Analysis of catastrophic health financing by key institutions

Abstract

Financial risk protection is one of the three main thrusts of the Department of Health’s (DOH) Universal Healthcare initiative. This raises the need to mitigate the patients and their families’ catastrophic health expenditures, or out-of-pocket spending on health that can drive them to or further into poverty (DOH 2010). Three prerequisites have been postulated to contribute to catastrophic expenditures, namely, health services requiring payment, low capacity to pay, and the lack of prepayment or health insurance (Xu et al. 2003). These conditions currently prevail in the Philippine setting. While a large segment of the population is impoverished, health services requiring payment are the norm in the country’s government facilities. To improve the access to health services among indigent families, the Philippine Health Insurance Corporation (PhilHealth) has implemented social health insurances, such as the Sponsored Program and the Z Benefits packages, wherein fixed but substantial support is provided for select medically expensive conditions. If only these programs were effective, then the lack of health insurance would have been addressed and adequate financial protection would have been assured for Filipinos. However, empirical evidence suggests otherwise.