Overview
This lecture covers the structure, goals, and functions of health care systems with a focus on the Philippines, examining reforms, financing, and current strengths and weaknesses.
Health Care System: Concepts and Goals
- A health system comprises resources, organizations, financing, and management to deliver health services.
- Key goals: improve population health, enhance system responsiveness, and provide fair health financing.
- Reducing disparities across social, economic, and demographic groups is central to health care planning.
- Responsiveness includes respectfulness, non-discrimination, confidentiality, and patient-centered decision-making.
- Fair financing means payments should not prevent access to care and contributions are proportional to income.
Functions of a Health System
- Health care provision: delivering care at primary (first contact), secondary (specialist), and tertiary (highly specialized) levels.
- Health service inputs: resources such as personnel, facilities, medicines, technologies, funding, and information systems.
- Stewardship: government oversight, policy setting, priority identification, coordination with other sectors, and performance monitoring.
- Health financing: collecting revenues, pooling risks (mainly via insurance), and strategic purchasing of services.
Philippine Health System and Services
- The Philippines has a dual health system: public (government-funded) and private (user-fee driven).
- Public sector includes the Department of Health (DOH) and local government units managing primary to tertiary care.
- Private sector includes market-oriented clinics, hospitals, and non-formal providers (traditional healers).
- PhilHealth (National Health Insurance) pools resources, subsidizes care, and aims for universal coverage.
- Top causes of death include heart disease, neoplasms, and cardiovascular conditions; both NCDs and communicable diseases remain concerns.
Health Sector Reforms in the Philippines
- Key reforms include the adoption of primary health care, Generics Act, Local Government Code, National Health Insurance Act, Universal Health Care Law (2019), and sin tax laws.
- Universal Health Care (UHC) Law aims for automatic coverage, stronger roles for DOH and PhilHealth, and equitable access to services.
Strengths and Weaknesses of Philippine Health Care
- Strengths: UHC law, increased insurance coverage, economic growth, young skilled workforce, and financial support from international agencies.
- Weaknesses: fragmented system due to decentralization, inequality in access, workforce migration, infrastructure gaps, bureaucracy, and corruption.
Key Terms & Definitions
- Health System — Organizations, institutions, and resources delivering health actions.
- Stewardship — Oversight and policy-setting by government for the health system.
- Risk Pooling — Combining financial resources to spread health care costs across members.
- PhilHealth — Philippines' National Health Insurance Program for universal coverage.
- Universal Health Care (UHC) — Provision of quality, accessible, and equitable health care to all citizens.
Action Items / Next Steps
- Review the roles of DOH, PhilHealth, and other key organizations.
- Study health system reforms and their impacts on service delivery.
- Prepare questions for the lecturer and submit them to your class president via Teams.