Universal Health Coverage in the Philippines : Progress on Financial Protection Goals

Bredenkamp, Caryn ; Buisman, Leander R.

World Bank, Washington, DC

关键词: POVERTY THRESHOLD;    HEALTH CARE PROVIDERS;    LIVING STANDARDS;    HEALTH INSURANCE COVERAGE;    INCOME HOUSEHOLDS;   

DOI  :  10.1596/1813-9450-7258
RP-ID  :  WPS7258

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Providing protection against thefinancial risk of high out-of-pocket health spending is oneof the main goals of the Philippines’ health strategy. Yet,as this paper shows using eight household surveys, healthspending increased by 150 percent (real) from 2000 to 2012,with the sharpest increases occurring in recent years. Themain driver of health spending is medicines, accounting foralmost two-thirds of total health spending, and as much asthree-quarters among the poor. The incidence of catastrophicpayments has trebled since 2000, from 2.5 to 7.7 percent.The percentage of people impoverished by health spending hasalso increased and, in 2012, out-of-pocket spending onhealth added 1.5 percentage points to the poverty rate. Inlight of these findings, recent policies to enhancefinancial risk protection—such as the expansion ofgovernment-subsidized health insurance for the poor, adeepening of the benefit package, and provider paymentreform aimed at cost-containment—are to be applauded.Between 2008 and 2013, self-reported health insurancecoverage increased across all quintiles and its distributionbecame more pro-poor. To speed progress toward financialprotection goals, possible quick wins could include issuinghealth insurance cards for the poor to increase awareness ofcoverage and introducing a fixed copayment for non-poormembers. Over the medium term, complementary investments insupply-side readiness are essential. Finally, an in-depthanalysis of the pharmaceutical sector would help to shedlight on why medicines continue to place such a largefinancial burden on households.