Cash-strapped universal healthcare faces uncertain future

As health sector reform run its course in the Philippines? The landmark Universal Health Care (UHC) law of 2019 was the culmination of two decades of health sector reform initiated by the late Health Secretary Quasi Romualdez in 1998.

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But Congress is moving to amend the law before its full implementation. The House of Representatives and the Senate are now scheduled to start deliberations to amend the law, supposedly to correct “weaknesses” inflicted by legislators. This comes after the same legislators deprived PhilHealth of the funds to implement key elements of the law from 2023-2025.

To make matters worse, Congress diverted the sin taxes intended for UHC implementation to patronage programs that covered fewer, but more favored patients. By waging war on so-called “excess funds” in PhilHealth, Congress made it impossible for PhilHealth to implement fully the Konsulta package for primary care when it forced it to cough up P89.9 billion in 2024 to cover nonhealth related infrastructure projects.

Former Health Secretary Francisco Duque signed the implementing rules and regulations (IRR) of the UHC Law in late 2019, a few months before the COVID pandemic. He announced then that it would take at least P300 billion a year for UHC to be effective, on top of the current health sector resources. That was what it would take to bring down the out-of-pocket health costs of Filipinos close to 30% from 49% in 2019.

Secretary Duque intended much of that increased spending for UHC to go to primary care and increased value of health benefit packages, which were only covering one-fourth of hospitalization costs. Under the UHC law, the comprehensive out-patient benefit at the primary level of care will be rolled out two years after the implementation of UHC.