PhilHealth’s role in pursuing universal health coverage

The recent international conference on primary health care, held in celebration of the 45th anniversary of the Alma-Ata declaration and the fifth anniversary of the Astana declaration, shed light on global efforts to attain universal health coverage (UHC).

his event, titled “Primary health care policy and practice: implementing for better results,” underscored the essential role of primary health care in achieving UHC and addressing the glaring gaps in global health-care coverage.In the context of the Philippines, the role of the Philippine Health Insurance Corp. (PhilHealth) is instrumental in the implementation of UHC and the promotion of primary health care. The recent adoption of the second high-level political declaration on UHC at the United Nations General Assembly reinvigorated the commitment to make health care accessible by 2030. However, it also highlighted the slow progress and insufficient investments to achieve this ambitious goal. The declaration emphasized the importance of shifting focus toward primary health care as the most effective path forward.

Like many other nations, the Philippines faces challenges in ensuring that its citizens have access to quality health care. While the country has made notable strides in expanding health services and improving access, there is still work to be done to achieve UHC. Primary health care is at the core of this effort, serving as the foundation for accessible and comprehensive health-care services.PhilHealth is one of the central figures in the Philippines’ journey toward UHC. Established in 1995, it was instrumental in expanding health coverage and reducing the financial burden of individuals seeking medical care. PhilHealth operates as a government-owned and -controlled corporation, tasked with providing health insurance for Filipinos.

One of the fundamental mechanisms through which PhilHealth supports primary health care is its sponsorship/financing of various health programs and packages. These packages encompass a range of services, including maternal care, child health, and outpatient consultations. By covering these services, PhilHealth plays a significant role in making primary health care services more affordable and accessible to the population. Additionally, the corporation has been actively promoting preventive and primary care services, aligning with the principles of the Alma-Ata declaration.

PhilHealth’s partnership with public and private health-care providers is another vital aspect of its contribution to primary health care and UHC. The corporation has accredited a vast network of health-care facilities, including hospitals, clinics, and health centers. This collaboration allows PhilHealth to channel financial support to these facilities, a partnership that helps bridge the gap between government policies and actual health-care delivery as a way to realize UHC. However, challenges remain in the Philippines’ pursuit of this goal.

One key issue is the need to improve the quality and equity of health-care services. There is a pressing need to address disparities in access to care, particularly in rural and underserved areas. Additionally, efficient governance and management of resources, alongside combating fraud and abuse, are paramount for PhilHealth to continue playing a vital role in primary health-care delivery.

In conclusion, the recent international conference on primary health care emphasized its significance in achieving UHC. In the context of the Philippines, the role of PhilHealth is pivotal in making direct health-care services more accessible and affordable. However, addressing disparities, improving quality, and enhancing governance are necessary for the country to fully realize the potential of primary health care in pursuing UHC. As the world continues its journey toward health for all, the Philippines, with PhilHealth’s active involvement, is an example of how primary health care can be the cornerstone of a more equitable and accessible health-care system.

Faustino Jerome Babate