A new study commissioned by the Unilab Center for Health Policy (UCHP) has called on the Philippine Health Insurance Corp. (PhilHealth) to introduce optional supplemental coverage for its members. The research, led by Dr. Hilton Lam and Dr. Michael Tee from the University of the Philippines, was presented at the recent UCHP Symposium focused on health budgets and benefit design.
According to the study, PhilHealth has expanded its benefits for both inpatient and outpatient care in recent years. However, it still lacks a framework for voluntary add-on packages, which are required under the Universal Health Care (UHC) law. The researchers highlighted international models from countries such as Indonesia, Myanmar, Singapore, Germany, and the United States. In these places, voluntary “top-up” schemes are available, allowing members to pay extra for enhanced healthcare coverage.
The study recommended that PhilHealth develop policies based on cost-effectiveness, equity, and feasibility. It also emphasized the importance of consulting stakeholders to make sure any supplemental packages meet urgent health needs while keeping financial sustainability in mind.
John Basa, director of the UCHP program, said this research complements an earlier study on local government health spending. That study focused on maximizing fiscal performance of health budgets and pointed out the need for better inter-agency guidance and coordination.
Calls for Reform Amid High Out-of-Pocket Health Spending
Basa explained that both local government units (LGUs) and PhilHealth are investing in health initiatives. However, he stressed that effective policy guidance and evidence-based frameworks are critical so that resources result in meaningful improvements for Filipinos.
The urgency for reforms in healthcare financing is underscored by a related 30-year review of National Health Accounts. The review showed that Filipinos still pay 45 percent of their health expenses out-of-pocket. This figure is much higher than the target of 30 percent set by health authorities.
With many citizens still struggling to afford medical costs, experts say it is important for PhilHealth to consider new ways to protect its members. Offering optional supplemental coverage could help close gaps in the current system and move the country closer to universal health care.
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