Mr. Jossel I. EbesateStaff Regent, University of the PhilippinesNational President, Alliance of Health Workers

Kalusugan Pangkalahatan:Para Kanino?

Kasalukuyang sitwasyon

6

80,000

sa kada 10 Pilipino ay namamatay nang walang atensyong medikal

sanggol na Pilipino ang namamaty taun-taon mula sa mga MAIIWASANG sakit

Life Expectancy: >80 years

Infant Mortality Rate <10

Maternal Mortality Ratio <15

Life Expectancy: <60 years

Infant Mortality Rate >90

Maternal Mortality Ratio >150

(Romualdez, 2008)

At current rate of decline, the Philippines is unlikely to reach the MDG target for MMR by 2015

0

50

100

150

200

250

1993 1998 2006 2011 2015

209

172162

52

140

70% ng mga Pilipino ay walang access sa mga pinaka-esensyal na gamot

(WHO World Medicines Situation, 2004)

HATIAN NG GASTOS SA PANGKALUSUGAN

59% out of pocket

23% government

18% Shared-Risk Schemes Including National Health Insurance (PhilHealth)

Philippine Health Insurance Corporation (PhilHealth)

Ang PhilHealth ay patuloy na ginagamit bilang instrumento ng POLITICAL PATRONAGE

Selected HDI Data 2005 -20101 Norway 1 10 US 4 61 Mal 57 73 Thai 92 84 Phils 97 108Viet113

Life Expectancy 79.4 81.0 77.4 79.6 73.2 74.7 70 69.3 70.4 72.3 70.5 74.9

Maternal Mort/100K 6 7 8 11 41 62 44 110 170 230 170 150

Infant Mort/1K 4 3 7 7 10 6 18 14 26 26 17 12

Birth Att by Prof’l (%) 100 100 99 99 97 100 99 99 60 62 85 88

Pop Growth 0.5 0.7 0.9 0.9 1.6 1.5 0.7 0.5 1.6 1.7 1.2 1.0

Sagot ng Pamahalaan sa

Malalang Kalagayang

Pangkalusugan

Comprehensive Reforms in Health

Universal Health Care (2010 -2016)Fourmula One

for Health (2005 – 2010)Health Sector

Reform Agenda (1999- 2004)

Strategy Five (HCF Strategy 2010-2020 - DOH):Secure fiscal autonomy of facilities

2010 2014 2020

DOH retained hospitals with income retention

DOH retained hospitals receive salaries from DOH budget

DOH retained hospitals are fully corporatized and autonomous; they do not receive subsidies

LGU health facilities without income retention

LGU health facilities with income retention

LGU health facilities receive minimal subsidy

Revenues = local taxes DOH and LGU fund capital outlay

DOH and LGU fund capital outlay

GOP spending on supply side: PHP 45 billion

PHP 60 billion

Patuloy na Pagbaba ng Budget Pangkalusugan

(Total Health Sector Budget and DOH Budget)

2011 2012 2013

P40,508,912

P50,558,824

P46,821,977

P30,618,385

P42,847,536

P40,969,880

Source: DOH Agency Budget Notes, HOR

Selected HDI Data 2005 -20101 Norway 1 10 US 4 61 Mal 57 73 Thai 92 84 Phils 97 108Viet113

Public Health Exp as % GDP

8.0 7.5 6.6 7.1 2.0 1.9 3.1 2.7 1.1 1.3 1.5 2.8

Private Health Exp as % GDP

1.6 2.2 8.0 9.1 1.8 2.9 1.3 1.6 1.8 2.5 3.7 4.4

/Capita ($)Health Exp

3,409

4,763

5,274

7,285 349 604 321 286 153 130 148 183

Physician/10,000 pop. 36 39 26 27 7 7 3 3 12 12 5 6

Hosp. Beds 34 39 27 31 19 18 22 22 13 5 26 28

Privatization sa porma ng corporatization

*HB 4069 – Rep Anthony Golez

*HB 6145 – Rep Raul Daza

*SB 3130 – Sen Franklin Drilon

*An Act Transforming the 26 Government Hospitals into Government Owned and Controlled Corporations and for Other Purposes

Corporatization• Refers to a public organization that transforms into a

corporation. The company’s activity is regulated under corporate law (Corporation Code) and the revenue is regulated by contract (Aidemark, 2005), but the company is still owned largely by the public and is usually not operated for profit.

• Corporatization can be seen as a step towards privatization (Öhrming & Sverke, 2001) or even as a form of privatization itself (Lundqvist, 1991).

Privatization

• It is sufficient that one of these functions (i.e., the financing, production or regulation) is transferred to private management to say that a privatization has taken place (Lundqvist, 1991)

• Privatization could also apply to the sale of state property, such as real estate or capital (Blomqvist, 2005).

Ibayong pagsasamantala sa Manggagawang Pangkalusugan

*Freeze Hiring (No creation of plantilla positions since 1995

*Contractualization including Outsourcing

*Installment Salary Increase/Freeze in Legislated Wage Increase

*Reorganization/Rationalization

Summary

Ang sagot ng pamahalaan sa

lumalalang sitwasyong pangkalusugan ay

ibayong pagtalikod sa responsibilidad nitong

itaguyod ang kalusugan ng mamamayan at

pagtaguyod ng interes ng negosyo sa

serbisyong pangkalusugan

Panawagan

*Tutulan ang pagsasapribado ng mga pampublikong ospital

*Maglaan ng sapat na badget pangkalusugan (5% of GDP – P527B)

*Siguraduhin ang sapat na bilang ng mga manggagawang pangkalusugan (WHO – 2.3:1,000 population)

*Ipaglaban ang libre, kumprehensibo at progresibong sistemang pangkalusugan