Health sector reform agenda in the Philippines--its effect on private hospitals. Priela JO Jr.

Abstract Despite the gains that Philippines posted towards improving the health of the Filipinos, more challenges need to be hurdled to further improve the countr !s health status i.e. high threat from infectious diseases, increasing degenerative conditions, emerging health problems due to environmental and wor"-related factors, etc. #he development and implementation of the Health $ector %eform Agenda &H$%A' is e(pected to address these problems through organi)ation*polic changes and financing structure needed to improve health care deliver , regulation and financing+ ,. Provide fiscal autonom to government hospitals- .. $ecure funding for priorit public health programs- /. Promote development of local health s stems- 0. $trengthen health regulator agencies! capacities- 1. 2(pand the coverage of the 3ational Health 4nsurance Program. #here is a need however to evaluate the implications of the H$%A implementation in the private hospital s stem as this sector accounts for 56.7,8 of the total number of hospitals, servicing 09./18 of the countr !s total bed re:uirements. ;a<or effects are+ ,. 4ncreased competition for patient mar"et- and conse:uentl - .. for funding*pa ments- /. =esser capital and financing access for service*facilit improvement- versus- 0. pressure from consumers*patients to render better :ualit , high-technolog service at a lower cost. >ertainl , an adverse effect on their operation will affect the access of a large percentage of the population currentl using their services. #his paper will provide an in-depth anal sis of the implications of the H$%A implementation on private hospitals, ma<or initiatives being underta"en to minimi)e adverse effect and innovations that can be capitali)ed to survive*grow in the new health environment. #he authors! active participation in the 3ational Health Planning >ommittee convened to oversee the H$%A implementation, the dialogues and conferences held with hospital sector for the Philippine Hospital Association, and actual involvement in hospital operation will provide a uni:ue perspective and authorit for this anal sis. Over-all ?oals #he implementation of FO@%mula O32 for Health is directed towards achieving the following end goals, in consonance with the health s stem goals identified b the Aorld Health Organi)ation, the ;illennium Development ?oals, and the ;edium #erm Philippine Development Plan+ better health outcomes B ;ore responsive health s stem- and B ;ore e:uitable healthcare financing. $pecific Ob<ectives+ Four mulaOne for Health will strive, within the medium term, to+ B $ecure more, better and sustained financing for healthB Assure the :ualit and affordabilit of health goods and servicesB 2nsure access to and availabilit of essential and basic health pac"ages- and B 4mprove performance of the health s stem

>arr ing out the ?ame Plan+Ainning $trategies to Attain FO@%mula O32 for Health >omponent-$pecific Ob<ectives F, >omponent 3o. ,+ H2A=#H F43A3>43? ;obili)ing resources from e(tra budgetar sources >oordinating local and national health spending Focusing direct subsidies to priorit programs Adopting a performance based financing s stem 2(panding the national health insurance program Ob<ective+ #he ob<ective of financing reforms under FO@%mula O32 for Health is to secure more, better and sustained investments in health to provide e:uit and improve health outcomes, especiall for the poor. F, >omponent 3o..+ H2A=#H %2?@=A#4O3 Harmoni)ing licensing, accreditation and certification 4ssuance of :ualit seals Assuring the availabilit of low-priced :ualit essential medicines commonl used b the poor Ob<ective+ #he main ob<ective of health regulation under FO@%mula O32 for Health is assuring access to :ualit and affordable health products, devices, facilities and services, especiall those commonl used b the poor. F, >omponent 3o. /+ H2A=#H $2%C4>2 D2=4C2%D ensuring the availabilit of providers of basic and essential health services inlocalities designating providers of specific and speciali)ed services in localities intensif ing public health programs in targeted localities Ob<ective+ FO@%mula O32 for Health interventions in service deliver are aimed at improving the accessibilit and availabilit of basic and essential health care for all, particularl the poor. #his shall cover all public and private facilities and services F, >omponent 3o.0+ ?OOD ?OC2%3A3>2 43 H2A=#H establishing FO@%-43-O32 advanced implementation sites

developing on =?@ FO@%mula O32 for Health $corecard institutionali)ing a FO@%mula O32 for Health 2(panded Professional >areer #rac" Ob<ective+ #he ob<ective of good governance in health is to improve health s s t e m s performance at the national and local levels. FO@%mula O32 for Health will introduce interventions to improve governance in local health s stems, improve coordination across local health s stems, enhance effective private-public partnership, and improve national capacities to manage the health sector.