Health advocates from the Sin Tax Coalition said on Monday that the government must ensure that the law is fully funded in order for Filipinos to truly reap its benefits.
Last week, Health Secretary Francisco T. Duque III signed the Implementing Rules and Regulations (IRR) of the Universal Health Care Law (UHC) or RA 11223, which will pave way for its implementation after President Rodrigo Duterte signed the law last February 20.
Under the UHC law, all Filipino citizens are automatically enrolled into the National Health Insurance Program as direct contributors, or those who have the capacity to pay premiums, and indirect contributors sponsored by the government such as indigents and senior citizens.
Duque said the UHC will ensure holistic health care for every “Juan and Juana” by reorienting health care towards health promotion and preventive care, from a curative care focused system.
“The health system must actively improve the health literacy, the built environment, and the social determinants of health of every Filipino,” said Duque.
“When we say, “Sa UHC, lahat kasama,” we do not just mean that UHC caters to every Juan and Juana, we are also calling on every Juan and Juana to contribute to this immense reform to shape their health future, a health future that is for them and as much as it is by them,” said Duque.
The STC welcomed the signing of the UHC IRR, but reminded the government to have enough funds to ensure its sustainability.
“It goes without saying that UHC is a landmark reform that brings us closer to the reality of an effective health care system, where all Filipinos are able to easily access health related services,” said the coalition’s co-convener Dr. Anthony Leachon.
Leachon called on legislators to support the passage of increased sin taxes on heated tobacco products (HTPs), vapor products, and alcoholic beverages.
“It is imperative that we secure the necessary funding that will help us reach the milestones that UHC aims to achieve. As such, we urge our senators to support the passage of the excise tax increase on vape, HTPs, and alcohol currently being deliberated in the plenary,” he said.
The coalition also thanked the Department of Health for their efforts in making this possible, Rep. Angelina Tan and former senator JV Ejercito, who led the efforts for the law’s passage in the House of Representatives and the Senate respectively.
Before Congress went on its sine die break, Senate Ways and Means committee chairperson Pia Cayetano filed Senate Bill 1074. Cayetano’s proposal seeks to align the tax rate of e-cigarettes and vape with that of traditional cigarettes at PhP 45 beginning next year.
For alcoholic beverages, Cayetano’s bill significantly increases the tax on distilled spirits from P23.5 to P90 per proof liter with a 20% ad valorem tax starting next year.
Meanwhile, the tax on fermented liquors and alcopops would be raised from P 25.4 to P45 per liter next year. Finally, a specific tax of PhP 600 will be imposed on sparkling wines, and a specific tax of P43 on still and carbonated wines beginning 2020, with an annual increase of 10%.
Finance Secretary Carlos Dominguez III said that Cayetano’s proposal is expected to generate at least P47.9 billion in incremental revenue. This would help bridge the funding gap that still exists for the first year of the UHC Law’s implementation.
In his State of the Nation Address this year, the President mentioned that further raising sin taxes was one of his priority measures this Congress.
Under the UHC, each Filipino will be assigned to a primary care provider (health worker) who shall be the first contact of health care.
Primary care providers will deliver free essential health services and will guide patients through the different health care facilities.
All Filipinos will also be automatic members of PhilHealth as direct or indirect contributors and shall be eligible to No Balance Billing once admitted to basic or ward accommodations in hospitals.
Availability of basic ward accommodation in all facilities will be ensured through prescribed basic-private bed ratios—90:10 for public health facilities, 70:30 for public specialty health facilities, and a minimum of 10:90 for private health facilities.
With UHC, the delivery of optimum and quality health services will be achieved through capacity-building of human resources for health and improved access to medicines and commodities by way of transparent pricing.
With all these promising improvements in the health system, the DOH reminds every Filipino to be cognizant of their role as agents of change, equally responsible for their own health.
Meanwhile, the Pharmaceutical and Healthcare Association of the Philippines (PHAP) expressed its commitment to work with the DOH to make medicines more affordable and widen healthcare services for Filipinos.
“We share the same objective with the Department of Health to lower medicine prices. We are exploring partnerships and we want to work hand in hand with the DOH in making quality medicines and healthcare services more accessible,” said Teodoro Padilla, executive director of PHAP.
Padilla said the industry would ask for a meeting with Secretary Duque to harmonize their efforts in not just lowering medicine prices by up to 84% for various disease categories but also in ensuring that patients are supported throughout their journey.
In the meeting with DOH, PHAP also aims to discuss existing high-impact patient assistance programs by individual PHAP members that give free screenings and diagnostic tests, education and counselling, and special medicine pricing for patients to lower total treatment cost. These patient assistance programs can serve as a framework for future expansion of the cooperation with the government, specifically in the areas of cancer, diabetes, cardiovascular, and chronic respiratory diseases among others.
“We are reaching out to the government as a partner so that it does not have to resort to price control which could be contentious and counter-productive as other countries that tried it had found out. We can work together, achieve exactly the same or better objectives, and sustain it over the long haul,” he added.
He said that cheaper medicines are not enough because the poor, based on a study on the impact of the first round of Maximum Retail Price (MRP) in 2009, did not fully benefit from it.
“In other countries, from our neighboring countries such as Thailand and Singapore to as far as United Kingdom, they have strong health insurance systems to help their citizens cover for medicine and healthcare expenses that would have been taken from their own family’s savings,” Padilla said.
“If more resources are allocated for the health of the people, the poor will benefit which is the essence of Universal Healthcare,” he said.
Padilla added that provisions for (1) centrally negotiated procurement, (2) expansion of primary care drug benefit, (3) early access to innovative medicines, (4) special access schemes from the private sector, (5) health technology assessment, and (6) pooled procurement are tools available under the Universal Healthcare Law (Republic Act No. 111223) and the Cancer Control Act (Republic Act No. 11215) that could make medicines more accessible and affordable.
“There is no doubt that the government, with the help and cooperation of the private sector, will be able to solve this problem,” he said.