trends and issues - group 10 tldc

8/11/2019 Trends and Issues - Group 10 TLDC

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COST OF HEALTH CARE IN THE PHILIPPINES

The Department of Healths budget for 2013 alone is 59.9 Billion; with a proposed 2014 budget

of 87.1 Billion. With this large amount intended for the countrys health care delivery system.

The allocation of these funds are aligned with the departments highest (Top 5) priorities,

namely:

1. Subsidy for Health Insurance Premium payment of indigent families to the National

Health Insurance Program

2. Health Facilities Enhancement Program

3. Implementation of the Doctors to the Barrios and Rural Health Practice Program

4. Family Health including Responsible Parenting

5. Expanded Program on Immunization

With the cost of health care at a constant increase, thegovernment is continuously trying to adjust the countrys

funds to fit the populations health needs.

In 2011 alone, a staggering 431 Million pesos was spent for

health care in the country. Of this amount, 115 million was

payment from the government funds, while 227 million wasout-of-pocket expenses for private citizens. This shows thatmajority of the countrys health expenses still come from

out-of-pocket funds, rather than being subsidized by the

government.

For this to be corrected, the country is now taking steps inincreasing sources for health fund, both in the public and

private sectors.

PHILHEALTH

The Philippine Health Insurance is a government-owned and

controlled corporation whose mandate is to provide social

health insurance to Filipinos.

PANTAWID PAMILYANG PILIPINO PROGRAM

The 4Ps program is a program started during the administration of the former president

Macapagal-Arroyo. It provide a financial allowance to specific families that meet the set

requirements, one of which is having a child in school.


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NOCHP

The Negros Occidental Comprehensive Health Program, under the Negros First initiative first

started by the incumbent Gov. Alfredo Maraon Jr. It provides a 5,000-per-year-allowance to

certain families in the province to aid them in hospital fees.

HMO HEALTH MAINTENANCE ORGANIZATION

Common managed care in the Philippines and usually acquired for free through employment.

Designed to cover basic medical expenses for preventive and outpatient care, medical treatment

and hospitalization

Examples:

Maxicare healthcare Corp.

Caritas Healthshield Incorporated

Intellicare Medicard Phils.Inc.

Cocolife Healthcare

PRIVATE HEALTH INSURANCES

Insures a person from critical illness and hospitalization. A basic health insurance policy covers

hospital expenses as a supplement to HMO coverage.

Examples:

Philam Life Health Insurance

SunLife

Philippine Prudential Life Insurance Company Inc.

DSWD- DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

A government agency in social welfare development. It provides community based services;through preventive, rehabilitative and developmental programs and initiatives that

mobilize/utilize the family and community to respond to a problem, need, issue or concern of

children, youth, women, person with disabilities, older persons and families who are in need andat-risk.

PDAF

The Priority Development Assistance Fund (also known as pork barrel) is a discretionary fund inthe Philippines available to members of Congress. It is designed to allow legislators to fund


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small-scale infrastructure or community projects which includes local health spending, road

pavement, livelihood programs and others which could benefit residents of the political districts.

.

P.C.S.O. CHARITY SERVICES

The PCSO is the principal government agency for raising and providing funds for health

programs, medical assistance and services, and charities of national character. Its primary

mandate is to provide funds in order to sustain free medical and health services to the poorest ofthe poor, and to augment the current resources of various institutions and organizations providing

health services to the general public

LAWS AND POLICIES AFFECTING HEALTH CARE

SENIOR CITIZEN ACT

The Expanded Senior Citizens Act of 2010 gives the elderly benefits and privileges not

included in the Senior Citizens Act of 1992 (Republic Act No. 7432).

Some five million senior citizens, defined as resident citizens of the Philippines aged 60

and above, will get the following (Bonabente, 2010):

A 20-percent discount and exemption from the value-added tax on the sale of goods andservices (medicines, medical and dental fees, transport fares, services in hotels and

restaurants, admission fees in theaters and other places of leisure). In case of discountpromos, the senior citizens shall avail themselves of either the promotional discount or

the 20-percent discount, whichever is higher.

Mandatory PhilHealth coverage Free medical and dental service, diagnostic and laboratory fees in all government

facilities

A monthly stipend of P500

For indigents, a P1, 500-monthly stipend and free vaccination against the influenza virus

and pneumococcal disease

A five-percent discount on water bills (if consumption is less than 30 cubic meters a

month) and electric bills (if consumption is less than 100 kilowatt-hours)

Educational assistance for those who shall meet school admission requirements

In case of death, the nearest surviving relative of the deceased senior citizen shall get2000.

The law also orders the Department of Health, local government units and otherconcerned organizations to institute a national health program for the elderly.

It also establishes an Office for Senior Citizens Affairs in all cities and municipalities,

and a senior citizens ward in every government hospital.

To avail themselves of benefits, senior citizens should present their passport or other documents

establishing their citizenship and age.


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ABUSE AND VIOLATIONS

First-time violators of the law face imprisonment of six months to two years and a fine of

P50, 000 to P100, 000. For subsequent violations, the fine can go up to P200, 000, and the prison

term can reach six years.

Anyone who abuses the privileges granted in the law shall pay a fine of P5, 000 to P50,

000, and shall be jailed for at least six months.

EFFECT ON HEALTH CARE DELIVERY:

Above mentioned were actually taking effect (most of the cities and municipalities in thePhilippines) depending on the city or municipality where the senior citizen is. (e. g. in

Makati, every Wednesday, senior citizens are free to watch movies at the movie theater;

in Toledo, Cebu, medical, laboratory and diagnostic tests are free in Toledo City GeneralHospital)

Many senior citizens felt their worth even though they are old and no jobs.

It gives a big help for the relatives of the senior citizens while taking good care of them

since they could at least afford to avail expensive medicines such as the maintenance

medications of their beloved parents/grandparents.

It gives our senior citizens the chance of having a quality care whenever they need it.

However, some senior citizens actually use their cards in purchasing a lot of medicines to sell it

to somebody else to gain some profit. Some relatives of senior citizen also use fake authorization

letters to avail the 20% discount for their own food/medicine and not for the senior citizen

UNANG YAKAP

The Unang Yakap is a special program composed of a sequence of essential procedures

being implemented in the delivery or operating room during child birth.

FOUR COMPONENTS:

1. Provision of warmth, drying and stimulating the baby;

a. Immediately upon the birth of the baby, the obstetrician/nurse/midwife wipes the

baby dry.

b. The baby is also stimulated to breathe or cry during the process of drying

especially if baby hasnt cried yet.

c. Baby is placed prone onto the mothers bare abdomen/between the breasts/chest.

2. Uninterrupted skin-to-skin contact (between the mother and the baby)

a. Helps baby to regulate his/her temperature normally;


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b. Allows baby to swallow normal bacteria from the mothers skin that will colonize

his/her intestines and aid baby fight against infection. These bacteria also

stimulates intestinal cells and delays onset of allergic disorders;

c. Helps correct abnormality of blood gas analysis; and

d. Helps baby maintain normal blood sugar.

3.

Delayed or properly-timed cord clamping

a.

Delay in clamping allows additional blood to transfuse from the placenta to the

baby and thus an extra iron depot for the baby.

b. Decreases incidence of iron-deficiency anemia and save the baby from iron

supplementation.

4. Initiation of breastfeeding

E.O. 51 MILK CODE

The Milk Code of the Philippines is a law that ensures safe and adequate nutrition for infantsthrough the promotion of breastfeeding and the regulation of promotion, distribution, selling,

advertising, product public relations, and information services artificial milk formulas and other

covered products.

It includes Breast milk substitutes, including infant formula and milk supplements; Foods,

beverages, and other milk products (when marketed or represented to be suitable, with or withoutmodification, for use as partial or total replacement for breast milk); Bottle-fed complementary

foods; and Feeding bottles and teats.

POLICIES

Exclusive breastfeeding is for infants from 0 to 6 months.

Breast milk has no substitute or replacement.

In addition to breastfeeding, appropriate and safe complementary feeding of infants

should start from 6 months onwards.

Breastfeeding is still appropriate for children up to 2 years of age and beyond.

Infant or milk formula may be harmful to a child's health and may damage a child'sformative development.

Other related products such as teats, feeding bottles, and artificial feeding paraphernaliaare prohibited in health facilities.

Donation of products and materials defined and covered by the Milk Code shall be

strictly prohibited. Other donations which are given in kind or in cash by milkcompanies, their agents, and

their representatives, must be coursed through the Inter-Agency Committee (IAC) for

approval.

PROHIBITIONS

Advertising, promotion, and other marketing materials that are not approved by the IAC.


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Giving of samples and supplies of covered products to any member of the general public,hospitals, health facilities, personnel within the healthcare system, and members of their

families.

Point-of-sale advertising, giving of samples, or any promotion devices to induce salesdirectly to consumers at the retail level (ex. special displays, discount coupons,

premiums, rebates, special rates, bonus and tie-in sales, loss-leaders, prizes or gifts). Gifts, articles or utensils [that may promote the use of breast milk substitutes or bottle

feeding] given to pregnant women, mother of infants, the general public and all mothers.

Direct or indirect promotion of covered products to pregnant women or mothers of

infants.

Gifts of any sort with or without company name, logo, or brand name, given by milk

companies, manufacturers, distributors, and representatives of products covered by the

Code, to any member of the general public, hospitals, and other health facilities,

including their personnel and members of their families.

Promotion of infant formula or other products covered by the Milk Code in the healthcare

system. Undermining of breastfeeding

Display of products covered by the Milk Code or placards and posters concerning such

products in a healthcare facility.

Using of "professional service" representatives, "mother craft nurses", or similar

personnel provided or paid for by manufacturer or distributors of products covered by the

Milk Code in the healthcare system.

Assistance, logistics, or training, financial or material incentives, or gifts of any sort from

milk companies to health workers.

Information that implies or creates a belief that bottle feeding is equivalent or superior tobreastfeeding.

Accepting financial or material incentives or gifts of any sort, from milk companies, by a

health worker.

Providing samples of infant formula or other covered products, or of equipment and

utensils for their preparation or use to health workers.

Giving of samples of infant formula to pregnant women and mothers of infants or their

family members by a health worker.

Health and nutrition claims on labels and in advertisements.

False or misleading information or claims on labels and in advertisements.

SANCTIONS

Violators may be imprisonment for two months to one year and be made pay a fine of not

less than ONE THOUSAND PESOS (P1,000.00) and not more than THIRTY THOUSAND

PESOS (P30,000.00), or Suspension or revocation of license.


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R.A. 10354 - R.H. LAW

Republic act no. 10354- An act providing for a national policy on responsible parenthood

and reproductive health. This Act shall be known as The Responsible Parenthood and

Reproductive Health Act of 2012.

PROVISIONS

Family Planning is more given attention (e.g. Nurses provides a Health Teaching in thecommunity through Health Centers, in the Hospitals)

Sex education is also tackled to High School Students either by the Nurse or Guidance

Counselors of the school so that students are made aware of the reality in Family

planning

Physicians (OB & Gyne) inform their patients on what type of Family Planning are theiroptions and what type of contraceptives would they be comfortable with taking into

consideration the patients religion or culture.

Public are made known for Responsible Parenthood, letting them understand the

importance of having enough children that they could support and raise well (education,food, shelter, attention that parents to be could provide)

The State stresses the importance of Maternal Health by having a well-planned and safe

pregnancy.

CAUSE OF DEBATE

The Church believes that this law is anti-life since it causes abortion. Others believe The RH

Bill is wrong because it will make people participate in extra-marital and pre-marital sex.

NURSING SHORTAGE

The nursing shortage results from a shortage of skilled nurses who can care to individual patients

and the overall population. Shortageof nurses is not necessarily a shortage of individuals with

nursing qualifications, it is a shortage of nurses willing to work in the present conditions. It is

global challenge, affecting every country in the world and is caused by numerous factors that

ultimately cause a decrease in the quality of health care received.

CAUSES OF NURSING SHORTAGE

Inadequate workforce planning and allocation mechanisms

Resource constrained undersupply of new staff

Poor recruitment

Retention and return policies, and ineffective use of available nursing resources through

inappropriate skill mix and utilisation


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Poor incentive structures and inadequate career support.

NURSING EDUCATION

From just 40 schools offering nursing courses in 1970, the country now has 481 schools

offering nursing courses, In the 1990s, there were 170 schools; in June 2003: 251; in April 2004:

370; in June 2005: 441; and in June 2006: 470 schools. The rising enrolment mirrors the rising

demand for the services of professional nurses in the Philippines and in other countries.

From 2000 to 2010, schools have produced some 2 million nursing students, but many

fail in the board exams.

NATIONAL PASSING RATE

With 490 nursing colleges in the country, the Philippines is producing up to 100,000

nurses every yearway beyond its needs.

In 2012, the Professional Regulatory Commission (PRC) expressed concern over the

quality of nursing education in the country. The report also noted that according to the PRC, the

December 2011 board exam passing rate of 33.92 percent was even lower than December 2010s

35.25 percent, which the CHED said was the lowest in history.

NURSE PATIENT RATIO

However, despite the large pool of nursing graduates, many nursing positions in public

and private health facilities in the country remain unfilled due to many factors, not least of which

are the low compensation and generally poorer working environment in the country. The ideal

nurse to patient ratio of 1:4 per shift has yet to be realized in our country. The Philippine General

Hospital has a nurse to patient ratio of 1:15-26 per shift, and Davao del Sur has a province-wide

ratio of 1:44-45 per shift

EMPLOYMENT RATE

Citing statistics from the Professional Regulatory Commission, on 2010 the number of

unemployed and under-employed registered Filipino nurses is 187,000 and unemployment ratereaches up to 324, 520 in July 2011.

With hundreds of thousands of unemployed licensed nurses desperate for work, thousands

of them went to hospitals to pay for the limited volunteer nurse slots or to train in order to gain

bedside clinical experience in exchange for certificates stating that they were nurse volunteers or

trainees for a specific period of time,"


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The Philippines is the primary exporter of nurses employed overseas

According to Masselink and Lee (2010), 85% of Filipino nurses worked overseas.

The Philippine government actually supports migration of the nurses by training a surplus

of nurses to be employed outside of Philippine borders

DEPLOYMENT RATE

Filipino nurses including doctors turned nurses continue to migrate in droves making the

Philippines one of the top source country of nurses, The Philippine Overseas Employment

Administration (POEA) reported that in 2008, nurse deployment at 11,495 was already doubl

that of 6,410 nurse deployment in 2000. These actual deployment figures were vastly lower than

the projected rates of deployment by the Department of Labor and Employment.

COUNTRIES WITH HIGH DEMANDS FOR NURSES

Every year, the Philippines has been sending thousands of nurses to different parts of the

world, particularly the U.S., the United Kingdom, the Middle East, Australia, Canada and even

New Zealand. And because of the nursing shortage present in these countries, they continue to

hire foreign nurses, providing better employment benefits and higher salaries.

COUNTRIES WHERE NURSES WERE DEPLOYED

The top destinations for Filipino nurses is theMiddle East with Saudi and the UAE leading the

market. In 2010, Saudi Arabia was the top destination of Filipinos with 8513 nurses deployed to

that country. The 3rd top destination, UAE lags behind with only a mere 473 nurses deployed

according to data from the POEA. On the other hand, only 83 nurses were sent to the US duringthat year. Demand for nurses in the US and Canada have slowed down since 2006.

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