finals in comparative health

8/8/2019 Finals in Comparative Health

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PRINCESS ROXANNE L. SUCOR

Master of Arts in Nursing

Comparative Health Care

MAN 215

FINAL EXAMINATION

1. Discuss the Philippine Health Care Delivery System, the programs, nature and structureunder the following periods:

a. Spanish period Traditional health care practices for healing were widely practiced during these

periods.

The friars were the ones who were responsible with the delivery of health careservices.

b. Commonwealth period Americans used a centralized system during their regime but to their own interests

only.

Not only the health care delivery system was improved during the commonwealthperiod, but the educational system as well.

c. Japanese period EO 94 provided for the post war reorganization of the DOH and public welfare. This

resulted in the split of the department with the transfer of Bureau of Public welfare

and the Philippine General Hospital to the Office of the President.

d. Marcos regimey PD 1397 renamed the DOH to the ministry of health. He also signed EO no. 851

which

reorganized the Ministry of health as Integrated Health Care Delivery System.

e. Cory Aquinoy Reorganization of the Department of Health. Transferred the ministry of health back

to the Department of Health. EO 119 clustered agencies and programs under the

office for Public health services, Office for Hospital and Facilities Services, Office for

Standards and Regulations and Office of Mangemetn Services.


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f. Ramosadministrationy RA 7160 known as the local Governemtn Code provided for the decentralization of

the entire government. This boruhg about a major shift in the role and function of

DOH.

g. EstradaadministrationEO no 102 redirecting the functions and operations of theDOH by Estrada graced the DOH

to proceed with its rationalization and steaming plan which prescribed the current

organizational and staffing structure consistent with its new mandate, roles, functions, and

post devolution

h. Arroyoadministration

y Botika ng Barangayy GMA 50 Program

2. Enumerate the local and national projects of the department of health. Arrange theseprograms according to your preferential prioritization.(defend your answer)

y Botika ng Barangayy GMA 50 Programy National TB Control Programy Knockout Tigdasy Dengue Control Programy Newborn Screening Programy Expanded Immunization Programy Dental Health Programy National Rabies Prevention and Control Programy Adolescent and Youth Health andDevelopment Programy Sangkap Pinoy Seal Programy Garantisadong Pambatay National Healthy Lifestyle Campaigny Family Planning ProgramAt present, the country is facing high mortality and morbidity rates. One possible reason for this is

inaccessible health care services and medical technology due to poverty. The most affected are the

marginalized poor Filipinos. I ranked Botika ng Barangayand GMA 50 Program at the top since these are

the programs that I think will address the problem. Although, some services involving medical

technology such as CT scan, Ultrasound and even the very basic X-ray are not covered by this program


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and which I think the government, specifically the Department of Health should look into. There are

some areas in Metro Manila that opened hospitals which render free services such as the one opened by

Mayor Lim.

Next in rank is the National TB Control Program. Although statistics showed that the number of TB

cases has been reduced compared to previous records, and also it only ranked number 6 from the

countrys list of top 10 Morbidity, it doesnt mean that the program will be of less importance to the

DOH. TB is still a communicable disease, and plus the fact that the living condition in our country is not

that good, some are homeless and a large percentage of our population live in slum areas, the chances

are TB can still spread among Filipinos.

For the following programs, I would like to group them as preventive programs: Expanded

Immunization Program, Newborn Screening Program, Knockout Tigdas, Dengue Control Program,

National Rabies Prevention and Control Program. Prevention is still better than cure. We can see a

drastic change in the countrys mortality and morbidity rates if at the start diseases or illnesses are

prevented.

The Sangkap Pinoy Seal Program and Garantisadong Pambata is equally important with all thenational and local programs of the DOH. Most Filipinos have poor eating habits, most probably due to

lifestyle. For example, living in Metro Manila is different with living in the province. People in the city are

always on the go, always racing with time. And so, these people most often than not eat in Fast food

chains. So having these programs can somehow help with the nourishing the Filipinos. Also, children are

avid fans of junk foods and so the Sangkap Pinoy seal program is of great help.

For the bottom part of the ranking, I would like to group them again as rehabilitative programs:

Adolescent and Youth Health and Development Program, and National Healthy Lifestyle Campaign.

I placed the Family Planning Program at the bottom because I share the same sentiments with Mr.

Villar, wherein he believed that being populous shouldnt be a hindrance to a countrys growth anddevelopment. The problem that I only see, in line with this, is the rampant corruption in the Philippines.

Only the rich and powerful Filipinos enjoy the countrys resources. It is not equally distributed to all.

3. Give the advantages and disadvantages of health care delivery system of the givencountries/continents?

a. United StatesUS

Advantages and Disadvantages: The government is spending much for the health care

of each Americans. However, it still ranks 37th

according the WHO. The problem with US

is that Americans are very poor with low-cost preventive care that keeps Europeans

healthy.

b. Middle east ( Saudi Arabia, Qatar, Jordan, Iran, Iraq, Turkey, Kuwiat , Israel)Jordan

Advantages and Disadvantages: Services are subsidized but are not free.


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Iranand Iraq

These two are the countries in middle east who are often involved in war. And because

of that, delivery of health care services is greatly affected.During the period of the conflicts,

some hospitals or institutions were destroyed, services were not delivered and so a drastic

increase in the cases of some communicable diseases emerged.

Qatar

Advantages and Disadvantages: Health care is free or is highly subsidized, it is likely that

you will have to pay for some of medical costs.

c. European ( Italy, Turkey, France, Spain, UK)

France

Advantages: Allows unlimited care, with no referral structure. All services is being paid

by the government for the people.

Disadvantage: Longer waiting periods specially for surgical procedures.

Italy

Advantages: Health care services including doctors fees, surgical procedures,

laboratory and diagnostic tests, and even prescription drugs are all free of charge.

Disadvantage: A fee is charged for cases brought to their emergency units which are

found out to be not urgent. Also, waiting periods for surgical treatments ranges from few

weeks to few months.

Spain

Advantages: Universal coverage with free access to health care for all citizens.

Disadvantages: It will take few weeks to months to be served for a surgical procedure.

Turkey

Advantages: Insurance coverage for the basic health services such as child

immunization, treatment of communicable diseases, and maternal and child health services.


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Disadvantages: Not all services are free of charge. Although for those who are unable to

pay costs of health services, the government has started implementing their Green Card for

the inpatients to cover for most of health care services.

UK

Advantages: Health services are free at the point of need. However the people are

paying for these services through general taxation or salary deductions.

Disadvantages: The government lack programs to help those who are unable to pay for

health care services, those who are unemployed and belong to the poor sector of the

society. The worst way to pay for care is out of pocket at the time of illness.

d. Asian nations(Cambodia, Singapore, Japan, South and North Korea, Vietnam, Taiwan,

Bahrain, Macau)

Cambodia

Advantages: They have access to OTC drugs at low costs.

Disadvantages: Cambodians deal with illness through traditional medicine and self-

medication, often using more than one treatment at a time. They also have few hospitals

and physicians.

Singapore

Advantages: There is a dual system of healthcare delivery in Singapore, a mixture of

public and private sectors, a structure dominated by modern Western medicine, co-existing

with Chinese medicine.

Disadvantages: inadequate financial discipline to rationalize the healthcare delivery

system and to control the rising cost of health care.

Japan

Good health standards that is relatively low cost. There are no waiting lists and patient has

freedom to choose who will be their providers.

Southand North Korea

Advantages:

Disadvantages:


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Vietnam

Healthcare services are not affordable, the government is still struggling in making it

universal and affordable to its populace specially the pharmaceutical prices which is really

high. Most health expenditure is out-of-the pocket, and national health insurance covers a

small portion of the population.

Taiwan

Advantages:

Disadvantages:

Bahrain

Advantages:

Disadvantages:

Macau

e. Western (Canada, Australia, New Zealand, Germany)

Australia

Advantages: Medicare covers a portion of the fees for medical services. However, it

doesnt cover those services in private hospitals. If you want to be admitted in private

hospitals, you have to get your own private insurance.

Disadvantages: You can only either be a private patient or be admitted in a private

hospital. If you choose to be a private patient, then they will cover the doctors fee. If you

choose to be admitted in a private hospital, then they will cover for the hospital fees.

New Zealand

Advantages: fees are usually free of charge or subsidized. Examples of free publicly

funded health care are Childrens immunization, prescription medicines for all public

hospitals and most laboratory test and x-rays except if it is done in privately operated clinics.


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Disadvantages: Possible longer waiting periods since the government does not fund the

public health system generously enough to allow most hospital treatments to be carried out

immediately. Exception to this is their 24 emergency clinic or ER which is free of charge.

Canada

Advantages: All essential basic care is covered. A health card is issued by the Provincial

Ministry of Health.

Disadvantages: Coverage of the insurance for health care services depends on the

annual contribution of an individual.

Germany

Advantages: Most of the people in Germany are obliged to take state regulated

insurance plans. For the unemployed or for those who cannot afford, the state covers the

contributions for health insurance.

Disadvantages: Medical costs are very high. Health care costs in Germany are among

the most expensive in the world.

f. Other Countries (Brunei, Malaysia, Pakistan)

Pakistan

Advantages: They have many hospitals, even the Ministry ofDefense has numerous

hospitals that renders services not only to their soldiers but also to the civilian as well.

Military personnel are very well taken care of even if they go to wars.

Disadvantages: Pakistan is often disturbed with fights among its people and even war

against other nation. This I think is the reason why despite the great numbers of hospitals

and the bed capacity Pakistan has, they still ranked 119 the among the 191 countries by the

WHO.

Brunei

Advantages: They offer free medical services to all, and for remote areas that is not

reached by these services, they have their flying medical services. The private sector and

those insurance companies are not very popular in Brunei since everything is being provided

for by the government. There is a small percentage of the population who are insured by


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private companies. These are international companies that got their insurance abroad and

requires their employees to avail of these insurance.

Disadvantage: They have less national programs that will specifically address the

diseases or illnesses included in their morbidity and mortality rates.

Malaysia

Advantages: Some of the medical services are free of charge. Even their referrals to

specialists are free. They also have specific programs to address their morbidity and

mortality rates.

Disadvantages: Considering the land formation of Malaysia that is areas are separated

by bodies of water, Malaysia should adapt or implement also flying medical services.

4. Make a comparative analysis of the health care delivery system between the countriesmentioned above with the Philippines on the following areas:

a. Insurance System ( medicare)We have our own medicare or Philhealth in the Philippines wherein fees are subsidized at

the point of need. This is also the same with other countries. However, there are few

Filipinos who avail of private insurances to cover their essential health needs since services

and most fees in our country are not free of charge. The government is only allotting a small

percentage of the national budget to for Health.

b. epidemiology ( mortality, morbidity)

All countries have mortality and morbidity cases, theres no exception to this even those in

the first world countries. However, there might be some countries who are free from

communicable diseases like Brunei who is poliomyelitis free and malaria free, and Qatar

who is also free from malaria.

But looking into the top mortality and morbidity of most countries, we can see that those

diseases ranked at the top are related to lifestyle. These are the degenerative lifestyle

diseases which include, diseases of the heart,Diabetes Mellitus and the like.

In few countries wherein, sexually transmitted diseases was among those at the top of the

list, they have developed national health programs to address the issue, just like in Malaysia.

Nowadays, it has been told over the news that there is an increasing number of STD cases in

the Philippines, and according to the news, most of the people recently affected worked in

Call Centres. I think the government, particularly the department of health should create


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health program to address the issue. There is a proposal to integrate sex education in the

curriculum of high school students which I find helpful in line with the issue.

c. public and private health setting

The Philippines has a dual system consisting of the public sector, which is largely financed

through a tax-based budgeting system at national and local levels and where health care is

generally given free at the point of service, and the private sector which is market oriented

and where health care is paid through user fees at the point of services.

Countries that has dual system like Philippines are Malaysia, Saudi Arabia, US, and

Singapore.

d. technologies and equipments

With regards to technological advancements, the Philippines is now catching up with

other countries. Some hospitals in our country like St. Lukes Medical Center, Medical City,

and Makati Medical Center currently have state of the art facilities that will match up with

the medical technology of 1st

world countries.

e. funding and financial supports

Just like with most countries, the finances intended for the delivery of health care

services is through taxation. A portion of the annual budget of the country is given to the

lead agency in health, the Department of Health. It is the duty of the DOH to provide funds

and financial supports to both national and local health programs.

However, unlike other countries that are well governed by its official, the Philippines is

one of the most corrupt countries in the world. Thats the reason why, we are facing great

deficits in terms of funds or financing.

5. Present at least five (5) current National Health issues that should be addressed and makean Action Plan.

6. Formulate your recommendations to reconstruct the weaknesses and strengthen thePhilippine Health care Delivery system.


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The Philippine Health Care Delivery System is a dual system and is comprised of public and

private sector. But there is nothing wrong with having a dual system. If we are to compare

Philippines with other nation who also have dual system, those countries are far better than

ours.

We can enumerate a number of problems that we can see in the health care delivery system

of the Philippines, but these problems all boil down to one specific problem, and that is

corruption. Corruption is like the center of all of these problems which makes delivery of

health care services dysfunctional. TheDOH has formulated very good national and local

health programs but we cannot see the effects of these programs. TheDOH and other

agencies were claiming that they lack budget to implement their programs. True enough

that the budget allotted for Health is not sufficient to implement the DOH programs

nationwide because there really are areas that are unluckily unable to experience and avail

of the health programs. However, we are blinded by the truth. We can now feel the effects

of the activities of corrupt officials.

The DOH has created good health programs, we only need to strengthen these programs.

Perhaps we can adapt the flying medical services being practiced in Brunei, so that health

care services can also reach out to the remote areas.

finals in comparative health

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