Today in Asia and the Pacific, spending on health is growing faster than economies. On average, nearly 8% of GDP is devoted to health. With governments around the world making ambitious commitments to universal health coverage, how can they get the most from this investment?
In the Philippines, around 55% of health spending is out-of-pocket, creating situations where families are pushed into poverty by paying for life-saving and health-preserving services. Not only is this a heart-breaking situation, it is bad for development. If people are forced to choose between paying for health and paying for education and basic necessities, their chances of becoming productive members of society are severely compromised.
It is commendable that through the UHC Act, the Philippines has chosen to invest in improving access to health for those in need, so out-of-pocket spending will become lower. Still, work has to be done to ensure everyone across the country has access to the health services they need, where and when they need them. Why? Because we are not yet investing in the most efficient ways of providing care.
Primary health care is the best buy
We need to think outside of the traditional hospital box and reorient the health care model. Investing in primary health care means multiple sectors working together to bring health care closer to where it matters to people, with the involvement of the community. The evidence shows that the most effective and efficient way to provide health for all is to invest in primary health care.
By placing primary care and essential public health functions at the core, primary health care offers an integrated, comprehensive, coordinated, and continuous range of services to people at the heart of the community. It enjoins multisectoral policy and action and the engagement of empowered communities to look at people’s health and well-being.
Primary health care ensures that people have a partner in their health needs from birth and all throughout life – through health promotion, disease prevention, treatment, rehabilitation and palliative care. This is an efficient, acceptable, and affordable way of providing health care. It is the first step on the road towards universal health coverage—a vision where all people get quality health services without financial hardship.
Why invest now?
We are seeing rapid changes here in the Philippines. The economy is growing, but improvements to health and well-being have been uneven, with women and children missing out most. Climate change is causing more extreme weather events, compromising food and water security and increasing the risk of disease outbreaks.
Filipinos’ expectations about what health services can offer are also changing, due to greater availability of information and advances in technology.
At the same time, the country is struggling to deal with shifting patterns of disease as a result of population ageing and unhealthy environments and lifestyles. Today, around 6 out of every 10 Filipinos are dying because of noncommunicable diseases such as diabetes, cancer, chronic respiratory disease, and cardiovascular disease, while more than 3 million Filipinos are living with mental health conditions. The country is still also addressing infectious killers, malnutrition and other maternal and child health problems.
This is an opportunity for the government and the private sector, including health care providers of all kinds, to take action and help redesign the way we live our lives, and access services we need to thrive and prosper. The UHC Act is replete with provisions that can be implemented to strengthen primary health care as the Philippines’ foundation for UHC.
Why now? Because with these challenges ahead, we cannot afford to wait.
Let’s get smart
This World Health Day, the 7th of April, let’s get smart about health spending. We know that investing in UHC is a best buy for the Philippines as it will result to people becoming healthier and more productive citizens. Health for all must be by all – national leaders, local governments, private sector, civil society, health workers. We must all commit to strengthening primary health care as a foundation for UHC.
Dr Gundo Weiler is the WHO Representative in the Philippines
This commentary was originally published in the Philippine Daily Inquirer on 7 April 2019.