Philippines' National Health Insurance Act

✍ Scribed by Reinhard Busse; Friedrich Wilhelm Schwartz

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 160 KB
• Volume: 12
• Category: Article
• ISSN: 0749-6753
• DOI: 10.1002/(sici)1099-1751(199704)12:2<131::aid-hpm464>3.0.co;2-#

✦ Synopsis

Through the recent National Health Insurance Act (NHIA), the Philippines have committed themselves to introducing a social health insurance with universal coverage within 15 years. Germany was the ®rst country to introduce a social health insurance system more than 100 years ago. Its system is based on the principles of corporatism, federalism and a mandate for equity. Based on long-term German experience with equity, quality, cost and eciency issues, the Philippines' NHIA is analysed concerning the entitlement to bene®ts and the bene®t package, the organization of the health insurance programme, health insurance ®nancing, and provider payment mechanisms. It is suggested that the Philippines could pro®t from including preventive and promotive services as well as pharmaceuticals in the bene®ts package. The organization of the health insurance system could be decentralized using the 13 regions as its principal units. To achieve ®nancial equity between regions and health funds, a contribution compensation scheme is proposed. To prevent over-utilization in over-served areas and to promote utilization in under-served areas, a relative value scale for fee-for-service payments seem advisable. (&1997 by