Piecing the Puzzle: Addressing the Multi-Payer and Fragmented Health Financing System in the Philippines

In this report, we characterize government health expenditures, examine the fragmented and overlapping nature of various financing streams, and propose a framework to address these challenges. Over the past decade, the Philippines has experienced unprecedented growth in government health expenditures, driven by increased fiscal space, a policy emphasis on health, and rising national income. While this trend is commendable, we have observed growing fragmentation within the system despite attempts at consolidation under the Universal Health Care Act. Multiple financing streams—including PhilHealth, the country’s national health insurance program, as well as national and local government budgets and medical assistance programs—often overlap and sometimes compete. This situation undermines efficiency and equity by disrupting risk pooling, limiting economies of scale, and leading to instances of “double funding”. Comments to this paper are welcome within 60 days from the date of posting. Email publications@pids.gov.ph.