Before healthcare could become easily accessible and consistently available for the Filipino people, well-supported policies and effective systems for governance and implementation must first be in place. To achieve this goal, PhilHealth and its partner institutions, Philippine Council for Health Research and Development and the Department of Science and Technology, came up with the PhilHealth Supporting the Thrust for Universal Healthcare through Data, Information, and Knowledge Exchange Systems (STUDIES) project. 

With the implementation of the Universal Healthcare Law in our country in 2019, research is arguably one of the crucial tools to ensure the successful execution of the law’s mandates. Thus, for the third installment of the PhilHealth STUDIES Forum held in Citadines Millennium Ortigas last November 27-28, 2019, the theme was “Geared Up for UHC Generating Research Evidence for Planning and Policy”.

Over a span of two days, professionals from different health and research institutions gathered to present their studies and paint a picture of the status of PhilHealth all over the country, as well as its impact on beneficiaries. I was lucky enough to be given a chance to attend this gathering along with my colleagues from EpiMetrics, Inc. Sitting inside that rather large auditorium, it felt surreal to be in the same venue as some of the top leaders and administrators of our country’s health sector. I was ecstatic to hear what they were going to discuss for the next few days.

The first day was focused on nationwide studies conducted to appraise the overall impact of the institution’s services. The research presented in the plenary session looked into client awareness and reception of PhilHealth’s services as well as current Support Values which serve as determinants for the coverage of support provided by the institution. 

To be exposed to the numbers presented by Dr. Dane Anacio and Ms. Carmelita Ericta, which defined how PhilHealth was responding to the needs of the people and how people responded to PhilHealth’s services in return, was quite an insightful and eye-opening experience. In the Support Values study, it was interesting to see how service and response varied across regions. Apart from this, findings were not just solely focused on the values that were determined. Problems surfaced in terms of information accessibility as well as compromised data from biases and the lack of documentation. And while I am aware that systems have limitations given the sheer diversity of the individuals they cater to, in my head, it made me wonder how PhilHealth plans to tailor its services to be able to meet the specific regional needs while also responding to the systemic problems. 

I had a similar question as I listened to the Client Awareness study. Though there was already a significant number of people who were both aware and benefitting from services offered by PhilHealth, one of the main recommendations actually mentioned increasing the coverage of the benefits. We can only infer that a lot of the more common health cases encountered in health care centers should be considered for and assessed to be included in the packages. Additionally, communication and proper education on health care insurance and how to maximize their benefits has also been shown to still be of primary concern. It was evident to see that though there is promise in the numbers, compared to the previous years, and there are clear signs of improvement, the current system still has a long way to go in terms of responding to the people’s health care needs. 

Following this, the afternoon part of the program was divided into three parallel sessions, each one focusing on a theme relevant to the implementation of the UHC Law in the country. Parallel Session One featured research from Dr. Josephine Bundoc, Dr. Rene Andrew Bucu, Dr. Lester Sam Geroy, and Dr. Eric Oliver D. Sison on the improvement of accessibility to health services, specifically looking into rehabilitation services, mental and neurological services, and Acute Coronary Syndrome. The second Parallel Session tackled studies on effective mechanisms to engage the informal sector and to get them to avail of health insurance services and continually pay for the premium. 

I had the privilege of attending the third parallel session. Here, Dr. Dante Salvador, Mr. Allan R. Ulitin, and Prof. Ma. Ella Oplas presented their research on the issues in health financing including health expenditure coverage by PhilHealth, cases of fraudulence in health institutions, and health service delivery and financial sustainability of LGU-owned hospitals, respectively.

Going into parallel session 3, I did not really know what to expect. Governance in the health sector was all but alien to me. When they started to talk about fraud, hospital financing, and share ratios, I managed to get a glimpse of what went on in one aspect of each. However, as the discussion went on, a lot of sirens went off in my head. I could feel my eyebrows knit together as I listened to the speakers, knowing full well that there was distress in reporting the truth about the system’s problems and yet needing to do so for the sake of improving on it. It felt heavy to see where systems were failing to protect the very people they were made for.

I had three main thoughts: First, I know that the current status of our health system has a long way to go, but I honestly didn’t know some of these issues, like fraudulent claims which were primarily attributed to health professionals, were prevalent in this context. Second, hearing about all these things is unsettling, and alarming. Finally, based on the input and discussion, what solutions are possible to resolve these issues without putting the vulnerable at risk? How can we avoid putting those who must benefit the most in compromised positions, or limit the benefits they receive?

Even with the initial feeling of frustration and anxiety, behind each issue lies a spark of hope and an assurance of a solution. The findings themselves have already provided us with the paths we could take to make small changes that could lead to greater solutions. The challenge now is how you can balance between correction and compassion as you strive for development and innovation. 

EpiMetrics Inc. assisted the Philippine Council for Health Research and Development in developing the conference proceedings for the PhilHealth STUDIES event.

For more information, email us at contact@epimetrics.com.ph.