MANILA, Philippines – Health Secretary Francisco Duque III admitted on Wednesday that the implementation of the Universal Health Care (UHC) law nationwide by 2020 is not possible due to lack of funding and preparedness.
Duque made the admission during the Department of Health (DOH) budget hearing before the House of Representatives’ Appropriations Committee.
“The strategic readiness of the DOH in the implementation of the Universal Health Care year one is 2020, and it is a progressive realization [that] it cannot be a national roll-out, your honors,” Duque said, adding that the DOH has identified certain provinces that would be “models” for the implementation of UHC’s various components.
“I guess the keywords are progressive realization given that we cannot do a national roll-out because of budgetary constraints and also because of the readiness,” he added.
Duque said they still need to conduct “capacity building” in the different provinces, which, under Republic Act No. 11223, would serve as convergence points of integration for reforms in the health care system.
Among the components of UHC, he said, are service delivery, health regulation, health care financing, governance and performance accountability, and health systems development.
Initial implementation sites
Usec. Gerardo Bayugo said there are 33 provinces and cities identified for the first-year implementation of the UHC law. He said these areas were chosen because they were the firsts that committed to implementing the law. Bayugo said the remaining areas would be covered in the next budget cycle or in 2021.
The 33 areas are:
- NCR: Valenzuela, Parañaque
- Region I (Ilocos) : Dagupan City
- Cordillera: Baguio City, Benguet province
- Region II (Cagayan Valley) : Isabela, Nueva Vizcaya, Quirino
- Region III (Central Luzon): Bataan, Tarlac
- Region IV-A (Calabarzon): Batangas, Quezon
- Region IV-B (Mimaropa): Oriental Mindoro
- Region V (Bicol): Masbate, Sorsogon
- Region VI (Western Visayas): Aklan, Antique, Guimaras, Iloilo
- Region VII (Central Visayas): Cebu
- Region VIII (Eastern Visayas): Biliran, Leyte, Samar
- Region IX (Zamboanga Peninsula): Zamboanga del Norte
- Region X (Northern Mindanao): Cagayan de Oro, Misamis Oriental
- Region XI (Davao Region): Compostela Valley, Davao del Norte
- Region XII (Soccsksargen): Saranggani, South Cotabato
- Caraga: Agusan del Sur, Agusan del Norte
- BARMM: Maguindanao
Lanao del Norte 1st District Rep. Mohamad Khalid Dimaporo denounced the exclusion of his province from the initial roll-out sites, while Bulacan 1st District Rep. Jose Alvarado said they were not aware of such consultation.
Duque assured that the congressmen’s constituents would not be discriminated but Dimaporo dismissed this.
“I personally feel and believe, one my entire province has been discriminated, number 2 I feel that we have been cheated out of the possibility of joining the first batch of the rolling out of this UHC law, and I feel that the DOH under regional directors simply chose the easiest LGUs to implement the UHC when they could have looked into areas where we’re really having a hard time,” Dimaporo said.
Bayan Muna Rep. Carlos Zarate, meanwhile, said the UHC and lesser funding for local public hospitals have worsened the privatization of health care in the country.
The Department of Budget and Management earlier said that some P166.5 billion was earmarked for the “full implementation” the UHC law under the 2020 National Expenditure Program.
Some P67.4 billion was allocated for the Philippine Health Insurance Corp. and P92.2 was set aside for the DOH.
While Duque admitted that the budget proposed for them would be “insufficient” for all the programs, he said they have other sources mandated by law like P40 billion from the Philippine Amusement and Gaming Corp., P1.5 billion from the Philippine Charity Sweepstakes Office and P67.5 billion subsidy from the national government.
About P257 billion would be needed to implement UHC in 2020, according to DOH.
Another target source of funding for the UHC is the proposed law on higher taxes on alcohol and vape products, which Congress has yet to pass.
READ: DOF warns of delay, health services cuts with House version of alcohol, tobacco tax
The cash-based new appropriations that DOH is requesting from Congress for 2020 is P88 billion, 5 percent less than its current budget.
Meanwhile, some lawmakers also questioned the DOH’s low disbursement rate of 61 percent or P67 billion in 2018. /gsg/muf