FOURmula 1+ for Health:

Boosting Universal Health Care

MARIO C. VILLAVERDE, MD, MPH, MPM, CESO I
Undersecretary
Health Sector Reform Cluster
 Situational Overview
Increasing Expenditures for Health
• Rising Total Health Expenditures
593B in 2015 to 655B in 2016 (10.5%
increase at current prices)*
• Sin Taxes exceeded target
collection by 19% and grew by 25%
from 112B in 2014 to 142B in 2015
• Increasing PhilHealth Coverage at
92% population coverage and paying
26% more benefits in 2015 (97B)

Sources: World Bank, BIR, *PSA (latest data released Nov 6, 2017)
Situational Overview
• Marginal improvement in health outcomes, despite increased
investment for health
q High infant-child-maternal mortality rates, especially among the

poor (NDHS, FHS)

q 1 out of 3 children stunted (NNS 2015)

q Immunization of children lowest in 25 years at 60% (NDHS 2013)

• Inadequate financial risk protection

q OOP at 56% of Total Health Expenditures (2014)

q Compliance to No Balance Billing at 63% (2016)

q 1.5 million Filipinos pushed to poverty from access to health

services (WB 2014)

Bottlenecks
● Inequitable access to quality primary care services,
primarily due to unjust distribution of health workers
● Inefficient financing system, with many pools of funds
with little leverage
● Highly fragmented public and private health care
providers
● Lack of clarity in roles leading to blurred lines of
accountability
 FOURmula ONE Plus for Health (F1+)

• Framework for the implementation of critical health interventions

as a single package backed by effective management structures
and financing arrangements

• Aligned with the Philippine Development Plan 2017-2022,

AmBisyon Natin 2040, and SDGs 2030

• Filipinos are among the healthiest people in Southeast Asia by

2022, and in Asia by 2040
 FOUR Strategic Pillars of F1+

HEALTH HEALTH HEALTH GOOD

FINANCING SERVICE REGULATION GOVERNANCE
DELIVERY IN HEALTH

Plus: Performance Accountability

 HEALTH FINANCING
Secure sustainable investments to improve health
outcomes and ensure efficient and equitable use of health
resources

Strategies
• Efficiently mobilize and equitably distribute more resources
• Rationalize health spending
• Focus financial resources towards high-impact interventions
 HEALTH SERVICE DELIVERY
Ensure the availability of essential quality health services at
appropriate levels of care, especially for the poor

Strategies
• Increase access to quality essential health products and
services
• Ensure equitable access to quality health facilities
• Ensure equitable distribution of human resources for health
• Engage SDNs to deliver comprehensive package of health
services
 Health Regulation
HEALTH REGULATION
Ensure high quality and affordable health products, devices,
facilities and services

Strategies
• Harmonize and streamline regulatory systems and
processes
• Develop innovative regulatory mechanisms for equitable
distribution of quality and affordable health goods and
services
 GOOD GOVERNANCE IN HEALTH
Strengthen the capacities and coordination of management support
systems, and lead a participatory approach involving patients to
ensure functional people-centered service delivery networks
Strategies
• Strengthen sectoral leadership and management
• Improve organizational development and performance
• Improve processes for procurement and supply chain management to
ensure availability and quality of health commodities
• Ensure generation and use of evidence in health policy development,
decision making, and program planning and implementation
 PERFORMANCE ACCOUNTABILITY

Use systems to drive better execution of policies and

programs in the DOH while ensuring responsibility to all
stakeholders

Strategies:
• Institute transparency and accountability measures at all
levels
• Shift to outcome-based management approach