Price Negotiation Board is constituted to negotiate prices on behalf of

DOH and PhilHealth. Drug outlets are compelled to carry, at all times,

the generic equivalent of all drugs in the Primary Care Formulary. Health

care providers and facilities are also required to make readily accessible to

the public all information regarding prices of health goods and services.

The UHC Act also mandates DOH, PhilHealth, HMOs, and private

health insurers to develop standard policies and plans that complement

PhilHealth’s benefit schedule.

In terms of ensuring equity, particularly to benefit the poor, the UHC

Act mandates DOH to annually update its list of underserved areas,

which will serve as basis for preferential licensing of health facilities and

contracting of health services. The law aims to guarantee the equitable

distribution of health services and benefits by prioritizing GIDAs in the

provision of assistance and support. The law also requires government

hospitals to allocate at least 90 percent of their beds as basic or service

ward accommodation. In the case of specialty hospitals, they are required

to allocate at least 70 percent of beds as basic or ward accommodation. On

the other hand, private hospitals are required to allocate at least 10 percent

of beds for such accommodation. This provision is linked to the “no copayment” scheme applied to all
PhilHealth members admitted in basic or

service ward accommodation.

Governance and Accountability

The UHC Act also aims to improve governance and accountability. All

health-related entities are required to submit health data to PhilHealth,

to help in planning and policy making for further enhancing UHC. Data

generated using public funds will be made available to the public subject to

the existing laws on data privacy. Moreover, the development of a cadre of

health policy and systems researchers, experts and managers is instituted.

The law also mandates the Philippine Statistics Authority (PSA) to conduct
relevant modules of household surveys annually, while DOH is tasked to

publish annual provincial burden of disease estimates.

Health Impact Assessment (HIA) is required for crucial health policies,

programs and projects, while Health Technology Assessment (HTA)

Framework and Mandates of Universal Health Care in the Philippines

12 Universal Health Care in the Philippines: From Policy to Practice

is institutionalized to inform policy and decision-making of DOH and

PhilHealth. For this purpose, a Health Technology Assessment Council

(HTAC) is created under DOH, which will eventually be transferred to

Department of Science and Technology (DOST) in order to make it an

independent entity separate from the DOH.

Ethics in public health practice will also be strengthened. Specifically,

declaration and management of conflict of interest will be required

from decision makers, policy makers, staff members, consultants, and

all stakeholders involved in policy-determining activities. Financial

relationships between health care professionals and manufacturers of drugs,

medical devices and supplies will also be tracked. To ensure compliance by

stakeholders, a Public Health Ethics Committee is formed as an advisory

body to the Secretary of Health.

All health service providers and insurers must 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. Data will be electronically

uploaded on a regular basis through interoperable systems. A health

information system will be developed and funded by DOH and PhilHealth.

Capacity for digital health and telemedicine will also be developed as part

of the health service package.

To fund the implementation of the UHC Act, various sources of funds

are pooled, particularly for financing individual-based health services.

These sources are the government collection of “sin” taxes or excise

taxes on tobacco and alcohol products; a portion of the national share

from the income of the Philippine Amusement and Gaming Corporation

(PAGCOR) and the Philippine Charity Sweepstakes Office (PCSO);

premium contributions of PhilHealth members; national government

subsidies to PhilHealth; and annual appropriations of DOH, as well as other

supplemental funding.

Appropriations and Other Relevant Provisions

for Universal Health Care

13

Sources of Funding

for Universal Health Care

funded by DOH and PhilHealth. Also, a Performance Monitoring Division

is established in the DOH to monitor and evaluate the implementation of

UHC.

The UHC Act envisions the managerial integration, including technical

integration, of P/CWHS within the first three years of its implementation.

Thereafter, financial integration is also expected within the subsequent

three years.

With DOH and PhilHealth taking the lead, the valuable support and

active participation of every Local Chief Executive and every local health

worker, including the private sector and civil society, are essential to the

implementation of the UHC Act.

The UHC Act provides specific

penalties in cases of violations of

any of its provisions committed by

health care providers, PhilHealth

members and their employers,

and PhilHealth officers and staff.

A Joint Congressional

Oversight Committee on

UHC is created to conduct a

regular review and systematic

evaluation of UHC performance

and impacts. At the same time,

National Economic Development

Authority (NEDA), PSA, National

Institutes of Health (NIH), and

other academic institutions are

mandated to conduct studies to

validate UHC accomplishments.

The validation process will be

Total incremental sin tax

collections

50% of the National Government

share from PAGCOR

40% of the Charity Fund, net

of Documentary Stamp Tax

payments and mandatory

contributions of PCSO

Premium contributions

of members

Annual appropriations

of the DOH

National Government subsidy

to Philhealth

Supplemental funding

Framework and Mandates of Universal Health Care in the Philippines

14 Universal Health Care in the Philippines: From Policy to Practice

Chapter References

1 World Health Organization (2010). The world health report: Health systems

financing: The path to universal coverage. Geneva, Switzerland: WHO.

2 Barker, P. (2016, December 12). Making universal health coverage

whole: Adding quality as the fourth dimension. Boston, MA:

Institute for Healthcare Improvement. http://www.ihi.org/

communities/blogs/_layouts/15/ihi/community/blog/itemview.

aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=340

3 Friebel, R., Molloy, A., Leatherman, S., Dixon, J., Bauhoff, S. & Chalkidou, K.

(2018). Achieving high-quality universal health coverage: A perspective from

the National Health Service in England. BMJ Global Health, 3(6), e000944.

https://doi.org/10.1136/bmjgh-2018-000944

4 World Health Organization, Organization for Economic Co-operation

and Development & International Bank for Reconstruction and

Development (2018). Delivering quality health services: A global imperative

for universal health coverage. Geneva, Swi