Health Care System

• System


  Is an arrangement of parts and interconnections come together for a purpose
• Health System


  Combinations of resources, organization, financing, and management that culminate in the delivery of health services to the population (Roemer, 1991)
• Health System


  All the organizations and resources that are devoted to producing health actions (WHO, 2000)
• Improving the health of populations


  Strive for equity in health
• Improving the responsiveness of the health system to the population it serves


  Quality, accessible and cost effective health services
• Fairness in Financial Contribution


  Families are protected from financial catastrophe from health care expenditure
• Health Service Provision


  Preventive, clinical, restorative, palliative care service to improve health
• Health Service Inputs or Resource Generation


  Management of resources to produce health intervention
• Stewardship


  Overall system oversight
• Health Financing


  Raising and pooling resources to pay for health services
• Revenue Collection


  Collected from the payments of health services (taxation/sin tax, out of pocket payments, payroll contribution)
• Risk Pooling


  Under this is Bismarck Model and Beveridge Model
• Bismarck Model


  Sickness fund is paid by employees and employers
• Otto von Bismarck


  Prussian chancellor and pioneer of Bismarck model
• Beveridge Pooling


  Health services is paid by the government through tax payments
• William Beveridge


  Social reformer who designed Britain's health/national health services
• System Building Blocks

  1. Service Delivery
  2. Health Workforce
  3. Information
  4. Medical Products, Vaccines, and Technologies
  5. Financing
  6. Leadership or Governance
• Overall Goals/Outcomes

  1. Improved Health (Level and Equity)
  2. Responsiveness
  3. Social and Financial Risk Protection
  4. Improved Efficiency
• Service Delivery


  Delivery of quality, accessible, and safe services
• Health Workforce


  Human Resource Management
• Health Information System


  Production, analysis, dissemination, and use of timely and reliable information
• Medical Products, Vaccines, and Technologies


  Ensure equitable access, assured quality and cost-effective medical products
• Financing


  Funds are adequate to protect people from financial burdens and promote accessibility of services
• Leadership and Governance


  Ensures strategic policies, oversight, accountability, and building partnerships
• Health Reform Initiatives


  Done to address issues in the Philippines Health System
• 1970: Primary Health Care for All


  Developed a largely centralized government-funded and operated health care system
• 1979: Adoption of Primary Health Care


  Promoted participatory management of the local health care system
• 1982: Reorganization of DOH


  Integrated public health and hospital services
• 1986: Milk Code 1986


  Prevention and nutrition to promote breastfeeding
• 1988: The Generics Act


  Prescriptions are written using the generic name of the drug in an attempt to lower expenditure on drugs by promoting and purchasing non-branded medicines
• 1991: RA 7160 "Local Government Code"


  Transfer of responsibility of health service provisions to the local government units
• 1995: National Health Insurance Act


  Aims to provide all citizens a mechanism for financial protection with priority given to the poor
• 1996: Health Sector Reform Agenda


  Major organizational restructuring of the DOH to improve the way health care is delivered, regulated, and financed
• 2005: FOURmula One (F1) for Health


  Adoption of operational framework to undertake reforms with speed, precision, and effective coordination
• 2008: RA 9502 "Access to Cheaper and Quality Medicines Act"


  Promotes and ensures access to affordable quality drugs and medicines for all
• 2010: AO 2010-0036 "Kalusugang Pangkalahatan"


  Universal health coverage and access to quality health care for all Filipinos
• 2013: Sin Taxes for Health


  Generating extra revenue for the Department of Health by discouraging harmful consumption of alcohol and tobacco
• 2019: Universal Health Care Law


  Enrolling all Filipino citizens automatically in the National Health Insurance Program administered by PhilHealth. All Filipinos are guaranteed equitable access to quality and affordable health care services.
• Local Government Code in 1991


  Led to dual governance in health, with the DOH governing at the national level and the LGUs at the subnational level
• DOH Functions

  • Develop national plans or guidelines on health
  • Licensing hospitals, laboratories, and other health facilities through HFSRB, and health products through FDA
  • Coordinates government, private sector, and development partner assistance on health and leverages funds for improved health performance