• The DOH, DILG, PhilHealth, and LGUs shall endeavor to integrate all local health systems
into province-wide health system and city-wide health system

Provincial and City Health Boards shall manage

● the Special HealthFund
● shall exercise administrative and technical supervision over health facilities and health human
resources within their respective territorial jurisdiction.
Chapter vi: Human Resources For Health
• National Health Human Resource Master Plan: the DOH, together with stakeholders shall
ensure that will provide policies and strategies for the appropriate generation, recruitment,
retaining, regulation, retention and reassessment of workforce based on the needs.
• National Health Workforce Support System- created to support local public health systems in
addressing their human resource needs, especially in Geographically Isolated And
Disadvantaged Areas. (GIDA).
• Scholarship and training program- CHED and the DOH shall develop and plan the expansion
of existing and new allied , health related degree and training programs including those for
community based health care workers
• Return service Agreement- all graduates of allied and health related courses who are recipients
of government funded scholarship programs are required to serve in priority areas in the public
sector for 3 full years with compensation and supervision of DOH.
 Chapter vii Regulation
Safety and Quality
v Philhealth shall establish a rating system under an incentive scheme to acknowledge and reward health
facilities that provide better service quality, efficiency and equity
vThe DOH shall institute a licensing and regulatory system for stand alone health facilities, including
primary care facilities.
Affordability
v. Mandating transparent pricing of health goods and services.
v Independent price negotiation board, to negotiate prices on behalf of the DOH andPhilHealth

Equity
v The DOH shall annually update its list of underserved areas, which shall be the basis for
preferential licensing of health facilities and contracting of health services.

v The government shall guarantee that the distribution of health services and benefits provided
for in this Act shall be equitable by prioritizing GIDAs in the provision of assistance and
support.
Chapter viii: GOVERNANCE AND
ACCOUNTABILITY
Health Promotion
vIncreasing health literacy with focus on reducing non-communicable diseases, implement
population-wide health promotion programs and activities to ensure the attainment of the
framework strategy and its programs to promote and to provide technical support to local
research and development programs and projects

Evidence-Informed Sectoral Policy and Planning for UHC

v All public and private, national and local health-related entities shall be required to submit
health and health-related data to PhilHealth including information about administrative,
public health, medical, pharmaceutical and health financing data.
Monitoring and Evaluation
vThe Philippine Statistics Authority (PSA) shall conduct the relevant modules of household
surveys in coordination with DOH annually during the first ten (10) years of the
implementation, and thereafter follow its regular schedule.
Health Impact Assessment (HIA).
vHIA shall be required for policies, programs, and projects that are crucial in attaining better
health outcomes or those that may have an impact on the health sector.
 Health Technology Assessment (HTA).
vThe DOH shall lead the health sector in the institutionalization of the HTA process as a fair
and transparent priority setting mechanism that shall be recommendatory to the DOH and
PhilHealth for the development of policies and programs, regulation, and the determination of
a range of entitlements such as drugs, medicines, pharmaceutical products, and other devices,
procedures and services as provided for under these Rules.
Ethics in Public Health Policy and Practice –
vAll stakeholders involved in policy-determining activities at all levels of policy-making are
required to act in a manner that shall serve the public's best interest, and thus are required to
disclose and manage any real or perceived conflicts of interest
Health Information System (HIS)
v All health service providers and insurers shall each maintain a health information system consisting
of enterprise resource planning, human resource information, electronic health records, and an
electronic prescription log consistent with DOH standards, which shall be electronically uploaded on
a regular basis through interoperable systems
Chapter ix: Appropriation
The amount necessary to implement this Act shall be sourced from the following:
vTotal incremental sin tax
v(50%) of the National Government share from the income of the Philippine AmusementGaming
Corporation (PAGCOR)
v(40%) of the Charity Fund, net of Documentary Stamp Tax Payments, and mandatory
contributions of the Philippine Charity Sweepstakes Office (PCSO)
vPremium contributions of members;
vAnnual appropriations of the DOH
vNational Government subsidy to PhilHealth
vSupplemental funding
SUMMARY

Key Benefits of UHC Act:

vEquitable Access: Eliminating financial barriers and ensuring healthcare access for all
Filipinos. Reducing health disparities and promoting health equity
vQuality Healthcare Services: Emphasizing the delivery of high-quality healthcare
services to all individuals.
v Preventive and Promotive Health: Focus on health promotion, disease prevention, and
early detection. Improving population health and reducing healthcare costs in the long
term
v Coordinated and Integrated Care: Enhanced coordination among healthcare providers
for better continuity of care.
 • The UHC Act establishes the framework for the implementation of universal health care in the Philippines. It
mandates the creation of the Philippine Health Insurance Corporation (PhilHealth) as the primary agency responsible
for implementing and administering the universal health care program. The UHC Act expands the coverage and
benefits of PhilHealth to include all Filipinos, ensuring that no one is left behind in terms of healthcare access.
• Under the UHC Act, every Filipino citizen is automatically enrolled in the National Health Insurance Program,
with contributions based on their income and capacity to pay. The law also includes provisions for the
premium subsidies and financial assistance to ensure that indigent and marginalized populations can access
healthcare services without financial barriers.

• The UHC Act also emphasizes the strengthening of primary healthcare services. It calls for the
establishment and enhancement of barangay health centers, rural health units, and other primary care
facilities to provide comprehensive and essential healthcare services at the community level. The law
promotes the use of health promotion, disease prevention, and early detection strategies to improve
overall population health.

• The UHC Act recognizes the importance of health human resources and allocates resources
for the training and deployment of healthcare professionals, especially in underserved
areas. It also emphasizes the need for the development and implementation of health
information systems to improve data collection, analysis, and monitoring of health
outcomes.
• Overall, the UHC Act represents a significant step towards achieving universal health care in the Philippines. It
embodies the government's commitment to providing accessible, equitable, and quality healthcare services to all
Filipinos, regardless of their socio-economic status. The successful implementation of the UHC Act requires
collaborative efforts among various stakeholders, including the government, healthcare providers, and the
community, to ensure the realization of its goals and objectives.
POST QUIZ
• What is RA 11223?
• Give one feature of UHC Act RA-11223?
• How many years the graduates of allied and health-related courses who are
enrolled in government-funded scholarship programs are allowed to serve for
how many years?
• Give one example of Indirect contributors?
• Failure to pay premium shall not prevent the enjoyment of any programs
benefits, is the statement True/False?
Answer key
• Universal healthcare for all filipinos.
• Equity, quality and affordable healthcare services to all filipinos.
• 3 years.
• Senior citizens who are not currently covered by the program OR persons with
disability.
• TRUE