Achieving True Universal Healthcare

Better Days

Sen. Sonny Angara

Senator Sonny Angara was the representative of Aurora Province for nine years before he was elected senator in 2013. He is now the chairman of the Senate committees on local government, and ways and means.

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Forty years ago, delegates from 135 countries, including the Philippines met at international conference at what is now Almaty, Kazakhstan, under the former USSR. There, they signed the first global declaration affirming “primary health care” as key to upholding every person’s right to a healthy life.

Many consider this “Alma-Ata Declaration” among the critical public health milestones of the 20th century, signaling a global commitment to make quality healthcare universally accessible by bringing it down to the community.

My late father, Senator Edgardo J. Angara, helped tremendously in this effort. Next to education, health was one of his main advocacies, having helmed the Senate committee on health as early as his first term in 1987.

Among the health-related laws he authored, the most critical was perhaps the measure providing for a nationwide health insurance policy and establishing the Philippine Health Insurance Corporation (PhilHealth) in 1995. This law laid out the groundwork for the government’s ongoing efforts at attaining true universal healthcare coverage.

Less than a year before he ended his last term, my father cast another crucial vote in favor of universal healthcare. On December 2012, he voted for the bicameral report on higher excise taxes on alcohol and tobacco products, which would be enacted as R.A. 10351.

This law marked a sea change in the country’s efforts at realizing “healthcare for all,” providing the billions that allowed the government to expand health insurance coverage to a little more than 90 percent of the population. What some may not know was that the fight for the law was so close in the Senate, that its ratification was approved on a difference of only one vote.

Today’s Senate also contributed to this effort. As part of the package of tax reforms the Senate passed last year, the excise tax on cigarettes was raised to PhP 35 (from June 2018 to December 2019) and will be raised to PhP 37.50 starting January 2020. This represents a magnitude of change, considering that less than a decade ago, the cheapest excise tax smokers had to pay was only PhP 3 per pack.

Still, the fight for true universal healthcare continues. Debates now rage led by the Senate health committee chair Senator JV Ejercito on SBN 1896 or the Universal Health Care for All Filipinos (UHC) Act—a measure which I co-authored and co-sponsored.

One objective of this measure is to make check-ups, x-rays and laboratory tests, including mental health consultations, cancer risk screenings and even certain medicines, free for all Filipinos. By making such services readily accessible, we hope to induce a change in attitudes among our people—who only go to see a doctor when their sicknesses are already very grave or at advanced stages.

The UHC Bill is also envisioned to cause a paradigm shift from curative to preventive interventions across the public health system—a hallmark of the “primary health care” envisioned in the Alma-Ata Declaration. We want to nip the sicknesses in the bud so to speak, by getting more of our countrymen into the habit of seeking immediate medical help.

An ounce of prevention would definitely provide substantial relief to Filipino families more than a pound of cure, given the skyrocketing costs of treatment and hospitalization. The same is true for the state, considering it spends significant resources on treating hemodialysis (PhilHealth’s top payout between 2013 and 2017) and on deaths caused by heart disease, neoplasms or cancerous tumors, pneumonia, strokes, diabetes and hypertension (which are the top 6 causes of death according to 2016 PSA data). All are preventable.

One issue needs to be settled however. The Department of Health (DOH) needs an extra PhP 60 to PhP 80 billion on top of the PhP 200-billion 2019 budget they’re slated to receive just to implement the UHC bill on the first year alone.

Clearly, government will need to channel more of its resources into implementing this measure, which President Duterte certified as urgent. In the same way that concerted action helped make tertiary education universally accessible, extra effort will be needed so that another fight for universal healthcare is won.

Nov 2018 Health and Lifestyle

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