The term social security is very complex and there is no clear definition. It is accepted that the social insurance system is a part of social security. But Social security is defined more broadly as a complex system of measures that shall provide social justice within a society via the solidarity principle. Therefore, social assistance is also a part of social security. According to a narrow definition social security is given when every member of society has achieved an acceptable standard of living. In Germany the definition of social security refers to its system of social insurance but social security is broader and further comprises measures within social policies e.g. an active labor policy, education policy etc. The German government focuses on the social insurance system as the
major column of social security as well. One focus of development policies of the German Federal Ministry for Economic Cooperation and Developments lies on social security. Within that framework major objectives are to strengthen social insurance systems and to provide basic social services to the (poor) populations of developing countries. The BMZ defines (national) social security systems as established institutions that are to support people in mitigating risks and coping with their impacts.
The aim in developing countries is to secure the (poor) population against the occurrence of future emergency situations and against existing current emergency situations. Social security systems shall strengthen the risk management capability in a sustainable way. This shall improve the capacity of coping mechanisms. Furthermore, there is a need for subsidizations of extremely poor people so that they can participate in social insurance systems.
The model for the development of social security systems in developing countries is the structure of the German welfare state. Thus, the provision of social security is a key task of the state. Germany’s social security system provides far-reaching security for
employees. It is based on the “five pillars” of social pension, disability, unemployment, long term care and health insurance. Four key principles have to be guaranteed for the successful implementation of social security systems.
Table of Contents
1. SOCIAL HEALTH INSURANCE AS A PART OF SOCIAL SECURITY
2. THE HEALTH STATUS IN THE PHILIPPINES
2.1 HEALTH INDICATORS
2.1.1 LIFE EXPECTANCY
2.1.2 MORTALITY RATES
2.2 ILLNESSES
2.3 REPRODUCTIVE HEALTH AND MALNUTRITION
2.4. ENVIRONMENT AND WATER
2.5. MISSING ACCESS
3. THE PHILIPPINE HEALTH SYSTEM
3.1 HEALTH FACILITIES, PERSONNEL AND THE DISTRIBUTION OF MEDICINES
3.2 REGIONAL DISSIMILARITIES AND THE DEVOLUTION
3.3 HEALTH CARE UTILIZATION
3.4 THE MAIN SECTOR PRIORITIES FOR HEALTH
4. HEALTH FINANCING IN THE PHILIPPINES
4.1 FINANCING RESOURCES AND AGENTS
4.1.1 PUBLIC SPENDING
4.1.2 PRIVATE SPENDING
4.1.3 EXTERNAL FUNDS
4.1.4 EQUITY WITHIN HEALTH FINANCING SYSTEM
4.2 USE OF FUNDS
4.2.1 PUBLIC HEALTH PROGRAMS
4.2.2 CURATIVE CARE
5. PUBLIC HEALTH FINANCING AGENTS IN THE PHILIPPINES -SOCIAL SECURITY FUNDS
5.1 GSIS:
5.2 SSS:
5.3. PHILHEALTH:
5.3.1 VISION, MISSION, MEMBERSHIP AND BENEFITS
5.3.2 PHIHEALTH PROGRAMS
5.3.2.1 The Indigent Program
5.3.3 THE EFFECTS OF IP ENROLLMENT ON POOR PEOPLE
5.3.3.1 Utilization in RHUs
5.3.3.2 Utilization in hospitals
Objectives and Scope
This academic paper examines the Philippine health system and the role of social health insurance in providing security against financial risks associated with illness. It specifically investigates whether the state-led health insurance initiatives are capable of ensuring equitable access for the impoverished population and reducing their heavy reliance on out-of-pocket payments.
- Analysis of the current health status and primary health challenges in the Philippines.
- Evaluation of the existing health infrastructure, including facilities, personnel, and regional disparities.
- Examination of health financing structures and the role of various funding agents.
- Assessment of the Indigent Program (IP) within the PhilHealth system regarding its effectiveness in improving healthcare utilization for the poor.
Excerpt from the Book
3.1 Health facilities, personnel and the distribution of medicines
In the Philippines a range of private and government facilities provide health care services. The private sector includes a wide range of health facilities. Primary, secondary and tertiary hospitals are part of the private sector as well as maternity centers, employer-based outpatient facilities, health management organizations, diagnostic laboratories, independent physicians/dentists. Furthermore, “group practice, pharmacists, chiropractors, traditional birth attendants, and other indigenous healers” constitute the private sector. The private sector focuses mostly on curative and rehabilitative care. According to a survey conducted by the Department of Health (DoH) and the National Statistic Coordination Board (NSCB) in 2003, more than 1,061 private hospitals with a bed capacity of more than 39,000 existed in the Philippines. These are more than 62% of all hospitals. The private sector operates approximately 19,000 drug distributors and outlets. “Other registered private providers included 92,000 physicians, 39,000 dentists, and 44,000 pharmacists.”
The remaining 640 (38% of all) hospitals are run by the government and provide more than 40,000 hospital beds. The government maintains health facilities on every political level. The most advanced facilities are specialty and tertiary hospitals at the national level. Tertiary hospitals suppose of “at least four specialty services” and some have teaching or research facilities.
Summary of Chapters
1. SOCIAL HEALTH INSURANCE AS A PART OF SOCIAL SECURITY: Defines the conceptual framework of social security and its application to development policies in developing countries, specifically focusing on the German welfare model.
2. THE HEALTH STATUS IN THE PHILIPPINES: Provides an overview of key health indicators, prevalent diseases, malnutrition, and environmental factors impacting public health in the Philippines.
3. THE PHILIPPINE HEALTH SYSTEM: Describes the structure of healthcare delivery, including the roles of public and private sectors, regional disparities, and the impact of the devolution of health services.
4. HEALTH FINANCING IN THE PHILIPPINES: Analyzes the sources and agents of health financing, focusing on public versus private spending and the inequity inherent in the reliance on out-of-pocket payments.
5. PUBLIC HEALTH FINANCING AGENTS IN THE PHILIPPINES -SOCIAL SECURITY FUNDS: Examines the transition from traditional insurance schemes (GSIS, SSS) to the current National Health Insurance Program administered by PhilHealth, with a specific focus on the Indigent Program.
6. CONCLUSION: Synthesizes the findings, highlighting the persistent challenges in achieving universal coverage and the limitations of current reimbursement structures for the poor.
Keywords
Philippines, Social Health Insurance, PhilHealth, Health Financing, Public Health, Indigent Program, Healthcare Utilization, Social Security, Healthcare Access, Medical Costs, Poverty Reduction, Health Infrastructure, Devolution, Out-of-pocket Payments, Preventive Care
Frequently Asked Questions
What is the core focus of this research?
The research explores the extent to which the Philippine state can provide social protection in the health sector, specifically analyzing the current health insurance system and its efficacy in covering the poor.
What are the primary thematic areas covered in the document?
The main themes include health indicators in the Philippines, the structure and delivery of health services, mechanisms of health financing, and the performance of government-sponsored insurance funds like PhilHealth.
What is the central research question?
The central question is how effective the Philippine social health insurance system is in providing sustainable social protection and equitable healthcare access, particularly for the impoverished sector of the society.
Which scientific method is employed?
The study relies on a descriptive and analytical approach, utilizing secondary data from the World Health Organization (WHO), government reports, and existing socioeconomic surveys to assess health utilization and financing.
What is treated in the main body of the text?
The main body examines the interplay between institutional health frameworks, financial barriers to treatment, the devolution of health services to local government units, and the impact of the Indigent Program on service utilization.
Which keywords characterize the work?
Key terms include social health insurance, PhilHealth, Philippine health system, health financing, indigent program, healthcare utilization, and poverty reduction.
How does the "devolution" of the health system affect local access?
Devolution transferred hospital management to Local Government Units (LGUs), which often led to inefficiencies and underfunding, as many LGUs struggle to allocate sufficient budgets to maintain high-quality care or adequate medicine supplies.
Does the Indigent Program (IP) significantly improve healthcare access?
While the IP has increased enrollment, the study notes that it has had limited impact on overall health outcomes, as actual utilization rates remain low due to physical barriers and the fact that PhilHealth reimbursements cover only a portion of total medical costs.
- Arbeit zitieren
- Diplomkulturwirt Daniel Weiss (Autor:in), 2006, The Health System in the Phillipines, München, GRIN Verlag, https://www.grin.com/document/73616
