ByRogelio Constantino Medina
DEPARTMENT of Health (DOH) Secretary Ted Herbosa reiterates to this writer that the priority of his agency is the continuous implementation oftheUniversal Health Care (UHC) Law – thecore of their actions in the DOH through its eight-point action agenda.
“You know, in 2019, we passed that law by the Senate and Congress that aims to give everyFilipino access to health care services, even in far-flung areas and for those who cannot afford topay for medical services,” he began.
There is also a plan, he said, to focus on the issue of the emigration of healthcare workers inthe country, and the visible solution is to increase their wages so that they have the ability tosupport their families financially and live a comfortable life.
The DOH is working with legislators to pass abill to increase the entry salariesofhealthcareworkers. “We’re trying to generate evidence and explore strategies and schemes forstandardizing the salary of HRH (human resources for health) in the public health sector at thenational and local levels for the medical, nursing, dentistry, and medical technology occupationalgroup. We’re also ramping up efforts in monitoring and assisting the DOH implementing units infilling up the available unfilled plantilla positions, about 4,500 for nurses.”
Herbosa recognized the unfathomable service and the hard work that the country’s healthcare professionals have provided their patients. As the Philippines is reaping the fruits of continuousefforts to combat the COVID-19 pandemic, the “importance of advancing our health care systemnetworks are now emphasized.”
Health is a basic human right guaranteed by the Philippine Constitution of 1987. This isprovided in the Philippines through a dual health delivery system composed of the public sectorand the private sector. The public sector is largely financed through a tax-based budgetingsystem where health services are delivered by government facilities under the national and localgovernments. The DOH supervises government corporate hospitals, specialty and regionalhospitals.
In view of this reality, Secretary Herbosa has agreed to promote, or intensify, public-private partnerships (PPP) in health for he firmly believes that the public-private partnershipsamong the government and these corporate bodies are pivotal in the realization of the goals ofUHC. “We need all hands to galvanize the initiatives that we have to implement for theimprovement of healthcare services to the Filipino people.”
PPP, he said, is being intensified right now, with NEDA PPP Center and DILG (as DOHSpecial Concerns Team) to upgrade capacities and functionalities of facilities both in the DOHand the local government unit (LGU). Other modalities in private sector engagement are beingexplored to maximize partnerships and complete service capability ofthe Health Care ProviderNetwork.
To effectively achieve the goals of the Philippine Health Sector Reform Agenda, Herbosacited the importance of efficient collaboration between offices, bureaus and other governmentagencies. “Research and development shall also take our current systems to the next step ofadvancement which will also allow the DOH and its allied agencies to make healthcare servicedelivery expand even to the far-flung-areas.”
“The DOH shall also continue its delivery of primary and specialized care to Filipinosthrough effective collaboration with our Centers for Health Development and throughestablishment of more health centers nationwide,” he pointed out.
Critics claim there is a need to organizeour health system which was fragmented by thedevolved setup. Each municipality has a management system for their local health system. Thehospitals are in the provinces, but the frontliners or primary healthcare providers are in themunicipalities.
“Pursuant with Section 19.1 of the UHC Act and its IRR (and as aligned withSection 33 of the Local Government code), the DOH, DILG, Philhealth and LGU shall endeavorto integrate local health systems into Province-wide and City-wide health system LGUs whichhave committed to integrate (currently 71 LGUs or UHC Integration Sites as of this writing) areexpected to exhibit managerial, technical and financial integration with the aid of DOH,Philhealth, development partners, and other stakeholders. As of December 2022, 91% of theUHC Integration Sites have finished the preparatory level and are currently undergoing activitiesto strengthen organization and management systems on integration,” Herbosa explained.
He continued, “To expedite reforms on financial integration (e.g., prospective payments,network contracting, ACR-Global Budget), Philhealth together with DOH will be implementingsandboxes on primary care (PCPNKonsulta) and healthcare provider networks (UHCSulong)and will continuously provide assistance to then LGUs to achieve local health systemsintegration and functional HCPNs.”
So what is the weakness of our health sector? Is it because our health system is more focusedon individual-based packages of health programs? For instance, the treatment of cases, surgicalprocedures, laboratory testing, so it is curative though they are preventive measures that areindividual.
Health systems operations, said Herbosa, must consider the full continuum of care, fromprimary prevention to reduce risk exposure, to secondary prevention which detects diseasesearly, and finally tertiary prevention that seeks to minimize complications and disability anddelay death. “We can restate this as a dichotomy between ‘preventive’services and ‘curative’services. Note that individual-based services can be either preventive or curative. An example ofa preventive individual-based service would be blood chemistry diagnosis, which would allowfor early detection and treatment of dyslipidemia (i.e., ‘high cholesterol’) that could lead to heartdisease.”
Between preventive and curative services, one cannot be ignored in favor of the other. Evenprimary health care by definition has three elements, noted Herbosa, one of which “is primarycare and essential public health functions at the core of integrated health care services whichincludes curative services.”
Herbosa clarified that in primary health care, preventive services are prioritized overcurative services. Prevention is clinically better for health, he said, and financially moresustainable for individuals and the economy as a whole. “Therefore our health sector shouldfocus on improving both preventive services (handled and paid for by DOH and LGUs) andcurative services (still handled by DOH and LGUs through their hospitals, but with financingavailable from Philhealth).”
Few people know that DOH Secretary Herbosa is the great grandnephew of ournational hero, Dr. Jose P. Rizal, who served in thebarrioswhen he was exiled, and for that “wecan cull great inspiration of selfless service and patriotism.” Lucia Rizal is the mother of hisgrandfather.
As an emergency doctor, Herbosa has witnessed the struggles of the ordinary Filipino toaccess healthcare services as well as the gaps that the government can bridge for the people thatit serves. That experience honed his perspective and competencies in the field. Having an on-the-ground training, he was molded to act with conviction and dedication in every step of the way.
“In times of crisis, you cannot think solely of yourself, as the people already own you. Servicelies at the heart of this profession, and though there might have been more economicallybenefiting opportunities in other places, I stood by my oath to serve the people.”
As to how his medical experience molds his outlook toward life, he said that “I’m the onethat molds the physician in me. It’s because of my character of wanting to help other people,wanting to save lives, wanting to teach, wanting to develop things and solve problems. Thedoctor did not train in me, my direction was because the doctor was the one that was fit for myaptitude to help solve problems, help people.”
All experiences add to learning and learning is vicarious. So if it is an experience, it willcreate new knowledge. All experiences create new knowledge, the same way as research andstudy both make it. These help him improve his service for his fellow Filipinos.
