Download presentation
Presentation is loading. Please wait.
Published byHolly Gardner Modified over 9 years ago
1
Financial Sustainability and Social Franchises for Health
2
SOCIAL HEALTH INSURANCE PHILIPPINES
3
Social Health Insurance Medicare in the early 70s – Formal sector scheme – Mostly hospitalization benefits – Deliveries were considered “non-insurable” and only first deliveries were paid for as “episiorrhaphy” – Private sector health care providers were always part of the scheme
4
Philippine Health Insurance Corporation (PhilHealth) 1995 – Medicare to PhilHealth Beyond the formal sector – (local + national ) government were to subsidize the poor In 2012, national government fully subsidized the poor identified by the Department (Ministry) of Social Welfare and Development Beyond inpatient care – Comprehensive benefits from primary care, outpatient medicines to complex inpatient care Beyond doctors – Providers can include other health professionals
5
Continuing journey 2001 – coverage of 1 st and 2 nd normal deliveries done by doctors and other health professionals in non-hospital facilities – Paid by case payment 2002 – rationalization of coverage of ambulatory/day surgeries/procedures 2006 – coverage of newborn care in non-hospital facilities 2007 – facility-based deliveries became national policy Later - 3 rd and 4 th normal delivery – increased case rates levels
6
But…. Be careful with constrained thinking – “2 nd normal delivery in midwife run clinics” Missed opportunities – System accreditation was approved in 2006 by the Board but not fully implemented – Global payment implementation was suspended in 2013 – Consolidation of primary care benefits and maternity care package benefits + other outpatient benefits still ongoing 5 in 1 contracting as a temporary measure
7
CENTRAL GOVERNMENT BANGLADESH
8
Urban Primary Care Project Local Government Division of the Ministry of Local Government, Rural Development and Cooperation Funding from the Government, ADB, UNFPA and Nordic Development Fund Partnership agreements with 9 local NGOs, 2 national affiliates of international NGOs (and the Chittagong City Corporation) for the provision of primary care services Paid per capita to deliver a basic package of services – Contracts can be terminated for poor performance – Bonus system
9
EMERGING TRENDS IN ASIA AND THE PACIFIC
10
Expansion of social health insurance systems by subsidizing the poor and (the non-poor) informal sector Central government (National/Federal Ministries) becoming purchasers of health services Inclusion of private sector health care providers in Universal Health Coverage (UHC) strategies
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.