MANILA, Philippines–Funding isn’t the only problem in the implementation of Republic Act No. 11223, or the universal health care (UHC) law, as the Department of Health (DOH) blamed its delay on local governments wanting to maintain political clout in their respective communities.
Mar Wynn Bello, officer in charge of the DOH’s Bureau of International Health Cooperation, said at a recent forum that the implementing rules and regulations (IRR) on the UHC law cannot be released until Oct. 10.
Stakeholders in the public health sector have been looking forward to the IRR since the law was signed by President Duterte in February.
But Bello said some local officials have warned the DOH outright about a possible court injunction on the law’s implementation should the department insist on carrying out a key provision of UHC regarding the integration of health resources and facilities in the provincial level.
Under new supervision
“They’re questioning the integration. [It’s] because not all local government units are willing to give up their health workers, health facilities to the provinces. In our consultation, the local chiefs are saying that there may be a TRO (temporary restraining order) issued against the law,” Bello said, without identifying which cities and municipalities are against the provision.
Under Chapter 5, Section 19 of RA 11223, “provincial and city health boards shall oversee and coordinate the integration of health services for province-wide and city-wide health systems, to be composed of municipal and component city health systems, and city-wide health systems in highly urbanized and independent component cities, respectively.”
The integration means that the provincial and city health boards will now have “administrative and technical supervision over health facilities and health human resources,” as well as manage a special health fund, in which local governments would pool their resources.
Bello said around “63 percent” of mayors opposed the mandated integration, especially since—as worded in the law—the DOH was only to “endeavor” it.
Political willingness
“It’s really political willingness. Of course, properties and people are sources of power. If you lose them, you will be losing your source of power,” he said.
Bello said the DOH is considering integration to be a mere option for local governments.
“There will be different degrees of implementation in terms of provision of health services. It will remain the same. It’s like nothing has changed except that everyone is now enrolled in PhilHealth (Philippine Health Insurance Corp.),” he said.