ArticleGlobal health action2018
The role of national health insurance for achieving UHC in the Philippines: a mixed methods analysis.
Article in Global health action, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Research gaps on universal health coverage in the South African context and other low and middle-income countries; putting things into perspective: a scoping review.BMC health services research · 2026Article
- The need for equity in interventional cardiology care in sub-Saharan Africa.Frontiers in cardiovascular medicine · 2026Article
- The Analysis of the Provider, Payer, and Regulator Stakeholders' Understanding and Acceptance of the Universal Healthcare Law in Three Provinces in the Philippines: A Qualitative Study Using a Content Analysis Approach.Acta medica Philippina · 2026Article
- Sociodemographic factors associated with concurrent stunting and wasting among children experiencing extreme poverty in the Philippines: A cross-sectional study.Nutrition and health · 2025Article
- Socioeconomic impacts of community-based health insurance: evidence from Gondar Zuria District, Amhara Regional State, Ethiopia.Health research policy and systems · 2025Article
- Patients Safety Events at Philippine General Hospital.Acta medica Philippina · 2025Article
- Moving toward universal health coverage with a national health insurance program: A scoping review and narrative synthesis of experiences in eleven low- and lower-middle income countries.PLOS global public health · 2025Article
- Assessing Household Out-of-Pocket Expenditures for Non-communicable Diseases in a 4Acta medica Philippina · 2025Article
- Experiences and effect of implementing social health insurance (SHI) program in Nepal-A mixed method study.PLOS global public health · 2025Article
- Impact of health benefit package policy interventions on service utilisation under government-funded health insurance in Punjab, India: analysis ofThe Lancet regional health. Southeast Asia · 2024Article
- Effect of a case-capped, fee-for-service payment mechanism on accessibility and affordability of health care.Health affairs scholar · 2024Article
- Strengthening Public Financing of Primary Healthcare in India: A Perspective.Health services insights · 2024Article
- Health Benefit Utilization and Out-of-Pocket Expenses in Outpatient Care and Hospitalizations: Baseline Surveys of Three Primary Care Sites in the Philippines.Acta medica Philippina · 2024Article
- Awareness, Availment, and Satisfaction on various Health Services among Residents of a Rural Community in Samar, Philippines: A Mixed Methods Study.Acta medica Philippina · 2024Article
- The Monetary and Non-monetary Costs of Health Care in the Philippines.Acta medica Philippina · 2024Article
- The Cost of Primary Care: An Experience Analysis in an Urban Setting.Acta medica Philippina · 2024Article
- Framing health taxes: learning from low- and middle-income countries.BMJ global health · 2023Review
- Health financing challenges in Southeast Asian countries for universal health coverage: a systematic review.Archives of public health = Archives belges de sante publique · 2023Article
- Advancing Universal Health Coverage in the Philippines through self-care interventions.The Lancet regional health. Western Pacific · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundAchieving Universal Health Coverage (UHC) has by now become a key health policy goal in many countries and some form of National Health Insurance (NHI) is often used for this. The Philippines has had more than 50 years' experience with social health insurance and in 1995 established PhilHealth, the country's national health insurer.
objectivesAnalyzing the role of the Philippine NHI scheme in moving towards UHC, identifying potential avenues for improvement as well as indicating challenges and areas for further development.
methodsThis paper is based on a mixed methods approach including extensive literature search, data from PhilHealth and other sources, and key informant interviews with staff at PhilHealth, health care providers, and policy experts at national and international level.
resultsMajor achievements were the expansion of population coverage using an earmarked revenue source ('Sin Tax'), the introduction of the no-balance-billing to prevent co-payments, and the Health Facilities Enhancement Program to improve quality. The share of PhilHealth in total health expenditures is still only 14%, managing quality and cost of providers remains insufficient, the benefit coverage does not reflect the country's burden of disease, and financial protection for PhilHealth members is low. The UHC bill would provide a massive jump forward as all Filipinos would then be automatically enrolled in and thus entitled to the benefits of PhilHealth.
conclusionsFor expanding a contribution-based NHI beyond formal employment there needs to be a large increase in budget transfers to cover for citizens unable to contribute. The Philippine UHC bill shifts from the idea of contribution leading to entitlement to the idea of citizenship leading to entitlement and can thus be seen as a paradigmatic change in thinking about NHI. There are three areas that we believe are of key importance in developing further NHI: (i) governance, (ii) financial impact, and (iii) strategic purchasing.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.