It remains a utopian dream for all of us, something which was just aspirational five or ten years ago. But now, it appears to be within reach. A well implemented universal health care or UHC is indeed the ultimate in the inclusive orientation of governance, the supreme indicator of how well-governed nations are managed. It is not so much for the haves, as for the have nots or the so-called sectors at the laylayan of society, as Vice President Leni Robredo describes the marginalized in our midst.
Indeed, not having to worry of the cost of diagnostic services to diagnose one’s medical problem or at least ensure that one remains well, of professional fees for consultation or much more so for operations is a big relief to the average Filipino who has a myriad of other basic necessities he needs to provide for. Hopefully, UHC can also include provision of some essential medicines for prevalent medical conditions like diabetes, heart diseases, chronic lung problems and serious debilitating conditions including cancer and end-stage kidney disease.
Reachable as UHC may seem now, there is still a gap that has to be filled. The available funds are not enough to sustain what needs to be done and provided for to have UHC’s engines really running. Even for this year alone, there is still a budgetary gap; and a big question mark hangs on the heads of our health officials, legislators and advocates where the additional funding is going to come from. It hinges on the increase of the excise taxes our legislators will agree to levy on tobacco and alcohol products.
For the first year alone, around PhP 257 billon is needed to implement the necessary health reforms and other provisions of UHC, recently signed into a law by President Duterte. According to Health secretary Francisco Duque III, there is still a funding gap of PhP 164 billion. The DOH has proposed to increase excise tax on cigarettes to PhP 90 per pack from the current PhP 32.50, which could generate an additional PhP 45 to PhP 47 billion. Other revenue centers in the government like the PAGCOR and PCSO would chip in to fill in the remaining budgetary deficit.
Whether the ideal increase in excise taxes will be approved by our legislators or not remains to be seen as we await the resumption of Senate hearings after the May elections. We hope and pray that our senators will be properly guided and unswerving in their commitment to do whatever it takes to implement UHC as it should be.
It’s a tremendous advance that the UHC law has been approved already and that the President is strongly pushing for it, but we need more advocates in the Senate and Congress who are truly knowledgeable on the intricacies of its implementation. Even nuances of its implementation in the level of our rural health facilities will matter a lot, too. An expert overseer is therefore necessary.
It’s for this reason that we wish Dr. Willie Ong, popularly known as Doc Willie, would make it in his Senate bid. He has committed to focus on health reforms, and the effective implementation of the UHC law. His G.O.A.L. platform consisting of libreng gamot (free medicines), operasyon (operations), abiso (free consultations) and laboratory tests are perfectly in line with UHC. With Doc Willie in the Senate, we can have a staunch advocate inside that can really make sure no stone is left unturned to achieve everything the spirit of the UHC law aims to achieve.
We also need to thank Senators JV Ejercito and Risa Hontiveros for sponsoring the bill and really fighting for its final approval, and Sen. Sonny Angara for his commitment to support the increase in sin taxes that can help subsidize UHC. We hope Senators JV and Sonny would also make it in their Senate bids so they could continue advocating for an effective UHC implementation.
We are also heartened by the all-out support of the Philippine Academy of Family Physicians for UHC. There is no question that a strong base consisting of our well-trained primary care physicians is imperative to make sure that our healthcare front line is secured and well taken cared of.
A crucial factor to improve the overall health of the nation is to shift healthcare from a curative orientation to a preventive approach. And the best medical specialists who can be in charge of that are the family physicians. They’re the front liners of health care; some call them the gate keepers of health care. Whatever they’re called, there’s no question that their role is crucial in reshaping and reorienting an ideal health care for our country.
After all, age-old wisdom has always taught is that it is much better and cheaper to prevent diseases, than to treat them.
RAFAEL R. CASTILLO, MD