Social health insurance in a developing country: The case of the Philippines
AbstractVery little is known about the Philippine health care system, and in particular its experience with social health insurance (SHI). Having initiated an SHI programme 35 years ago, the Philippines hold many lessons for the development of such schemes in other low and middle-income countries. We analyse the challenges currently facing PhilHealth, the national health insurer. PhilHealth was formed in 1995 as a successor to the Medicare programme and was given a mandate to achieve universal coverage by 2010. To date, PhilHealth has been quite successful in some areas (e.g. enrolment), but lags behind in others (e.g. quality and price control). We conclude that SHI in the Philippines has been a success story so far and provides lessons for countries in a similar situation. For example: (i) SHI is based on value decisions and the clear statement of societal goals can give guidance in the technical execution, (ii) SHI is a financing institution and needs to be treated accordingly, (iii) SHI can be implemented independently of the current economic situation and might actually contribute to economic development, (iv) community-based health care financing schemes should be merged with the national SHI in the long run, and (v) there is a strong need to push for high quality care and improved physical access. No clear suggestions can be given with respect to the benefit catalogue and the balance between economies of scale and decentralisation. Although riddled with many inadequacies, PhilHealth was set up as a strong and largely politically independent institution for the development of SHI. SHI can act as a stabilizing institution in a politically and economically volatile environment.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 62 (2006)
Issue (Month): 12 (June)
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Annear, Peter Leslie & Bigdeli, Maryam & Jacobs, Bart, 2011. "A functional model for monitoring equity and effectiveness in purchasing health insurance premiums for the poor: Evidence from Cambodia and the Lao PDR," Health Policy, Elsevier, vol. 102(2), pages 295-303.
- Hou, Xiaohui & Chao, Shiyan, 2011. "Targeted or untargeted? The initial assessment of a targeted health insurance program for the poor in Georgia," Health Policy, Elsevier, vol. 102(2), pages 278-285.
- Konrad Obermann & Matthew Jowett & Juanito Taleon & Melinda Mercado, 2008. "Lessons for health care reform from the less developed world: the case of the Philippines," The European Journal of Health Economics, Springer, vol. 9(4), pages 343-349, November.
- Ellen van de Poel & Eddy van Doorslaer & Owen O'Donnell, 2011.
"Measurement of Inequity in Health Care with Heterogeneous Response of Use to Need,"
Tinbergen Institute Discussion Papers
11-155/3, Tinbergen Institute.
- Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
- Clouston, Sean A.P. & Quesnel-Vallée, Amélie, 2012. "The role of defamilialization in the relationship between partnership and self-rated health: A cross-national comparison of Canada and the United States," Social Science & Medicine, Elsevier, vol. 75(8), pages 1342-1350.
- Adam Wagstaff, 2010.
"Social health insurance reexamined,"
John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
- Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009.
"Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme,"
Journal of Health Economics,
Elsevier, vol. 28(1), pages 1-19, January.
- Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
- Caballes, Alvin B. & Söllner, Walter & Nañagas, Juan, 2012. "Financial protection mechanisms for inpatients at selected Philippine hospitals," Social Science & Medicine, Elsevier, vol. 75(10), pages 1820-1827.
- Ellen van de Poel & Eddy van Doorslaer & Owen O'Donnell, 2011. "Measurement of Inequity in Health Care with Heterogeneous Response of Use to Need," Tinbergen Institute Discussion Papers 11-155/3, Tinbergen Institute.
- Wagstaff, Adam, 2007. "Health insurance for the poor : initial impacts of Vietnam's health care fund for the poor," Policy Research Working Paper Series 4134, The World Bank.
- Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer, vol. 11(5), pages 437-447, October.
- Gabriela Flores & Owen O'Donnell, 2012. "Catastrophic Medical Expenditure Risk," Tinbergen Institute Discussion Papers 12-078/3, Tinbergen Institute.
- Garcia-Diaz, Rocio & Sosa-Rub, Sandra G., 2011. "Analysis of the distributional impact of out-of-pocket health payments: Evidence from a public health insurance program for the poor in Mexico," Journal of Health Economics, Elsevier, vol. 30(4), pages 707-718, July.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.