The research, led by Dr. Hilton Lam and Dr. Michael Tee of the University of the Philippines, was presented at the recent UCHP Symposium on health budgets and benefit design.
It highlighted that while PhilHealth has broadened its inpatient and outpatient benefits in recent years, the agency has yet to develop a framework for voluntary add-on packages — a measure mandated under the Universal Health Care (UHC) law.
Lessons from abroad
Researchers pointed to models in Indonesia, Myanmar, Singapore, and developed economies such as Germany and the United States, where voluntary “top-up” schemes allow members to contribute more for enhanced coverage.
The Philippine study recommended that PhilHealth adopt policy frameworks based on cost-effectiveness, equity, and feasibility. Consultation with stakeholders would also be essential to ensure supplemental packages address pressing health needs while maintaining financial sustainability.
Policy agenda for 2025
UCHP program director John Basa said the research complements an earlier study on local government health spending (“Maximizing Local Government Fiscal Performance of Health Budget”), highlighting the need for stronger inter-agency guidance and coordination.
“Together, these studies highlight that while both LGUs and PhilHealth are investing in health, effective policy guidance and evidence-based frameworks are critical to ensure resources translate into meaningful outcomes,” Basa said.
A related 30-year review of National Health Accounts showed Filipinos still shoulder 45 percent of health expenses out-of-pocket—well above the 30 percent target—underscoring the urgency of reforms in financing and coverage. —Ed: Corrie S. Narisma
