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Overview

The World Health Organization defines health care as an overall maintenance and solution to the health needs of a person, family, or community. It is a system that addresses these health needs are fulfilled through prevention, treatment, rehabilitation, and palliative care. WHO states that the system needs financial stability, well-trained human resources (along with proper salary), proper information/data, and proper maintenance of up to date facilities to be able to deliver quality services, medicine, and researches.

The health care in the Philippines has been defined by the WHO as "fragmented", meaning there's a large gap between the quality and quantity of health services for the poor and the rich. With different reasons such as low budget, low number of man power, or general neglect for the poor, the Philippines has always been unable to keep up with the high standards of healthcare abroad. That is not to say that there have been no efforts to improve the system. Last February 20, 2019, The Universal Health Care (UHC) Bill was signed into all, aiming to provide proper healthcare services for all. Although faced with many problems, there have been efforts for a better healthcare system for the Philippines since it is what takes care of the people which in turn leads to other aspects of the country such as economic growth.

History

The Pre-Spanish Era: Pre 1656

Health care in the Philippines extends as far back as the 15th century. Prior to the arrival of the Spaniards, life and by extension health care, was centered around the animate and inanimate world.

A babaylan would mediate ritual offerings, bridging the gap between spiritual and physical world. Offerings ranged from food to blood sacrifices, as it was believed health could be restored by appealing to the gods.

Traditional Filipino medicinal herbs were used for a wide variety of ailments. Anonas leaves were applied to the stomach for indigestion. Betel-nuts leaves and areca nut leaves were common for injuries, chewed and then applied. Sambong was used to treat kidney stones, rheumatism, coughs, colds, hypertension, and diarrhea .

Spanish historian Miguel de Loarca said the natives were “good physicians and had a remedy for every poison.” The seeds of the igasud were chewed as an antidode for poison. It was renamed Pepita of San Ignacio by the Spanish. Other antidotes include boiled bark of palanigan and the bark of the bagosabak. While the Spanish were impressed by the medicinal knowledge of the Filipinos, they still believed that Western health care would have to be taught to the Filipinos .

The Spanish Era: 1565 –1898

Further Information: Spanish colonial period

As the Spanish were exposed to the unfamiliar environment of the Philippines, they were stricken with foreign disease. To combat this, they created hospitals specially for their health. Some of the first health institutions in the country were handled by Spanish friars.

Hospital Real

Built in Cebu in 1565, Hospital Real was the first hospital in the Philippines. It was relocated to the Manila to accompany the government. The hospital aimed to nurse the Spanish army and navy, those inflicted with disease, and military casualties. Miguel Lopez de Legazpi had permission from King Philip II to set up the hospital exclusively for Spanish soldiers and sailors, it denied Spanish and mestizo women. Although Hospital Real received funding from the Spanish Government, it lacked finances, manpower, and supplies. Administration of Hospital Real was transferred to both the Order of St. Francis and the Confraternity of La Misericordia. Hospital Real was destroyed during an earthquake on June 3, 1863.

Hospital De Naturales

Fray Juan Clemente, a 54-year-old botanist and lay brother, was instrumental in conception of the Hospital De Naturales. He often made medicine for the many people who begged outside the convent, until eventually the number of patients could grew too large for accommodations. Clemente raised funds in order to build better facilities, and he himself constructed two wards of nipa and bamboo.

Public and Private Health Sector

The Department of Health (DOH) lists 1,071 licensed private hospitals, and 721 public hospitals in the Philippines. The Department attends to 70 of the public hospitals while local government units and other state-run agencies manage the rest.

Private hospitals in the country have better technical facilities than the public hospitals, assuring patients of higher quality services than public institutions can provide. Facilities, however, pale in comparison with those in high-end health institutions abroad.

Public Healthcare Systems

Although doctors and nursing staff in public hospitals are highly proficient, public healthcare in the Philippines is highly limited. Because health care providers and health educators are concentrated in urban areas, such as Metro Manila, there is a scarcity of healthcare manpower in the rural areas. This strain on public healthcare is worsened from both treating the large number of Filipinos who rely on public healthcare and from the trend of Filipino medical staff migrating to Western countries. This has resulted in understaffing in many hospitals, resulting in delayed patient treatment.

Philippine Health Insurance Corporation

Public healthcare in the Philippines is administered by the Philippine Health Insurance Corporation (PhilHealth), a government owned corporation. Philhealth subsidises a variety of treatments including inpatient and outpatient care. Outpatient benefits would include: non-emergency day surgeries, radiotherapy, hemodialysis, blood transfusion, Primary Care Benefit (PCB), and Expanded Primary Care Benefit (EPCB).

Private Healthcare Systems

Although doctors and nursing staff of public hospitals are as efficient as doctors practicing in the private section, private facilities are much better equipped and treatment is typically faster. Private services are considered to be expensive by most locals, but relatively cheap by standards abroad. The relative affordability of private healthcare can be seen in the increasing popularity of the Philippines as a medical tourism destination.

Drug Prescription

Most pharmacies in the Philippines provide medicines approved by the Bureau of Food and Drugs. While pharmacists in some countries provide drugs to patients even without a doctor’s prescription, pharmacists in the Philippines have to follow strict guidelines on the sale of drugs. According to Republic Act No. 2382 (Philippine Medical Act), only licensed physicians are authorized to prescribe medicines. Similarly, according to the Republic Act No. 5921 (Pharmacy Law), only registered pharmacists can dispense and sell drugs.

Government Initiatives

Universal Health Care

The Universal Health Care (UHC) Bill was signed into law (Republic Act No. 1223) by President Rodrigo Duterte on February 20, 2019. The UHC Bill automatically enrolls all Filipino citizens in the National Health Insurance Program (NHIP), guaranteeing equitable access to quality and affordable health care services for all.

The UHC Act is the culmination of decades of progress and two years of dedicated political and technical work. It is the first UHC Act of its type in the Western Pacific region; this is particularly remarkable considering the strong presence of the private sector in the Filipino health system. The Act prescribes system reforms in accordance with the multiple financing and service delivery mechanisms at work in the Philippines.

In accordance to the Bill, PhilHealth will be renamed Philippine Health Security Corporation (PHSC) to emphasize the agency’s role in providing financial security in health rather than just helping people pay for health services. With this reform, the agency will provide uniform benefits for all; develop a single but comprehensive primary care package including medicines; create supplementary coverage by Health Maintenance Organizations (HMOs) and private health insurance; provide network-based licensing, contracting, and accreditation of facilities.

PhilHealth members will be identified as either a Direct Contributor or Indirect Contributor (non-contributors). Direct Contributors are paying members who are by default deducted for the premium through their payroll. Indirect Contributors are non-paying members who will be fully subsidized through tax collections.

The Bill will also utilize different agencies to deliver different healthcare services according to their classified scope. The Department of Health (DOH) will conduct the population-based health interventions, which include: financing of population-based services, improvement of doctor-to-patient ratio, increase of the number of hospital beds and equipment, and the establishment of hospitals in remote areas. PhilHealth will focus on the individual-based health interventions, which include: financing of individual-based level services, and delivery of individual hospitalization, rehabilitation, and emergency healthcare provision.

Medical Tourism

The Philippine Medical Tourism Program (PMTP) is a DOH project, which intends to make the country a global leader in “providing quality health care for all through universal health care.”

The program will further improve the Philippines’ healthcare manpower capabilities and facilities in both public and private sector to make the Philippines the country of choice for health care. The program aims to attract more visitors from abroad availing of medical services while simultaneously ensuring that the quality of currently offered services are suitable by Global Health Care standards. With the program, the local health care industry can generate substantial income to boost the Philippine economy.