FY 2013 DOH BUDGET

National Expenditure Program

Universal Health Care

Education

HousingConditional Cash

Transfer

Investing in Filipinos,

especially the poor

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Why should UHC focus on the poor?

Poorest

1,015 1,732

Middle Income

2,641

Rich

4,285

Richest

11,647

UHC Phase I UHC Phase II

• Poor families were left out in previous health reform efforts• Poorest families spend as much as 67 percent of their income on

food, making them most vulnerable to risks of paying for costs of health care.

• Of these poorest families, more than two-thirds of those who reported falling ill did not see a doctor, or seek any type of health care

Average per capita monthly income, in PhP

Source: NSO, 2009

Poor

2

How should we define coverage?

Covered

Enrolled (Registered) in PhilHealth

Informed of Benefits and Entitlements;

Can Access Preventive Care

Can Access Quality Care at

a Facility

Health Facilities

Enhancement

Community Health Teams as

Navigators

Full NG Premium Subsidy

3

Why should UHC focus on the poor?

Poorest

1,015 1,732

Middle Income

2,641

Rich

4,285

Richest

11,647

PoorUHC Phase I UHC Phase II

• Poor families were left out in previous health reform efforts• Poorest families spend as much as 67 percent of their income on

food, making them most vulnerable to risks of paying for costs of health care.

• Of these poorest families, more than two-thirds of those who reported falling ill did not see a doctor, or seek any type of health care

Average per capita monthly income, in PhP

Source: NSO, 2009

Poor

4

What will Universal Health Care achieve?Kalusugan Pangkalahatan

All Filipinos especially poor families will be enrolled in PhilHealth

PhilHealth “support value” will increase from 34% (2008) to 60% in 2016

Every PhilHealth family will have access and obtain essential, quality and affordable health services

Care will be provided in modern hospitals and other health facilities

Poor families are informed and guided by Community Health Teams for their health needs

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Interventions Done (2011-2012): Financial Risk Protection

5.3 million poor families under the NHTS-PR enrolled into PhilHealth through full National Government subsidy

Additional 5.33 million poor families enrolled/sponsored by LGUs

81.63 million Filipinos or 85% of the population now enrolled to PhilHealth (from 62% in 2010)

Introduction of PhilHealth Case Rates Payment Scheme

Catastrophic Care Packages introduced last July 2012

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0 1 2 3 4 5 6 7 8 9PhilHealt

hin NUMBERS

Membership Category

Number of Registered Members (in millions)

Number of Beneficiaries(in millions)

2010 2011 2012 2010 2011 2012

Formal Government 1.95 2.01 2.02 5.76 5.90 6.02

Formal Private 7.86 8.50 9.56 15.78 18.10 18.96

Non-poor Informal (IPP) 3.75 4.34 4.68 9.31 9.91 10.72

OFW 2.34 2.57 2.64 4.73 5.09 5.21

Lifetime 0.50 0.57 0.61 0.81 0.95 1.02

Sponsored - NHTS - 4.90 4.74 - 21.84 20.15

Sponsored – Local Government 6.05 4.67 5.33 21.93 17.09 19.55

Total 22.4 27.92 29.28 58.32 78.87 81.63

Projected Population 94.01 95.74 95.98

Enrollment Rate 62.04% 82.38% 85% 7

23 Case Rates (No balance billing for Sponsored Program beneficiaries in government hospitals)

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TYPE Z (CATASTROPHIC DISEASES) BENEFIT PACKAGE

BENEFIT CASE RATE

Leukemia in Children Php210,000.00

Breast Cancer 100,000.00

Prostate Cancer 100,000.00

Renal Transplantation 600,000.00

Selected Cardiac Operations For finalization

• Can only be availed initially in PhilHealth accredited Level 3 or Level 4 government hospitals that have signed a contract on the provision of specialized care;

• No balance billing policy will be implemented to members of the Sponsored Program;

• In the future, for non-SP members, fixed co-pay for each condition will be paid on top of the packaged amount.

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Summary of HFEP Infrastructure Projects, by Type of Health Facility, 2007-20122007 2008 2009 2010 2011 2012 TOTAL

BHS 0 34 179 129 586 80 1,008

RHU 0 6 117 90 994 296 1,503

Level 1 5 21 65 51 192

Level 2 17 35 59 46 107

Level 3 1 6 9 10 1 371 1,040

Level 4 0 7 3 15 5

Special/ Specialty 0 3 6 5 0

Others 2 (PNP) 1 (PNP) 3 (P/CHO) 5 RBC; 4 P/CHO 0 9

Total 25 113 441 355 1,885 756 3,575

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Status of Health Facilities Enhancement Program (Infrastructure/Equipment as of August 2012)*

2011 2012

EquipmentTotal Cost(as programmed)

Php 1.434 B Php 2.550B

Bidded/Awarded 100% 91%

InfrastructureTotal RHUs & Hospitals(as programmed)

1230 755

Completed 194 (16%) -

Ongoing 1036 (84%) 755 (100%)

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Complete Treatment Packages(Compacks)

Compacks: free drug access program for poor families covered by the Pantawid Pamilya introduced in 2011

• 24 complete treatment regimens for the most common diseases

• Provided to RHUs in 1,020 CCT municipalities

12

REGISTERED NURSES FOR HEALTH ENHANCEMENT AND LOCAL SERVICE

RN HEALS DEPLOYMENT

Batch 1 9,518 (Feb. 2011 – Jan. 2012)

Batch 2 11,283 (Oct. 2011 – Sept. 2012)

Batch 3 10,000 (Mar. 2012 – Feb. 2013)

Total 30,801 (Cumulative Total)

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DTTB and Midwives

Doctors to the Barrios Midwives

2011 2012BATCH I

(Oct. 2011 - Dec. 2012)BATCH II

(Mar. 2012 - Dec. 2012)

113 106 832 3,000

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Attainment of MDGsIndicator 2011 Accomplishments Targets for 2016

Community Health Teams (CHT) deployed

61,911 deployed (2012)646,541 HH’s visited (2012)

100,000 CHTs deployed

Fully Immunized Child (FIC) 82% 95%

Contraceptive Prevalence Rate (CPR)

48.9%* 65.4%

Antenatal Care (ANC)(at least 4 visits)

78%* 90%

Facility-Based Deliveries (FBD) 55.2%* 90%

Infant Mortality Rate (IMR),(per 1,000 livebirths)

22* 19

Under 5 Mortality Rate (U5MR),(per 1,000 livebirths)

30* 26.7

Maternal Mortality Rate (MMR)(per 100,000 livebirths)

221* 52

*2011 Family Health Survey 15

Maternal Mortality Ratio

Data Source: FHS 2011 (NSO, DOH, USAID)

260

182

224

120

196

128

MDG Target: 52

16

Attainment of MDGsIndicator 2011 Accomplishments Targets for 2016

Community Health Teams (CHT) deployed

61,911 deployed (2012)646,541 HH’s visited (2012)

100,000 CHTs deployed

Fully Immunized Child (FIC) 82% 95%

Contraceptive Prevalence Rate (CPR)

48.9%* 65.4%

Antenatal Care (ANC)(at least 4 visits)

78%* 90%

Facility-Based Deliveries (FBD) 55.2%* 90%

Infant Mortality Rate (IMR),(per 1,000 livebirths)

22* 19

Under 5 Mortality Rate (U5MR),(per 1,000 livebirths)

30* 26.7

Maternal Mortality Rate (MMR)(per 100,000 livebirths)

221* 52

*2011 Family Health Survey 17

Attainment of MDGsIndicator 2011 Accomplishments Targets for 2016

TB Prevalence Rate(per 100,000)

502 (as of 2010) 387

TB Case Detection Rate 73% 90%

TB Cure Rate 84% 90%

Malaria Morbidity Rate(per 100,000)

9.5 4

Malaria Mortality Rate(per 100,000)

0.01 < 0.03

HIV AIDS Prevalence Rate < 1% of total population < 1% of total population

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Malaria Control Program

Malaria Indicator 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Morbidity Rate (per 100,000 population) 47 51 53 55 41 41 26 22 21 9.5

Mortality Rate(per 100,000 population) 0.01 0.08 0.07 0.17 0.14 0.08 0.06 0.03 0.03 0.01

• Significant reduction in morbidity and mortality

• 24 provinces are malaria-freeCavite, Batangas, Marinduque, Catanduanes, Albay, Masbate, Sorsogon, Camarines Sur, Iloilo, Aklan, Capiz, Guimaras, Bohol, Cebu, Siquijor, Western Samar, Eastern Samar, Northern Samar, Northern Leyte, Southern Leyte, Biliran, Benguet, Camiguin, Surigao Del Norte

• Provinces recently evaluated to be declared as malaria-free: Batanes and Dinagat Islands

• Target of 40 malaria-free provinces by 2016

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Number of New HIV cases per month (highest for every year)

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MDG-Max to Address High Burden of Non-Communicable Diseases

Data• Mortality rate from Heart Diseases: 90.4 deaths per 100,000 (PHS)• Mortality rate from Diabetes Mellitus: 21.6 deaths per 100,000 (PHS)• Prevalence rate of adults with high fasting blood sugar: 4.8% (NNS)• Prevalence rate of hypertension: 25.3% (NNS)

Strategies• Healthy Lifestyle Promotion Programs• Disease Registries, Surveys and Studies• Diagnosis and Treatment

– Philhealth Outpatient Benefit Package– PhilHealth Type Z (Catastrophic) Package– Complete Treatment Package (ComPacks)

PHS – Philippine Health Statistics, 2005NNS – National Nutrition Survey, 2008

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The Proposed DOH Budget, FY 2013 NEP

PARTICULARS GAA 2012(in ‘000 pesos)

NEP 2013(in ‘ 000 pesos)

Office of the Secretary 42,155,963 39,497,343 (74.4%)

Personnel Services 7,633,148 8,866,448 (16.7%)

M O O E 25,994,815 30,412,719 (57.3%)

Capital Outlay 8,528,000 218,176 (0.4%)

Health Facilities Enhancement Program* 13,558,065 (25.6%)

Total New Appropriations 42,155,963 53,055,408

* HFEP of Php 13.558 B is lodged under the Priority Social and Economic Projects Fund

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DOH and Attached Agencies, FY 2013 NEPParticulars Amount (in ‘000) % Share

(of 54.63B)Department of Health

Office of the Secretary 39,497,343 72.29% Health Facilities Enhancement Program* 13,558,065 24.82% Commission on Population 304,543 0.56% National Nutrition Council 327,744 0.60%

Sub-Total 53,687,695 98.26%Specialty Hospitals (Corporate) Lung Center of the Philippines 173,400 0.32%National Kidney and Transplant Institute 202,865 0.37%Philippine Children’s Medical Center 345,000 0.63%Philippine Heart Center 187,000 0.34%

Sub-Total 908,265 1.66%Attached Corporations Philippine Health Insurance Corporation In DOH Office of the SecretaryPhil. Inst for Traditional & Alternative Health Care 40,000 0.07%

GRAND TOTAL 54,635,960 100%

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FY 2013 NEP Per Capita Allocationby Geographical Area

Philippines: P53.06B; Per Capita P564.34

*Budget of DOH-ARMM not included; only DOH allocations to ARMM

Luzon28.5 B (54%)

Per capita 542.10

Visayas9.5 B (18%)Per capita

500.11

Mindanao*15.02 B (28%)

Per capita 671.28

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ALLOCATION OF DOH-PROPER Budget, FY 2008 – 2013, In Billion Pesos

CY 2008 CY 2009 CY 2010 CY 2011 CY 2012 CY 2013

Series1 18.91 23.67 24.65 31.83 42.08 53.06

5

15

25

35

45

55

25

Comparative Allocation of DOH-Proper Budget, By Expense Class, FY 2008-2013, In Billion Pesos

GAA 2008 GAA 2009 GAA 2010 GAA 2011 GAA 2012 NEP 2013

PS 5.83 6.73 6.87 7.71 7.63 8.87

MOOE 10.64 10.58 11.32 15.19 25.99 30.41

CO 2.44 6.35 6.46 8.93 8.53 13.78

2.5

7.5

12.5

17.5

22.5

27.5

32.5

*Allocation for PhilHealth Sponsored Program incorporated in DOH-MOOE starting 201126

FY 2013 Priority Programs, Activities and Projects in support of UHC Programs, Activities and Projects 2012 GAA

(in ‘000)2013 NEP(in ‘000)

% Share(of 53.06B)

1 Subsidy for Health Insurance Premium payment of Indigent Families to the NHIP

12,028,000 12,612,283 23.8%

2 Health Facilities Enhancement Program* 5,078,000 13,558,065 25.6%

3 Implementation of the Doctors to the Barrios and Rural Health Practice Program

1,741,801 2,799,383 5.3%

4 National Pharmaceutical Policy Development including provision of drugs and medicines, medical and dental supplies to make affordable quality drugs available

1,000,000 1,038,116 2.0%

5 Expanded Program on Immunization 1,874,792 1,949,783 3.7%6 Family Health and Responsible Parenting 2,279,573 2,539,420 4.8%

7 Tuberculosis Control 1,021,000 1,021,023 1.9%8 Elimination of diseases as public health threat such as

malaria, schistosomiasis, leprosy and filariasis 594,926 570,443 1.1%

9 Other infectious diseases and emerging diseases including HIV/AIDS, dengue, food and water-borne disease

223,797 321,951 0.6%

10 Rabies Control Program 72,000 118,740 0.2%TOTAL 25,913,889 36,529,207 69.00%

* Lodged under the Priority Social and Economic Projects Fund 27

FY 2013 DOH Budget Proposal (in ‘000 pesos) for Priority PPA’s

Program 2012 GAA

2013 Proposal Remarks

FINANCIAL RISK PROTECTION

Subsidy for health insurance premium of indigent families enrolled in NHIP

12,028,000 12,612,283 Premium subsidy of 5.3 Million families at P2,400 per annum per family

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FY 2013 DOH Budget Proposal (in ‘000 pesos) for Priority Programs, Projects, Activities (PPAs)

Program 2012 GAA

2013 Proposal Remarks

IMPROVING ACCESS TO QUALITY HEALTH SERVICES

Health Facilities Enhancement Program

5,078,000 13,558,065

Lodged under the Priority Social and Economic Projects Fund

Implementation of Doctors to the Barrios and Rural Health Practice Program (RN, MWs, etc)

1,741,801 2,799,383 Hiring of 22,500 RN-HEALS for deployment in CCT/4Ps areas (Batch 4)

Deployment of 221 Doctors to the Barrios

National Pharmaceutical Policy Devt incl Provision of Drugs

1,000,000 1,038,116 Procurement of Complete Treatment Packages for distribution to 1,395 RHUs and 160 district hospitals in CCT/4Ps municipalities 29

Program 2012 GAA

2013 Proposal

Remarks

PRIORITY HEALTH PROGRAMS INCLUDING ACHIEVING HEALTH-RELATED MDGs (4, 5 & 6)

Expanded Program on Immunization

1,874,792 1,949,783 BCG, DPT, OPV, HepB, Measles, TT, MR, Pneumococcal Conjugate Vaccine, Rotavirus vaccines

Tuberculosis Control

1,021,000 1,021,023 Anti-TB Drugs and commodities

Family Health and Responsible Parenting

2,279,573 2,539,420 Includes cost of vaccines for Senior Citizens (Pneumococcal and Influenza)

FY 2013 DOH Budget Proposal (in ‘000 pesos) for Priority Programs, Projects, Activities (PPAs)

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Needed Legislative Support

• Restructuring of Excise Taxes of alcohol and tobacco• Passage of Responsible Parenthood Bill• Amendment of the National Health Insurance Act• Laws for corporate governance of hospitals • Amendment of selected laws governing practice of

health professionals (e.g., medical act, midwifery law, nursing law, etc)

Note: An omnibus law on universal health care that shall contain specific provisions necessary to enact required policies or amend existing laws can also be legislated

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