Urgency to transform fragmented health system

The coronavirus disease 2019 (COVID-19) global pandemic has severely affected the global economy and overwhelmed health systems in many countries. In the Philippines, it exposed several gaps on both public health infrastructures and national health policies. It has also highlighted the country’s fragmented governance and the lack of healthcare facilities and human resources for health that led to the slow-phased responses to the pandemic.

Last year, Health Secretary Francisco T. Duque III mentioned that “battling the COVID-19 pandemic has demanded much from our health system and not only revealed its faults but emphasized an urgent need to transform and heal the system as a whole. The Universal Health Care (UHC) Law was crafted to address this very gap that has plagued our system for many years. Hence, it is a critical moment to seize, to fast track the transition to universal healthcare.”

It has been two years since the passage of the UHC Act. One of its key objectives is to realize universal coverage through a systemic approach and clear delineation of roles of key agencies and stakeholders towards better performance in the healthcare system. Like any other health law, the vision of the UHC Act is remarkably outstanding, however the main challenge is in its implementation. If the UHC law is fully implemented, it will provide equitable access to quality and affordable healthcare services while protecting against financial risk for every Filipino. However, as frequently stated by the Department of Health (DoH), the law cannot be implemented instantly, but only progressively, mainly due to its high resource requirements at all levels.

The transformation of the whole health system to achieve a sincere universal healthcare will entail serious investments by the government and the constant participation of different stakeholders. Indeed, adopting a whole-of-society and people-centered approach is vital to improve overall health system performance.

As often recognized, different stakeholders, such as patient associations and civil society or grassroots organizations, play important roles in monitoring the health reforms towards the path of UHC. It is also recognized that engaging stakeholders of the health ecosystem is an effective way to support common advocacies and pro-actively participating in developmental policy reforms to achieve universal healthcare for all Filipinos.

In line with this, UHC Watch, an advocacy led by patient groups, health advocacy organizations, and consumer groups, was officially launched on Feb. 19. UHC Watch was formed by a coalition of Citizen Watch Philippines; Philippine Alliance of Patient Organizations (PAPO), Health Justice Philippines (HJP), and Bantay Konsumer, Kalsada, Kuryente (BK3) to ensure the full implementation of the Universal Health Care Act and the mandated programs of other health related laws.

At the event, Dr. Jaime Galvez Tan, former Health secretary and board member of HJP, mentioned that “now the UHC Law is in full swing despite being in the pandemic, we hope that our government will not lose sight and continue to prioritize the reforms needed by the health system.”

Prof. Louie Montemar, convenor of BK3, said that “consumers are now struggling in this deep recession, we need an accelerating pace of execution of the health services mandated in the UHC Act. Let us not forget that COVID-19 is not the only disease killing our people. The deaths from other infectious and non-infectious diseases such as heart disease and cancer are alarmingly way above the pandemic. And, the sad reality is that this pandemic is affecting the continuity of treatment of these diseases.”

On her part, Ma Fatima “Girlie” Garcia-Lorenzo, PAPO’s president, mentioned that “accountability and transparency are vital to delivering safe, effective and affordable healthcare. All stakeholders need to be held accountable on commitments they made to implement universal health coverage and be accountable to the patients they serve.”

Further, “The implementation of a universal healthcare system benefits the economy. The interlinking dynamics of health and the economy and the disruptive consequences of its imbalance is one of the hardest lessons of this pandemic. This is how critical, and how urgent Universal Health Care is,” said Orlando Oxales, lead convenor of CitizenWatch Philippines.

By now, everyone has realized what a pandemic-like situation looks like. Dealing with the pandemic has opened our eyes to the current new normal. Many have probably also seen how being prepared to respond to this kind of crisis, such as prioritizing investments in the healthcare system, would lessen the burden that many of us have experienced in the past year.

Let us work together to rebuild our healthcare system. The implementation of government’s health policies and programs are more likely to succeed and to be sustained when different stakeholders work together towards the achievement of universal healthcare.

Alvin Manalansan is a Non-Resident Fellow at the Stratbase ADR Institute and a Convenor of CitizenWatch Philippines.