LIVE: SENATE HOLDS INQUIRY ON CHANGES IN HEALTHCARE IN TERMS OF PAYING FOR

HEALTHCARE, AND ITS CHANGES IN SOCIETY IN TERMS OF CULTURAL, GENDER, AND GENERATION
DIFFERENCES

Senate Committee on Health and Demography and Senate Committee on Finance

Senators:
-Mark Jhon Pausanos
-Kristel Pepito
-Shaira Rapsing

Government Agencies
Philippines Health Insurance Corporation (Philhealth) representative
-Rymel Pedong

Department of Health (DOH) representative

-Gladilyn Paredes

Department of Budget and Management (DBM) representative

-Trixie Papuran

Catarman, Northern Samar LGU representative

-Jumbo Pornelos

Health Insurance Providers

Health Maintenance Organization (HMO)
-Shelah Parane

Healthcare Providers
NSPH Hospital Director
-Kayetryn Raspado

Philippines Nurses Association (PNA) nurse representative

-Nicole Oroncillo
SCRIPT
Sen. 1: Good day, everyone. “The greatness of a nation and its moral progress can be judged by the
way its animals are treated,” Mahatma Gandhi famously said. But if we broaden this thought, we
might say that the true measure of a nation’s greatness is also reflected in how it treats its most
vulnerable—especially when it comes to healthcare. Today, we are here to address a pressing issue
that affects millions: the quest for universal healthcare coverage and the myriad challenges that
come with it.

Universal Healthcare Coverage (UHC) is a noble goal that promises to provide every
individual with access to essential health services without financial hardship. Yet, this vision remains
elusive for many. In the Philippines, despite the enactment of the UHC Law, which aims to offer
health services to all Filipinos, the reality is stark. Over 47% of health expenditures in the Philippines
come out of pocket, burdening low-income households who often have to choose between paying
for medication or putting food on the table. Globally, this issue is pervasive; the World Health
Organization estimates that 800 million people spend over 10% of their income on healthcare,
pushing 100 million into extreme poverty each year.

In our quest to address these issues, PhilHealth was established as a safety net for millions.
However, recent revelations of inefficiencies and corruption have raised serious concerns about its
efficacy. While PhilHealth covers 92% of Filipinos, the actual support it provides often falls short due
to bureaucratic inefficiencies and limited coverage, leaving many patients with unexpected medical
bills and financial strain. These challenges are not unique to the Philippines—many countries face
similar issues with their national health insurance systems.

Addressing these challenges requires more than just policy changes; it demands a holistic
approach that includes improving governance, expanding financial protections, and ensuring that
healthcare systems are truly inclusive and accessible to all. We need to advocate for comprehensive
reforms that not only promise universal coverage but also deliver equitable care for every individual,
regardless of income, identity, or background.

As we engage in today’s forum, let us commit to turning our discussions into actionable solutions.

FIRST TOPIC (UHC)

SEN. 1: Universal healthcare coverage (UHC) is a crucial global goal, with countries making varied
progress in providing equitable access to healthcare without financial hardship. While nations like
the UK and Japan have well-established UHC systems, many others, including the Philippines, are still
navigating challenges in implementation. The Philippines' Universal Health Care Act (RA 11223) seeks
to provide all citizens with affordable and quality healthcare. However, despite this legislation,
challenges such as inadequate healthcare workforce, underfunded healthcare facilities, and difficulty
reaching remote areas continue to hinder full implementation, affecting access to essential services,
especially in rural and underserved communities.

Question for the Philippine Nurses Association: How is the PNA addressing the issue of nurse
shortages in rural areas, and what support mechanisms are being put in place to ensure nurses
remain in provinces like Northern Samar?
Question for the Northern Samar Local Government: How is the local government collaborating
with national agencies to strengthen healthcare facilities and improve service delivery for UHC in the
province?

Question for the Northern Samar Provincial Hospital Representative: What specific challenges is the
hospital facing in providing UHC-compliant services, and what assistance is needed from the national
and local governments to improve healthcare quality?

POSSIBLE Follow-up Questions: (PAG READY NALA)

For the DOH: Are there plans to provide targeted funding or programs specifically for geographically
isolated and disadvantaged areas like Northern Samar to accelerate UHC implementation?
For the PNA: How can nurses be incentivized to work in remote areas, and what is being done to
address their concerns about workload and compensation?
For the Local Government and Hospital: What collaborative efforts are in place between the
provincial hospital and the local government to enhance healthcare services, and how can the
national government further support these initiatives?

Sen. 1: In Southeast Asia, according to [Link], Thailand's Universal Coverage Scheme

(UCS) has been lauded globally, covering over 99% of its population and providing comprehensive
healthcare with minimal out-of-pocket expenses. The system has improved health outcomes and
reduced catastrophic health spending to just 2% of households in 2023. In contrast, the Philippines’
PhilHealth aims to provide universal healthcare through the Universal Health Care (UHC) Act passed
in 2019. While all Filipinos are technically included under the National Health Insurance Program,
PhilHealth has faced significant issues in recent years. Corruption scandals, inefficient claims
processing, and coverage gaps, such as inadequate support for specific illnesses and slow
reimbursements, have eroded public trust and placed an additional burden on marginalized groups.
In fact, out-of-pocket spending for healthcare in the Philippines remains high, contributing to the
financial strain on families

Question for the DOH: What strategies is the DOH considering to improve the administration and
efficiency of PhilHealth, drawing lessons from successful models like Thailand's Universal Coverage
Scheme?

Question for the PhilHealth Representative: How is PhilHealth addressing the current challenges of
corruption, delayed reimbursements, and underfunding to strengthen public confidence and deliver
more comprehensive healthcare coverage?

Question for the Department of Budget and Management (DBM): How does the DBM plan to
allocate sufficient resources to ensure PhilHealth can sustainably fund its operations and provide
universal health coverage as mandated by the UHC Act?

Question for Health Insurance Providers/HMOs: How are private insurance providers working
alongside PhilHealth to supplement coverage and ensure affordable healthcare for Filipinos,
especially for services that are not currently covered by PhilHealth?

Possible Follow-up Questions:

For the DOH: What specific reforms are being implemented to ensure that PhilHealth's structure and
funding are as efficient as Thailand’s UCS?
For the PhilHealth Representative: How will PhilHealth address the issues of limited coverage,
particularly for specialized treatments, to make healthcare more equitable?
For the DBM: How does the government plan to prevent budget shortfalls for PhilHealth in the long
term, especially with increasing healthcare demands?
For HMOs: What role can HMOs play in expanding healthcare access to marginalized populations
who may not be fully covered by PhilHealth?
Sen. 2: Healthcare costs pose significant challenges for low-income households and marginalized
communities, particularly in countries like the Philippines and other developing nations. These
groups are often the most vulnerable to financial hardships when faced with medical expenses, as
they lack access to affordable healthcare services and adequate insurance coverage. The burden of
out-of-pocket payments forces many families to make impossible choices between essential medical
care and other basic needs such as food, education, or shelter. In marginalized communities, the
situation is worsened by geographical barriers, underfunded healthcare systems, and limited access
to quality services. Globally, the high cost of healthcare perpetuates cycles of poverty, deepens social
inequalities, and leads to poorer health outcomes, especially in countries with weak healthcare
infrastructure. Understanding the impact of healthcare costs on these vulnerable populations is
crucial for crafting inclusive policies that ensure equitable access to medical care and promote long-
term economic stability.

Sen. 2: Are there differences in how healthcare is funded for marginalized groups in the Philippines
compared to other countries?

(Ate Trix or Ate Nicole pwede magbaton)

Sen. 2: What is the effectiveness of health insurance schemes, subsidies, and other social safety nets
in the Philippines and other countries in reducing financial strain?

(Kayet or Jumbo mabaton)

Sen. 2: What strategies can be used to make healthcare more affordable for indigenous and
marginalized communities in the Philippines and worldwide?

(Ate Trix or Ate Nicole pwede magbaton) (pls make sure an baton related sa iyo org or magsuggest
kam sa other org like DOH or philhealth)
Sen. 3:
Gender inequalities and gender-based norms heavily impact access to and payment for
healthcare services in the Philippines. Women often face systemic challenges due to societal
expectations around reproductive roles, limiting their access to comprehensive care. LGBTQ+
individuals encounter additional hurdles due to cultural prejudices and lack of acceptance, further
complicating their access to affordable healthcare.
Low-income individuals may only seek care at private facilities for emergencies if they can
afford it, reflecting a reactive approach to healthcare rather than proactive management. Long wait
times and limited access at public facilities exacerbate these issues, particularly for those in poverty.
Women in different age groups face varied challenges: younger women may struggle more with out-
of-pocket expenses for antenatal care, while older women required care for age-related health
concerns, however, they might benefit from stronger social networks and financial support.
The persistent global gender pay gap, worsened by the COVID-19 pandemic, means women
generally earn less than men and face greater financial difficulties in affording healthcare. LGBTQ+
individuals often face workplace discrimination that impacts their earnings, compounded by the lack
of comprehensive anti-discrimination laws in the Philippines.
Addressing these disparities requires legal reforms, increased workplace protections, and
continued advocacy to ensure equitable healthcare access and financial support for all individuals.
Understanding these dynamics is key to advancing health equity in the Philippines.

Sen 3: Can you provide an update on any ongoing or planned legislative reforms aimed at reducing
gender-based discrimination in the workplace?
----- Response ni glad -----
Sen 3: How is the DOLE ensuring that workplace health and safety regulations are inclusive of the
needs of women and LGBTQ+ workers?
----- Response ni glad -----
Sen 3: How is the DOLE collaborating with other government agencies to improve healthcare access
and financial support for workers, particularly those in vulnerable and marginalized groups?
----- response ni glad ------

Sen 3: PhilHealth: Are there any plans to enhance financial support or subsidies for those who
struggle to afford out-of-pocket expenses for healthcare?
------ response ni rymel -----
Sen 3: How does the DOH plan to address long wait times and access issues in public healthcare
facilities?
------- response ni rymel -----