Universal Health Care Act Quiz

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Questions and Answers

What is the purpose of the Health Technology Assessment (HTA) process?

To provide recommendations to the DOH and PhilHealth for the development of policies, programs, regulation, and the determination of a range of entitlements such as drugs, medicines, pharmaceutical products, and other devices, procedures and services.

Which of the following are key components of the primary care provider network, as mandated by the Universal Health Care Act?

  • Accurate, sensitive, and timely epidemiologic surveillance systems (correct)
  • Patient records accessible throughout the health system (correct)
  • Integrated and coordinated care that is accessible at the time of need, including a range of services for all presenting conditions (correct)
  • Proactive and effective health promotion programs or campaigns (correct)

PhilHealth is required to provide immediate eligibility for a health benefit package to all members.

True (A)

What is the main role of the Health Promotion Bureau?

<p>To improve health literacy and mainstream health promotion and protection.</p> Signup and view all the answers

What are the three types of funds that PhilHealth will establish?

<p>A fund to secure payouts to lifetime members (A), A fund for optional supplemental benefits that are subject to additional contributions (B), A fund to secure benefit payouts to members prior to their becoming lifetime members (C)</p> Signup and view all the answers

What is the primary purpose of the Joint Congressional Oversight Committee?

<p>To conduct a regular review of the implementation of the Universal Health Care Act.</p> Signup and view all the answers

What is the main objective of the HTA process regarding health interventions?

<p>To reduce out-of-pocket expenses for patients (A), To focus on the most burdensome medical conditions affecting the population (B), To ensure interventions are safe and effective for the users and healthcare providers (C), To ensure interventions are cost-effective and provide overall health gain to the health system (D)</p> Signup and view all the answers

Which act, as amended, is partially repealed by the Universal Health Care Act?

<p>Republic Act No. 7875, otherwise known as the &quot;National Health Insurance Act of 1995.&quot;</p> Signup and view all the answers

Which of the following are included in the list of investments that PhilHealth's reserve fund can be placed in?

<p>Debt securities and corporate bonds of prime or solvent corporations created or existing under the laws of the Philippines (A), Interest-bearing bonds, securities or other evidences of indebtedness of the Government of the Philippines (B), Interest-bearing deposits and loans to or securities in any domestic bank doing business in the Philippines (C), Preferred stocks of any solvent corporation or institution created or existing under the laws of the Philippines listed in the stock exchange with proven track record or profitability over the last three (3) years and payment of dividends for a period of at least three (3) years immediately preceding the date of investment in such preferred stocks (D)</p> Signup and view all the answers

The Universal Health Care Act mandates that all government hospitals must operate at least 90 percent of their bed capacity as basic or ward accommodation.

<p>True (A)</p> Signup and view all the answers

What is the purpose of the Health Impact Assessment (HIA) process?

<p>To evaluate the potential impact of policies, programs, and projects on the health sector.</p> Signup and view all the answers

What is the main purpose of the Data Privacy Act of 2012 in the context of the Universal Health Care Act?

<p>To ensure the confidentiality and protection of patient health information.</p> Signup and view all the answers

What is the role of the Health Technology Assessment Council (HTAC)?

<p>To provide recommendations on the financing or coverage of health technologies and to oversee the HTA process.</p> Signup and view all the answers

What are the main sources of funding for the Universal Health Care Act?

<p>Total incremental sin tax collections mandated by law, 50% of the National Government share from PAGCOR's income, 40% of the Charity Fund, premium contributions of members, annual appropriations of the DOH, and National government subsidy to PhilHealth.</p> Signup and view all the answers

How often are the provincial burden of disease estimates published by the DOH?

<p>Annually.</p> Signup and view all the answers

The Universal Health Care Act mandates that the DOH must establish the Health Promotion Bureau within two years of the Act's effectivity.

<p>True (A)</p> Signup and view all the answers

What is the main objective of the Health Promotion Bureau?

<p>To improve health literacy and mainstream health promotion and protection.</p> Signup and view all the answers

What are the key goals of the Universal Health Care Act?

<p>To ensure all Filipinos have immediate eligibility and access to comprehensive, quality, and affordable medical, dental, mental and emergency health services, promote health consciousness, and protect Filipinos from financial hardship related to health services.</p> Signup and view all the answers

Flashcards

What is the main objective of the Universal Health Care Act?

This act ensures all Filipinos have equitable access to quality and affordable health care services, along with protection against financial risk.

What does 'Abuse of authority' mean in the context of the Health Care Act?

It refers to a person's actions exceeding their authorized duties, harming the public good.

What are 'Amenities' in healthcare?

These are features enhancing comfort or convenience in a health service.

What does 'Basic or ward accommodation' refer to in hospitals?

This means regular meals, a shared room with a fan, and shared bathroom facilities.

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What is 'Co-insurance' in health insurance?

This refers to a percentage of medical costs that the insured pays themselves.

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What is a 'Co-payment' in healthcare?

This is a fixed fee paid at the time a service is accessed.

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Who are 'Direct contributors' to the Universal Health Care Program?

These include employed individuals, self-employed professionals, and migrant workers, along with their dependents.

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What defines an 'Emergency' in the context of the Health Care Act?

This refers to a situation where a patient requires immediate medical attention to prevent loss of life or disability.

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What is the 'Essential health benefit package'?

This refers to a set of health services covered by the National Health Insurance Program.

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What constitutes a 'Fraudulent act' in the context of the Health Care Act?

This involves any deceitful act resulting in unjust personal gain.

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Who or what is considered a 'Health care provider'?

This encompasses various entities involved in providing healthcare.

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What is a 'Health care provider network'?

This refers to a group of primary to tertiary care providers working in a coordinated manner.

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What is a 'Health Maintenance Organization (HMO)'?

This is an organization offering pre-paid health services to its members.

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What is 'Health Technology Assessment (HTA)'?

This is a systematic evaluation of the properties and effects of health technologies.

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Who are considered 'Indirect contributors' to the Universal Health Care Program?

These individuals are not direct contributors and receive premium subsidies from the government.

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What are 'Individual-based health services'?

These are services performed within a health facility or remotely, with individual recipients.

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What are 'Population-based health services'?

These are interventions addressing large populations, such as health promotion campaigns.

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What is 'Primary care'?

This refers to the first point of contact in the healthcare system, providing accessible, comprehensive, and coordinated care.

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Who is a 'Primary care provider'?

This is a healthcare worker trained to deliver initial healthcare services.

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What is 'Private health insurance'?

This involves coverage of defined health services financed through private payments.

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What is considered an 'Unethical act' within the Health Care Act?

This refers to any act or scheme against the National Health Insurance Program, like overbilling or ghost patients.

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Who is covered by the Universal Health Care Program?

All Filipino citizens are automatically included in the National Health Insurance Program.

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How does the Universal Health Care Act aim to achieve its goals?

The Universal Health Care Act aims to achieve 'universal health care' through a systematic approach.

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How is membership in the National Health Insurance Program organized?

Program membership is divided into two categories: Direct contributors and Indirect contributors.

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What are the key benefits enjoyed by members of the National Health Insurance Program?

All members have immediate eligibility for the Program's health benefits, regardless of PhilHealth card or co-payments for basic accommodation.

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How are premium contributions determined for direct contributors?

Direct contributors pay monthly premiums based on their income, with rates increasing each year.

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How are premium contributions handled for indirect contributors?

The government gradually adjusts and finances the premium subsidy for indirect contributors through the General Appropriations Act.

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What purpose does the Program Reserve Fund serve?

PhilHealth reserves a portion of its revenue as a reserve fund to ensure the program's financial stability and future growth.

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What is the maximum limit on PhilHealth's administrative expenses?

PhilHealth allocates no more than 7.5% of its collected premiums for administrative costs.

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Who governs the National Health Insurance Program?

The PhilHealth Board of Directors oversees the National Health Insurance Program.

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How is the President and CEO of PhilHealth selected?

The President and CEO of PhilHealth is appointed by the President of the Philippines, based on the recommendation of the Board.

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How are PhilHealth personnel classified?

All PhilHealth personnel are classified as public health workers, receiving benefits under the Magna Carta of Public Health Workers.

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How does the DOH prioritize health service delivery?

The DOH prioritizes population-based health services, aiming for province-wide and city-wide health systems with integrated care.

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How are individual-based health services delivered under the Universal Health Care Act?

The Act emphasizes a performance-driven approach for individual-based health services, with networks contracted for delivery.

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Who manages the Special Health Fund for local health systems?

LGUs are responsible for pooling resources for health services and managing them through a Special Health Fund.

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Where does the Special Health Fund get its funding?

The Special Health Fund is financed by income from PhilHealth payments and government grants, allocated for improving the local health system.

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Study Notes

Republic Act No. 11223 (Universal Health Care Act)

  • Short Title: "Universal Health Care Act"
  • Policy of the State: Protect and promote the right to health of all Filipinos, foster health consciousness, adopt an integrated and comprehensive approach.
  • General Objectives: Realize universal health care in the country, ensure equitable access to quality and affordable healthcare.
  • Definition of Abuse of Authority: Acting beyond authorized duties, adverse to public interest, under amended National Health Insurance Act of 1995 (IRR)
  • Definition of Co-insurance: Percentage of medical charge paid by insured, remaining paid by health insurance plan
  • Definition of Co-payment: Fixed fee or predetermined rate paid at a point of service
  • Definition of Direct Contributors: Those with capacity to pay premiums, employed and bound by employer relationships or self-earning professionals and migrants
  • Definition of Emergency: Condition requiring immediate support and treatment to avert significant loss or injury, pregnant woman
  • Definition of Essential Health Benefit Package: A set of services from the National Health Insurance Program (NHIP) including primary care, medicine, diagnostics, preventive, curative, rehabilitative services
  • Definition of Fraudulent Act: Misrepresentation to gain undue advantage, procedure deviation, financial gain
  • Definition of Health Care Provider: Includes medical facilities, healthcare professionals (doctors, nurses, midwives, dentists), community-based healthcare organizations, pharmacies, drug outlets, diagnostic clinics
  • Definition of Health Care Provider Network: Integrated, coordinated delivery of healthcare services, primary care provider acting as coordinator
  • Definition of Health Maintenance Organization (HMO): Entity providing, offering or covering healthcare services under a premium
  • Definition of Health Technology Assessment: Systemic evaluation of health-related technologies, procedures, medicines for solving health problems, and outcomes. Utilizes a multidisciplinary, cost-benefit, social and ethical approach
  • Definition of Indirect Contributors: All those not included as direct contributors, including those with special laws
  • Definition of Individual-based Health Services: Services uniquely targeted to a given recipient (versus population-based interventions) with limited population-wide impact, e.g. medical care, medicine or procedures.
  • Definition of Population-based Health Services: Health-related interventions impacting the general population, e.g., health promotion, disease surveillance, disease vector control
  • Definition of Primary Care: Initial, accessible, continuous, comprehensive healthcare encompassing all conditions, referrals
  • Definition of Primary Care Provider: Competent healthcare worker certified in primary care, managed by DOH or licensed institution
  • Definition of Private Health Insurance: Insurance coverage, financed by personal payments in the form of premium, to insurer
  • Definition of Unethical Act: Overbilling, ghost patients or false recruitment, practice contrary to code of ethics, other similar acts impacting NHIP integrity

Chapter II (UHC)

  • Population Coverage: All Filipino citizens are automatically included in NHIP

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Related Documents

Republic Act No. 11223 PDF

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