All Filipinos are covered by national health insurance under the Universal Health Care Act, which was signed into law on 20 Feb 2019. The Philippine Health Insurance Corp. (PhilHealth) — which administers the country’s universal health care program — will publish implementing rules and regulations within six months of that date. Highlights of the law, aimed at guaranteeing equitable access to quality and affordable health care, include the following:
- All Filipinos are automatically enrolled in PhilHealth’s National Health Insurance Program, and membership has been simplified — members are either direct contributors (those who can pay health premiums) or indirect contributors (those whose premiums are subsidized by the government).
- Under the current PhilHealth system, members contribute 2.75% of their income, shared by the employer and employee, but contributions will increase to 5% by 2025 to help cover the costs of the new law. Late employer contributions are subject to 3% interest, compound monthly. Employers also face fines for noncompliance.
- All Filipinos will have access to preventive, promotive, curative, rehabilitative and palliative care, with primary care services a priority.
- All Filipinos are guaranteed zero copayments for basic/ward accommodations and will pay a fixed copayment for nonbasic admissions in public hospitals. Copayments and coinsurance will be regulated.
- The current fragmented local health systems will be consolidated into province-wide and city-wide health systems.
- Performance-based incentive schemes will be established for health facilities. Health Technology Assessment and Health Impact Assessment will be used to inform decision making.
- All public and private health care entities will be required to submit health-related and financial data and publish the prices of all health services and goods offered.
- Mechanisms will be established to monitor and evaluate the progress of programs, plans and actions.