Social Health Insurance in a Developing Country : The Case of the Philippines  

Oleh:

Obermann, Konrad ; Jowett, Mattherw R. ; Alcantara, Maria Ofelia O. ; Banzon, Eduardo P. ; Bodart, Claude

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 12 (Jun. 2006), page 3177-3185.
Topik: health; social health insurance; philippines; decentralization; health care

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.4 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Very little is known about the philippine health care system and in particular its experience with social health insurance (SHI). Having initiated and SHI programme 35 years ago, the philippines hold many lessons for the development of such schemes in other low and middle income countries. We analyse the challenges facing PhilHealth. The national health insure. PhilHealth was formed in 1995 as a successor to the medicare programme and was given a mandate to achieve universal coverage by 2010. To date, PhilHealth has been quite successful in some areas (e.g. enrolment) but lags behind in others (e.g. quality and price control). We conclude thath SHI in the philippines has been a success story so far and provides lessons for countries in a similar situation. For example : 1. SHI is based on value decisions and the clear statement of societal goals can give guidance in the technical execution 2. SHI is a financing institution and need to be treated accordingly 3. SHI can be implemented independently of the current economic situation and might actually contribute to economic development 4. community based health care financing schemes should be merged with the national SHI in the long run, and 5. there is a strong need to push for high quality care and improved physical access. No clear suggestions can be give with respect to the benefit catalogue and the balance between economies of scale and decentralisation. Although riddled with many inadequacies, PhilHealth was set up as a strong and largely politically independent institution for the development of SHI. SHI can act as a stabilizing institution in a politically and economically volatile environment.

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