A culture of health
People complain of the erratic nature of the President, and it can be difficult to understand and accept. But it works; 82 percent of the people believe in him—more than halfway through his term. No Philippine president has even gotten close to this. No world democratic leader has. It’s really quite remarkable. It’s not just cult fervor, there’s some basis for it. Reforms that president after president have shied away from, scared of public reaction or whatever, are being done. It started with the “Build, build, build” program where infrastructure spending is targeted to hit 7 percent of GDP by 2022 (it was 3 percent under former president Benigno Aquino III).
Then there’s the matter of taxes, unchanged for 20 years, now being updated to modern terms. Rice has been demonopolized. A peace deal with the Moros and the creation of the Bangsamoro Autonomous Region in Muslim Mindanao has been accomplished. Landmark laws such as free college tuition and the Ease of Doing Business Act have been passed. Then there’s one that ranks in the top three as important to people’s lives: health. On Feb. 20, 2019, Mr. Duterte signed the Universal Health Care (UHC) Act. Congress’ courage to drastically increase the taxes on cigarettes and alcohol (sin taxes) will help make health free for all who need it. It’s something many countries are trying, without too much success in most cases. The Philippines can be a leader here. The UHC law is a highly sensible measure, particularly for poor Filipinos and those living in far-flung areas who die without ever seeing a physician.
I’ve written several columns on this topic before, and I cannot overemphasize enough how vital health care is. But as we all know, laws here are only as good as their implementation.
Last December, the Wallace Business Forum co-organized the 2019 Hospital CEO Forum with our partners Novartis, Asian Institute of Management and the Embassy of Switzerland in the Philippines. In that forum, leaders of public and private hospitals in the country shared their ideas and practices on how they could contribute to the successful implementation of the UHC law. There were four key takeaways.
First, no country can be considered an expert in universal health care. Each is struggling with its own set of challenges. The Philippines will struggle, too. The passage of the UHC law is only the first step in the long and rough journey of providing universal health coverage. What the Philippines can do is to learn from the experiences and best practices of other nations. Policies and programs, especially in health, should be based on evidence, not on emotions and patronage.
Second, responsibility for health services has been devolved to local government units (LGUs). They need to establish partnerships at the community level to make programs more responsive to the needs of the people. The role of LGUs is of paramount importance. Local leaders need to put health care as a priority and not just as a footnote in their list of programs. It is also crucial to build a “culture of health” in the community, an environment where health care providers do not just provide health services to the people, but also develop among them an awareness and understanding of the need to look after your own health, and provide a healthy community. In the effort to foster a healthy community, UHC’s thrust in organizing health care provider networks per province/city is a step in the right direction. No single health care provider (HCP) or hospital can provide for all the health needs of families. This can be done through a network of HCPs where the primary care provider acts as a navigator, and where one hospital’s deficiency can be addressed and supplemented by another health facility.
Third, the harnessing of data and technology is necessary to improve the implementation of the UHC. In my column, “Health care without paper” (2/28/19), I envisioned an integrated, computerized, paperless system for the Philippines where physicians can instantly access the health record of the patient online with just a tap on a screen. We are far from that reality, but we must start now by improving the IT system in our health facilities, especially those in the countryside.
Lastly, more than just addressing the shortage of health professionals and workers, which is a real worry, doctors should be trained as leaders of the community. It’s important to improve not only their technical skills, but also their social and economic skills.
PhilHealth, under the guidance of the Department of Health, needs to reach out to all stakeholders on a regular basis so as to develop the best system and services. Collaboration between the private and public sectors just works.
UHC can make a difference in the lives of Filipinos. UHC is a journey. It’s up to the government to make it work, but it cannot do this journey alone. The UHC journey is best done with development partners, civil society, and the private sector. There’s no other way.
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