Health policy brief on global budgeting in the Philippines

The Philippines’ Universal Health Care (UHC) Act of 2019 seeks to ensure financial protection and equitable access to health services for all citizens. PhilHealth, the national health insurance program, has expanded coverage to 100% of the population and shifted from fee-for-service to case-rate payments. Despite these reforms, out-of-pocket expenditures remain high, and PhilHealth’s contribution to total health expenditure is limited. Declining Share Ratios, inefficiencies in claims and reimbursements, inadequate case rates, and uneven capacity across health facilities, particularly primary care, challenge PhilHealth’s effectiveness as a strategic purchaser. This policy brief recommends adopting a global budgeting approach, integrating multiple funding sources, enhancing primary care capacity, and implementing digital and managerial reforms. Increasing PhilHealth’s Share Ratio and financial support is critical to reducing out-of-pocket expenses, improving health system efficiency, and advancing UHC goals in the Philippines.