Universal Health Care Act Philippines

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Questions and Answers

What are the two types of membership introduced by PhilHealth for individual-based services?

Basic and premium members

Direct and indirect contributory members (correct)

Public and private members

Indirect and voluntary members

What is the main goal of consolidating fragmented providers into province-wide and city-wide service delivery networks?

To navigate and coordinate health services (correct)

To improve the quality of health goods

To reduce the cost of health services

To increase the number of health providers

What is the purpose of institutionalizing primary care provider networks?

To provide specialized care

To promote health education

To provide minimum components of population-based health services (correct)

To reduce the cost of health services

What is the main goal of ensuring benefit complementation between PhilHealth and Private Health Insurance (PHIs) and Health Maintenance Organizations (HMOs)?

To provide better health benefits to patients Signup and view all the answers

What is the purpose of expanding scholarship programs and requiring 3 years return service in underserved areas for government scholars?

To augment HRH through national health workforce support system Signup and view all the answers

What is the main goal of strengthening medicines procurement, price negotiation, and affordability?

To provide affordable health goods and services Signup and view all the answers

What is the primary purpose of the National Health Insurance Program (PhilHealth) in the Philippines?

To be the preferred single payer for healthcare services for patients Signup and view all the answers

What is the dual system composed of in the Philippines?

Public sector and a strong private sector Signup and view all the answers

What is one of the requirements for effective decentralization in healthcare in the Philippines?

Clear role delineation between national and local governments Signup and view all the answers

What is funded by line-item government budgets in the Philippines?

Essential public health functions Signup and view all the answers

What is necessary to support the devolution of powers and functions in healthcare in the Philippines?

Adequate financing through intergovernmental transfers Signup and view all the answers

What is necessary to ensure effective healthcare service delivery in the Philippines?

Institutionalizing accountability mechanisms Signup and view all the answers

What is the primary purpose of the Universal Health Care Act?

To ensure access to quality and affordable health care for all citizens Signup and view all the answers

What is the role of the Department of Health in service delivery?

To contract with health care providers to deliver services Signup and view all the answers

What is the purpose of the National Health Insurance Program (NHIP)?

To ensure that all citizens have access to quality and affordable health care Signup and view all the answers

What is the role of PhilHealth in service delivery?

To contract with health care providers to deliver services Signup and view all the answers

What is the purpose of the integration of local health systems?

To ensure that health care services are accessible and affordable to all Signup and view all the answers

What is the role of the Provincial/City Health Board in the integration of local health systems?

To oversee the integration of health services Signup and view all the answers

What is the purpose of the incentive scheme for health care providers?

To improve the quality of health care services Signup and view all the answers

What is the role of the Health Technology Assessment (HTA) in the Universal Health Care Act?

To evaluate the effectiveness of health care technologies Signup and view all the answers

What is the financing model for the Universal Health Care Act?

A combination of funding sources, including sin tax collections and PhilHealth premiums Signup and view all the answers

What is the role of the Joint Congressional Oversight Committee (JCOC) in the Universal Health Care Act?

To oversee the implementation of the Universal Health Care Act Signup and view all the answers

Study Notes

PhilHealth Membership Types

Two types of membership: Individual-Based Membership and Group Membership.
Individual-Based Membership targets self-employed citizens, while Group Membership focuses on organized groups or employers.

Service Delivery Network Consolidation

Aims to unify fragmented health service providers into comprehensive province-wide and city-wide networks.
Enhances coordination and accessibility of health services for the population.

Primary Care Provider Network Institutionalization

Establishes structured networks of primary care providers to improve health service delivery.
Ensures consistent and quality care is available to patients.

Benefit Complementation Goal

Strives to ensure that PhilHealth's benefits align with those provided by Private Health Insurance (PHIs) and Health Maintenance Organizations (HMOs).
Aims to reduce coverage gaps and enhance overall healthcare access and affordability.

Scholarship Program Expansion

Expands programs for government scholars with a requirement of 3 years of service in underserved areas.
Addresses healthcare worker shortages in rural and underserved locations.

Medicines Procurement Strengthening

Focuses on improving processes for procuring medicines and negotiating prices.
Ensures that essential medicines are affordable and accessible to all patients.

National Health Insurance Program (PhilHealth) Purpose

Provides health insurance coverage for all citizens in the Philippines.
Aims to protect individuals from high healthcare costs and improve access to medical services.

Dual System Composition

Consists of both public and private healthcare sectors in the Philippines.
Promotes a balanced approach to providing health services.

Effective Decentralization Requirement

Requires clear delegation of powers and responsibilities from national to local government units.
Ensures localized decision-making in health service provision.

Line-Item Government Budget Funding

Healthcare services, programs, and initiatives are funded through specific line-item allocations in government budgets.
Provides transparency and accountability in the use of public funds for healthcare.

Support for Devolution of Healthcare

Requires capacity building for local governments to manage health services effectively.
Ensures that local entities are equipped to take on healthcare responsibilities.

Effective Healthcare Delivery Necessities

Coordination among multiple health agencies and stakeholders is essential.
Establishing clear health policies and guidelines supports seamless service provision.

Universal Health Care Act Purpose

Aims to provide all Filipinos with access to comprehensive health services without financial hardship.
Promotes equitable health service distribution and strengthens the healthcare system.

Department of Health’s Role

Oversees health service delivery and ensures that health policies are implemented effectively.
Responsible for setting national health standards and guidelines.

National Health Insurance Program (NHIP) Purpose

To safeguard citizens against financial risk due to healthcare costs.
Aims to enhance access to quality healthcare services through insurance coverage.

PhilHealth’s Role in Service Delivery

Acts as the primary government agency for health insurance in the Philippines.
Facilitates access to healthcare services through reimbursement mechanisms for providers.

Integration of Local Health Systems Purpose

Aims to create a cohesive health system at the local level for better coordination and resource use.
Enhances the efficiency and effectiveness of health service delivery.

Provincial/City Health Board Role

Responsible for the strategic planning and governance of local health systems.
Ensures alignment of health services with the needs of the community.

Incentive Scheme Purpose for Providers

Encourages healthcare providers to enhance the quality and accessibility of services.
Provides additional compensation for delivering services to underserved populations.

Health Technology Assessment (HTA) Role

Evaluates the effectiveness and cost-efficiency of health technologies.
Informs policy decisions under the Universal Health Care Act to ensure value-based healthcare delivery.

Universal Health Care Act Financing Model

Primarily funded through government budgets, contributions from employers and employees, and other revenue sources.
Aims to create a sustainable financial framework for universal healthcare coverage.

Joint Congressional Oversight Committee (JCOC) Role

Monitors the implementation of the Universal Health Care Act.
Ensures accountability and effectiveness in the deployment of healthcare resources.

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Description

Test your knowledge of the Implementing Rules and Regulations of Republic Act No. 11223, also known as the Universal Health Care Act, which aims to provide comprehensive health services in the Philippines. Learn about the principles and approach to healthcare, health literacy, and protection from hazards and risks.