UNIVERSALLY

The House of Representatives has approved on 3rd and Final reading HB 5784 or the Universal Health Coverage (UHC) Bill. The bill passed with a 222-7-0 vote.

Deputy Minority Leader and Kabayan Party-list Representative Harry L. Roque on Wednesday said the passage of House Bill (HB) No. 5784  was a golden opportunity for change for a better health system as he lauded the passage of the landmark bill.

 

“It is our duty and responsibility to see the enactment of this bill that gives spirit to the right to health of the people and I am very happy that today we took a giant step forward to realizing this,” Roque, one of the leading proponents of the bill, said.

 

“This bill is groundbreaking because with it, every Filipino is granted the right to health by virtue of citizenship. It provides health security to Filipinos not because they can pay premiums, but simply because they are Filipinos,” he added.

 

Roque defended the bill during its second reading. According to the lawmaker, one of the key features of HB 4784 is that it enables all individuals and communities to receive the full spectrum of health services they need, from health promotion to prevention, treatment, rehabilitation and palliative care.

 

“This includes inpatient, outpatient, and emergency care services encompassing preventive, promotive, curative, rehabilitative, and palliative medical, dental, and mental health services,” the lawmaker stressed.

 

“In short, UHC enables everyone to access the services that address the most important causes of disease and death, and ensures that the quality of those services is good enough to improve the health of the people to receive them,” he added.

 

Under the proposed UHC Bill, the Philippine Health Insurance Corporation (PhilHealth) is also reconstituted into the Philippine Health Security Corporation (PHSC) as it becomes the national purchaser of health services.

 

“UHC membership will be categorized into two: contributory, or those who pay such as public and private workers; and non-contributory workers, or those who give no contributions such as indigents,” Roque explained.

 

Moreover, HB 4784 provides for the adoption and institutionalization of Health Technology Assessment and the creation of the Health Technology Assessment Council (HTAC).

 

HTA denotes any process of examining or reporting properties of a medical technology used in health care, including safety, efficacy, feasibility, and indications for use; cost-effectiveness; as well as social, economic, and ethical consequences, whether intended or unintended.

 

“HB 5784 provides for the institutionalization of HTA to guide decision makers, particularly in the procurement of medical devices, commodities, drugs, and vaccines. The HTAC will serve as advisory body to the Health Secretary and the Board of Directors of the PHSC on the priority entitlements for universal health coverage,” the lawmaker said.

 

Another key feature of the bill is the mandating of income retention for all government health facilities.

 

Roque explained the bill authorizes Department of Health (DOH)-retained hospitals, specialty hospitals, and LGU-hospitals to utilize 100 percent of their income to enhance their capacity and improve the quality of their services.

 

Furthermore, UHC bill provides for a clear delineation of functions of agencies and sectors involved in health services, addressing the high fragmentation of the present health system in the country.

 

“The bill explicitly provides for a division of labor among the DOH, PSHC, the Department of Social Welfare and Development (DSWD), the Department of the Interior and Local Government (DILG), and the local government units (LGUs),” he said.

 

“The DSWD is mandated to cover all indirect costs that are borne out of accessing medical services such as transportation, accommodation, or halfway house, and meals. The DILG, in partnership with the DOH, shall coordinate and promote the implementations of the UHC law, including the execution of the operation and investment plans of LGUs related to health. The LGUs, meanwhile, will be responsible for delivering population and individual-based health services in communities within their respective jurisdictions,” Roque added.

The Makabayan bloc opposed the passage of the bill.

Gabriela Party list rep Arlene Brosas said, “bagamat kinikilala natin ang matiding pangangailangan para sa reporma ng sistemang pangkalusugan sa bansa, naniniwala po ang Gabriela na hindi ito ang sasagot sa mga pangangailangang pangkalusugan ng ating mamamayan. sa paanukalang batas, nililimitahan ng mga conditions for acces tulad ng pagkatali sa insurance financing, parusa sa mga missed contributions, listahan ng negative  and positive lists of covered health conditions at maging ang mga bureaucratic interventions na nagdidikta kung aling mga sakit ang covered ng health insurance….sa halip na dahdahan natin ang budget upang makapagpatayo ng mga bagong ospital, makapag acquire ng mga medical facilities at makapag hire ng mga medical personnel, patuloy natin binabawasan ang pondo ng pampublikong ospital. dahil dito, nadodomina ng mga pribadong ospital ang pagbibigay ng medical care sa ating mga mamamayan. kaya kung mayroon man seserbisyuhan ang batas na ito, hindi ang mamayan kungdu ang pagbibigay ng guaranteed profit sa private health care institutions.”

Anakpawis Rep. Ariel Casilao said, “ Madam Speaker, allow me to briefly explain my negative vote on the bill. In the initial deliberation of this bill, this representation supported in lieu of the need of a comprehensive health care program for the Filipinos that is accessible, if not free. If it’s too much to ask for a free health services from the government since we are currently deliberating the budget for 2018. However, upon the continued deliberations of this bill in the Committee, this representation found out so many loopholes and so many provisions that are essentially anti-people. Article II, Declaration of Principles and State Policies of the 1987 Constitution clearly states in Section 15, Madam Speaker, “The state shall protect and promote the health of the people and instill health consciousness among them.” Article 13, Section 11 stipulates also, “The state shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost.”

Madam Speaker, isang matingkad na puna ng kinatawang ito sa mga probisyon ng panukalang batas na ito, ng House Bill 5784, the Universal Health Care Bill, ay ang pagbibigay ng malaking kapangyarihan sa isang health provider na mala-insurance. Hindi po ito ang health services na nilalayon ng kinatawang ito na magkaroon ang ating gobyerno. Maraming pera po ang ating gobyerno na pwedeng ilaan hindi lamang sa isang curative mode ng health services kundi sa mas mainam na preventive at doon sa hindi lamang kung kailan magkasakit ang isang mamamayan na kung saan kailangan nyang magamit o pwede nyang gamitin. Ang karapatan sa kalusugan ng mamamyan ay nailalagay sa kondisyon at dagdag na mga proseso na maaaring magresulta sa inaccessibility ng health care at exclusion ng maraming maralita o mahihirap. With this Madam Speaker, the negative vote for the House Bill 5784. Thank you.”

ACT Teachers Party List Rep. France Castro said in a statement, “Una, isang health care system na heavily insurance-based ang naisin ng panukala.  Ang sinasabing “universal access” ay equated sa universal coverage lamang sa PhilHealth at iba pang health insurance providers, public and private.  Di pa nga sinosolusyunan ang mabibigat na isyung umiikot sa PhilHealth, dito pa iaasa ang so-called “universal health care.”  Sa ilalim ng PhilHealth ng UHC bill, “zero co-payment” ang para sa tinatawag na “non-contributory” group, at “co-insurance” naman sa “contributory” group, o silang magbabayad para sa tinutukoy ng panukala na “higher types of accommodation.”  Kabilang sa grupong ito ang lahat ng may sahod o suweldo o anumang kita, kahit job order, contract of service employees, minimum wage earners, nasa informal economy. Ikalawa, gusto rin nito ang labis na pagpapahina ng DOH, at pagpaigting ng devolution na napatunayang nagpapalayo lalo sa mga mamamayan mula sa serbisyong pangkalusugan, lalo na ang mga nasa mahihirap at liblib na probinsya at munisipalidad.  Wala ring mandate sa national government na mag-invest o pondohan ng sapat ang pagpapatayo ng mga ospital at barangay health stations, rural health units, at iba pang institusyong pangkalusugan, bukod sa kakaunting banggit sa Section 9 (pagtatalaga lamang ng per capita allocation na LGUs na ang bahalang mag-appropriate), at mag-hire ng sapat na bilang ng health workers, at iba pa.  Akalain mo, kailangan pa ng isang “Certificate of Need” mula sa DOH bago makapagtayo ng ospital o anumang health facility ang LGU sa isang lugar, samantalang alam naman natin na halos lahat kundi man lahat ng lugar sa bansa ay kulang na kulang sa mga ospital at health center.  Sa ilalim ng bill na ito, ang DOH ay magiging tagapag-siguro ng “sustained health financing,” tech support para sa service providers, at monitoring PhilHealth, HMOs, and public health insurance companies.  Kung ngayon ay taun-taon binabawasan ang MOOE at CO ng mga ospital, sa ilalim ng UHC bill na ito ang pambansang pamahalaan ay hindi na mag-aabalang magpondo para sa MOOE at CO.

Isang matinding epidemya ang dulot ng bill na ito sa mamamayan, lalo na ang mga kababayan nating mahirap at marginalized.”

Gabriela Party List Rep. Emmy de Jesus said, “ sa panukalang batas tila magsisilbing kolektor na lamang ng kontribusyon ang gobyerno sa halip na pangunahing nagpoondo para sa pampublikong serbisyong kalusugan. sa kabila ng pangakong pagtitiyak ng coverage for indigent patients, hindi maikakaila na sa panukalang ito na may presyo ang bawat serbisyo, gamit at gamot sa mga ospital,  habang limitado rin ang reimbursements mula sa Philippine Health Security Corporation. ang mga conditions for access and delineated exclusion ay maaring magesulta sa lalong inaccessibiity ng health services. kabilang sa maaring manaakwan ng karapatan sa serbisyong kalusugan ang napakarami nating mga mamamayan sa informal sectors na di makakabayad ng contributions, maging mga katutubo at iba pang mamamayang nasa geographically isolated and depressed areas.”

Kabataan Party List Rep Sarah Elago said “sa bahagi ng mga kabataan ang representasyong ito ay bumoboto ng no sa HB 5784 sa kadahilanan na kung talagang libreng serbisyong pangkalusugan  ang ating layon ang serbisyong pangkalusugan na dapat ay sapat libre at direkta mismo sa mga pampublikong ospital wala nang rekisitos tulad ng Philhealth membership Philhealth claims, Listahanan sa NHTS atbp pabigat na hakbang . ang pondo para sa Philhealth at iba pang insurance packages na ito  ay dapat na lang ilagay sa MOOE ng ating mga pampublikong ospital  imbes na ang kalkhan ng pondo na nailalagay sa philhealth ay papakinabangan din para sa pribadong interes.”

ACT Teachers Party List Rep. Antonio Tinio manifested on the floor, “ Madam Speaker, bumoto po ako ng NO sa House Bill No. 5784, Universal Health Care Bill. Malinaw po sa kinatawang ito na ang panukalang batas na ito ay ang sukdulan ng layunin na itulak tungo sa privatization at commercialization ang ating sistemang pangkalusugan. Mauugat ito mula sa ginawang devolution ng health services noong 1990s at nagpatuloy sa pagtulak ng mga patakaran ng commercialization at privatization sa mga public hospitals na pangunahing ginawa sa pamamagitan ng korporatisasyon ng mga ospital ng gobyerno at yung tuloy-tuloy na pagbawas sa Maintenance and Other Operating Expenses (MOOE) ng mga ospital. Sa ilalim ng panukalang batas na ito, tatanggalan na po ng MOOE ang mga public hospitals at iaasa na lamang ang buong kita nila sa mga reimburment mula sa PhilHealth. Sa ganitong modelo po ay ganap nang naging commercialized ang operasyon ng mga public hospitals at malinaw na sa pamamagitan ng batas na ito hindi makakamit ang layunin ng milyon-milyong mga kababayan nating Pilipino lalo na ang maralita para sa isang libreng sistemang pangkalusugan para sa bawat Pilipino kaya bumoto po tayo ng NO, Madam Speaker.”

Bayan Muna Rep. Carlos Zarate withdrew as co-author of the bill. in his letter to the Rules committee, Zarate said, “ This representation would like to withdraw his co-authorship of House Bill 5784, mainly because said consolidated bill, we submit, is not in consonance with our position that free healthcare and a unified public healthcare should directly be funded by the Government through public hospitals.”