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UHC Reforms and Timelines

As we celebrate the International Universal Health Coverage Day or as we say here in the Philippines, Universal Health Care (UHC), let me give you a glimpse of our journey towards the full realization of UHC.

Looking back, it was during the 17th Congress that the UHC Act was passed into law, and it underwent a series of deliberations and committee hearings from both the House of Representatives and the Senate of the Philippines, until its eventual passage in February 2019 when President Rodrigo Roa Duterte signed it into law.

Immediately after the enactment of the UHC Law, a task force with Technical Working Groups were created. The DOH and PhilHealth buckled down to work on the promulgation of the Act’s Implementing Rules and Regulations (IRR).

Eight months after the passage of the law, DOH Secretary Francisco T. Duque III  signed the UHC Act’s IRR on October 10, 2019. The IRR was the product of a number of workshops and roundtable discussions with various stakeholders in the public sector (LGUs) and private sector (NGOs, civil society organizations, etc.). There were very many consultations that were done during that time.

To start the implementation of the UHC in the country, the DOH undertook several key activities on the implementation of the UHC law. These included:

Engagement of 58 UHC Integration Sites (UHC-IS), which include Bataan. These 58 integration sites already constitute 49% of all  the provinces, highly urbanized cities and independent component cities in the country. They are the first batch of local government units (LGUs) who have committed to integrate their local health systems toward the implementation of the UHC law.

Development of 60 plus operational guidelines and policies, which were identified as critical operational policies that are essential in setting up the province-wide and city-wide health systems, as well as in implementing the many reforms that were included in the UHC Law.

Capacity-building through e-learning modules and this was fast-tracked by the pandemic. We have created an online UHC implementers’ course. This is to aid in the operationalization of the UHC law at the local level. In this series of modules, there are a total of 12 modules under the UHC implementers’ course, which were created during panel discussions to provide an overview of the UHC Act, its IRR, as well as many of those 60 operational guidelines and policies are also discussed in those 12 modules. This is so that the key stakeholders can have a better understanding of the vision and reforms in the UHC Law. For all our participants, if you want to learn more about the UHC law and the reforms and these policies, you may register and enroll in the UHC implementers’ course at learn.doh.gov.ph. This course is absolutely free and you will learn a lot about the UHC Law.

Staffing proposals. There is a need to re-assess existing functions, systems and procedures, organizational structure and staffing to determine the appropriate human resource complement that would be responsive to the recently passed health legislation that is the UHC law, as well as the full devolution of health services, following the Supreme Court ruling on the Mandanas-Garcia petition. Through this, we can determine the proper human resource complement for the different offices of the DOH, including the regional offices of the DOH, and the other concerned attached agencies, which would lead to the proper delineation of roles as well as avoid overlapping of functions.

The alignment of the DOH’s budget to the UHC. The prioritization of the DOH’s budget toward programs, activities and projects that are related to the implementation of the UHC law, also for COVID-19 response and health system resilience.

MOVING FORWARD

According to the law, the UHC is a progressive realization, so we will not be able to achieve it overnight. We are slowly but surely attaining its goals. However, there are much to be done. We will need the help and cooperation of everyone in the health sector to realize UHC.

The DOH and its regional offices, including the Centers for Health Development, must always be ready to provide assistance to every LGU that would endeavor to form their province-wide and city-wide health systems.

Amid the pandemic, capacity-building must continue, particularly through e-learning platforms while face-to-face meetings are not allowed. So we must maximize these e-learning platforms, such as the UHC implementer’s course.

Further, financing mechanisms for UHC such as the Special Health Fund and other health financing reforms under PhilHealth must be in place and be readily available for smooth implementation by the LGUs.

For the general timeline, the UHC law and its IRR specify a 10-year general timeline for the attainment of UHC.

During the first six years from the enactment of the law, the national government, through the DOH, the Department of Interior and Local Government (DILG), PhilHealth, and LGUs are mandated to provide technical and financial support to select LGUs that would commit to integrate their health systems into province-wide and city-wide health systems. This is over and above the support that is regularly provided by the DOH to the LGUs.

Even prior to the passage of the UHC law, the DOH has been assisting the different LGUs, either through the health facility enhancement program, human resource for health deployment, the different commodities, as well as technical assistance and capacity building. All these must continue.

For the first three years (2020-2022), the province-wide and city-wide health systems are expected to undergo both managerial and technical integration.

Three years thereafter, from 2023 to 2025, these province-wide and city-wide health systems would already undergo financial integration, including pooling of funds and establishment of the special health fund.

At the end of the six years, if there is a positive recommendation by an independent study on the overall benefit of the integration of these local health systems, an Executive Order will then be issued by the President of the Philippines mandating the integration of local health systems in the whole country.

As we progress in this journey toward the full realization of UHC, we hope that we stay on track with what the law has laid out for us. UHC is for all and as we say, everyone is included. No one is to be left behind in the service of the Filipinos. Nonetheless, the road to UHC requires a call to action, a call for bayanihan, where every Filipino is encouraged to contribute.

In the end, UHC is about inclusivity and solidarity in the pursuit of a healthcare system that is by the people and for the people. And through the UHC law, we aspire to provide a better quality of life for all Filipinos and we can fulfill this UHC dream if only we will work harder, smarter and closer together with a solid roadmap leading the way.

Director Lester Tan
Dr. Lester M. Tan is presently the Division Chief at the Bureau of Local Health Systems Development of the Department of Health-Philippines. His current work involves developing policies, guidelines, and tools on the integration and strengthening of local health systems, as mandated by the Universal Health Care Law. Prior to that, he worked as Medical Officer and OIC-Division Chief at the Health Planning Division of the Department of Health-Philippines from 2010 to 2014. He also worked previously as M&E and Program Manager on Programmatic Management of Drug-Resistant Tuberculosis at the Tropical Disease Foundation, Inc. which was supported by the Global Fund to Fight AIDS, TB and Malaria. He finished his Bachelor’s Degree in Chemistry at the University of the Philippines-Diliman, Medical Degree at the University of the East-Ramon Magsaysay Memorial Medical Center, Master of Public Health at the University of the Philippines-Manila, and Master of Science in Global Health & Development at Hanyang University in Seoul, South Korea.

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