Proposed Senate Bill 2021-2
FREE HEALTH CARE ACT
Our own experiences under the current health care system – especially as we all suffer under the now two-year old pandemic – can be summed up as a long, endless litany of financial crowdsourcing, online begging, and medical-related bankruptcies which, unfortunately are not being discussed (or even considered as a problem) by mainstream political groups. In the Philippine Congress, only the Makabayan Bloc has seriously taken health care as an urgent policy concern which it aims to address through House Bill 9515 (“AN ACT PROVIDING FOR A FREE, COMPREHENSIVE, AND PROGRESSIVE, NATIONAL PUBLIC HEALTH CARE SYSTEM”) which was filed just last May 29, 2021. Outside the halls of Congress, Laban ng Masa’s platform for the 2022 elections include funding a “universal health care program delivering quality, preventive care for free.”
Meanwhile, no sitting senator has come up with a Senate version of Makabayan Bloc’s bill, despite the current Senate’s nominal support for Universal Health Care. This proposed Senate bill intends to fill such gap.
Universal Health Care in the Philippines was nominally adopted in 2019 through Republic Act No. 11223 or the Universal Health Care Act. While such policy shift enabled the Philippine government to provide free health services to the poorest segments of society, its framework still allows the collection of co-payments beyond the maximum amount per illness and per type of service covered by the national public health insurance system, run by the Philippine Health Insurance Corporation or PhilHealth. Hence, our country’s citizens remain burdened with huge out-of-pocket payments (OOPPs) from medical consultations to prescription medicines, and from major surgical operations to rehabilitation procedures. Out-of-pocket expenditure as % of current health expenditure amounts to almost 54% of the country’s total health spending in 2018, lower than the all-time high of 58.9% in 2011 but way above the all-time low of 41.2% in 2000, in contrast with the global average pegged at just slightly more than 18% in 2018 and peaking at 19.3% in 2000 (World Bank, 2021). Among Southeast Asian countries, the Philippines is the third worst country when it comes to OOPPs.
The current Senate bill intends to establish a genuinely 100% FREE HEALTH CARE SYSTEM for every Filipino citizen, thereby reducing OOPPs to zero.
Be it enacted by the Senate and the House of Representatives of the Philippines assembled.
SECTION 1. Short Title. This act shall be known and cited by its short title “Free Health Care Act of 2021.”
SECTION 2. Declaration of State Policy. Protection and promotion of the people’s right health, as a state policy enshrined in ARTICLE II, Section 15 of the 1987 Philippine Constitution is hereby reiterated and implemented: “The State shall protect and promote the right to health of the people and instill health consciousness among them.”
SECTION 3. Coverage. This Act shall cover the whole health care system in the Philippines.
SECTION 4. Free Health Care Services in Public Clinics, Laboratories, Pharmacies, & Hospitals. This Act hereby provides for free health care services in all government-owned and/or government-run clinics, laboratories, pharmacies, and hospitals.
SECTION 5. Prohibition Against Out-of-Pocket Payments in Public Health Care Facilities. All public clinics, laboratories, pharmacies, and hospitals are hereby prohibited from collecting any payment from Filipino citizens.
SECTION 6. De-commodification of Health Care in Private Facilities. In the period of transition, while the government is in the process of making the public health care system sufficiently capable of serving all citizens’ health care needs, private health care facilities are hereby required to de-commodify health care services they offer by eliminating profit-taking in their systems.
SECTION 7. International Benchmarking. The Department of Health and other pertinent agencies, in consultation with public health advocacy groups and public health care professionals and researchers, are given 6 months from this Act’s effectivity to ensure that the country’s public health care system is aligned with the standards of robust public health care systems in both developing and developed countries.
SECTION 8. Transition Period. For a period of 3 years from this Act’s effectivity, the government will ensure that the country’s public health care system is capable of efficiently serving the needs of all Filipino citizens during which: every barangay should have at least one functioning health care center, with stationed general practitioners, midwives, and nurses everyday; every congressional district should start having at least one public general hospital capable of most types of surgery, one public pharmacy, and one diagnostic laboratory; the country should strive to achieve a doctor-patient ratio of 1:200.
SECTION 9. Nationalization of Giant Pharmacies & Big Private Hospitals. Within the period of transition, the government will nationalize giant pharmacies and big private hospitals, with adequate compensation for small and medium-sized shareholders, and with a negotiated rate for corporate ones.
SECTION 10. Public Health Insurance Premium. Within the period of transition, PhilHealth will be abolished, and its personnel will be absorbed by the public health care system. After its abolition, all PhilHealth funds would be directly rechanneled to the public health care system. Payment of premiums by all employers and employees will continue at current rates, subject to possible reduction through an act of Congress, a presidential executive order, or a recommendation from the Department of Finance, after the period of transition. From the effectivity of this Act, premiums are hereby labeled as “public health insurance premium.” All private Health Maintenance Organizations (HMOs) will be deemed dissolved as soon as PhilHealth is abolished. Henceforth, those who previously paid premiums to private HMOs would be encouraged to pay additional public health insurance premium commensurate to rates they have paid to private HMOs. Such additional public health insurance premium will be deductible from their payable personal income tax.
SECTION 11. Funding. All public health care services will be funded by public health insurance premium, and yearly subsidies from the general appropriations.
SECTION 12. Implementing Rules and Regulations. The Department of Health, in coordination with pertinent agencies, public health advocacy groups, and representatives of health care personnel and health care researchers, will draft and release the implementing rules and regulations of this Act, not later than 3 months from its effectivity.
SECTION 13. Separability Clause. In case any provision in this Act shall be declared invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired.
SECTION 14. Repealing Clause. All laws, decrees, executive orders, proclamations, rules and regulations, and other issuances, or parts thereof which are inconsistent with the provisions of this Act, are hereby repealed or modified accordingly.
SECTION 15. Effectivity Clause. This Act shall take effect upon its publication in at least two (2) national newspapers of general circulation.