A Brief Overview of the Philippine Healthcare System

Summary

This video offers an insightful look into the Philippine Healthcare System, exploring its six critical building blocks through the lens of a Filipino couple, Jacob and Althea. It delves into service delivery, healthcare workforce, essential medicines, health information, health financing, and government leadership. The video highlights the system's challenges, such as uneven distribution of healthcare facilities, shortages of healthcare workers, and issues with essential medicines availability. It also discusses the impact of government policies and devolution on healthcare services, providing a comprehensive yet concise overview of the current state of healthcare in the Philippines.

Takeaways

• 🏥 The Philippines has a diverse healthcare system with both public and private providers, including over 22,000 public health stations and various levels of hospitals.
• 🤰 For expectant couples like Jacob and Althea, the Philippine healthcare system offers a range of services from prenatal care to birthing facilities, with over 1,900 licensed birthing homes and hundreds of thousands of hospital beds.
• 🛌 Hospital capacity in the Philippines is categorized into three levels based on the severity and complexity of conditions, with 750 level one hospitals for basic care, 327 level two hospitals for intensive care, and 120 tertiary hospitals for specialist treatment.
• 👩‍⚕️ The Philippine healthcare workforce is substantial, with over 90,000 nurses, 40,000 doctors, 43,000 midwives, and 13,000 medical technologists employed in institutions as of 2017.
• 💊 Essential medicines and medical devices are generally available in public health centers, but there can be inconsistencies in supply, with private pharmacies and medical device resellers as alternatives.
• 📊 The Philippine healthcare system tracks diseases like Dengue, Tuberculosis, and HIV to monitor and manage outbreaks, with various bureaus and institutions under the Department of Health (DoH) responsible for data collection.
• 💻 Health information systems in the Philippines are still developing, with efforts to modernize and digitize, though electronic medical record systems are not as widespread as in developed countries.
• 💰 Healthcare costs in the Philippines amount to 1.18 trillion pesos annually, roughly 6% of the GDP, with a significant portion (41.5%) being out-of-pocket expenses for individuals.
• 🏛 Government and leadership play a crucial role in the healthcare system, with devolution transferring power from the national to local governments, which can lead to conflicts and resource disparities.
• 🚑 Geographic disparities exist in healthcare service delivery, with urban areas having more facilities, leading to overutilization of larger hospitals and underutilization of rural health centers.
• 💼 There is a shortage of healthcare workers in the Philippines, with many trained professionals either concentrated in cities or choosing to work abroad or in other industries due to better pay and conditions.

Q & A

What are the six building blocks of a healthcare system as mentioned in the script?

The six building blocks of a healthcare system are service delivery, healthcare workforce, availability of essential medicines and medical devices, health information, health financing, and government and leadership.

What types of healthcare providers are available in the Philippines according to the script?

In the Philippines, there are public and private healthcare providers, including over 22,000 public barangay health stations, 2500 primary healthcare facilities, rural health units, outpatient departments of approximately 1200 hospitals, and private health clinics and teleconsultation services.

How does the script describe the hospital capacity and capability in the Philippines?

The script describes three levels of hospital capacity and capability in the Philippines: Level one hospitals for simple cases, level two hospitals for intensive care or procedures, and tertiary level hospitals for severe or rare diseases, with 750, 327, and 120 hospitals at each level respectively.

What is the role of the barangay health stations in the healthcare system of the Philippines?

Barangay health stations play a crucial role in the healthcare system of the Philippines by providing primary healthcare services, including well-baby care, to the community. However, they may not always have healthcare workers on duty, with only about 90 of the 22,000 stations having a nurse or midwife on duty.

How does the script address the issue of healthcare workforce in the Philippines?

The script highlights that as of 2017, the Philippines had over 90,000 nurses, 40,000 doctors, 43,000 midwives, and 13,000 medical technologists employed in institutions. It also points out issues such as the concentration of healthcare workers in urban areas and the outmigration of trained professionals.

What challenges does the script mention regarding the availability of essential medicines and medical devices in the Philippines?

The script mentions that while essential medicines and medical devices are often available, there can be variability in supply, with some primary health centers having essential medicines only about 57 to 76 percent of the time, and level 2 hospitals or higher at about 23 to 77 percent availability.

How does the script discuss the issue of health financing in the Philippines?

The script discusses that the Philippines spends approximately 1.18 trillion pesos annually on healthcare costs, which is about 6% of the GDP. It also mentions that 41.5% of total health expenditure is out-of-pocket, with about 50.3% covered by government schemes and 8.2% by private health insurance.

What is the significance of the devolution in the Philippine healthcare system as mentioned in the script?

Devolution in the Philippine healthcare system means the transfer of power from the national government to local governments, with the national government setting guidelines and standards. This has implications for the distribution of healthcare services and funding, and can lead to issues such as conflicts over politics and jurisdiction.

What are some of the problems with the healthcare infrastructure in the Philippines as described in the script?

The script describes several problems with the healthcare infrastructure in the Philippines, including a shortage of hospital beds relative to the population, an uneven distribution of healthcare facilities with a concentration in urban areas, and a shortage of healthcare workers, especially in rural areas.

How does the script suggest the private healthcare sector complements the public sector in the Philippines?

The script suggests that the private healthcare sector in the Philippines complements the public sector by providing services such as private pharmacies and medical device resellers, which can help alleviate gaps in the public healthcare sector, especially when there are deficiencies.

What is the role of telemedicine in the Philippine healthcare system as highlighted in the script?

The script highlights that telemedicine has grown considerably in the Philippines since the start of the pandemic, offering an alternative means of healthcare delivery, especially in situations where physical access to healthcare facilities is limited.

Outlines

00:00

🏥 Introduction to the Philippine Healthcare System

The video introduces the Philippine Healthcare System through the lens of a Filipino couple, Jacob and Althea, who are planning to start a family. It outlines the six building blocks of any healthcare system and discusses the first block, Service Delivery. The Philippines has a dual healthcare system with both public and private providers, including over 22,000 public health stations, 1200 hospitals, and various private clinics. The video also touches on the availability of birthing homes and the three levels of hospital capacity and capability, which range from basic care to specialist treatment. It mentions the pre-pandemic numbers of various health facilities and the potential for seeking healthcare outside the Philippines.

05:01

👩‍⚕️ Healthcare Workforce and Essential Medicines

The second building block discussed is the Philippine Healthcare Workforce. The video highlights the challenges of healthcare worker availability, with only about 90% of health stations having a nurse or midwife on duty, and less than 10% having a doctor. It also covers the statistics of healthcare professionals in the Philippines, including over 90,000 nurses, 40,000 doctors, and 43,000 midwives. The third building block is the availability of essential medicines and medical devices, which are sometimes inconsistently available in public health centers. The video contrasts this with the private sector, which has 29,000 pharmacies and numerous medical device resellers to help fill the gaps in public healthcare.

10:02

💊 Special Concerns, Health Information, and Financing

The video addresses the special public health concerns like Dengue, tuberculosis, and HIV, which are monitored by a network of facilities reporting to the Department of Health (DoH). It discusses the fifth building block, Health Information, and the challenges in modernizing and digitizing health information systems in the Philippines. The sixth and final building block, Health Financing, is also covered, detailing the annual healthcare costs for the Philippines, which amount to 1.18 trillion pesos or about 6% of the GDP. The video explains how healthcare is primarily funded through out-of-pocket payments and government subsidies, with a smaller portion funded by private health insurance. It also touches on the issues of healthcare infrastructure, such as the insufficient number of hospital beds and the urban concentration of healthcare facilities.

Keywords

💡Archipelago

An archipelago refers to a group of islands, typically located close together in the sea or a large body of water. In the context of the video, the Philippines is an archipelago with over 7,000 islands, which is a fundamental geographical aspect of the country that influences its healthcare system's structure and accessibility.

💡Healthcare System

A healthcare system is an organized structure that provides medical services to people. The video discusses the Philippine Healthcare System, which is composed of six building blocks, and is crucial for understanding how medical care is delivered to the population of over 110 million people in the Philippines.

💡Service Delivery

Service delivery in healthcare refers to the way medical services are provided to the public. The script describes the dual nature of service delivery in the Philippines, with both public and private healthcare providers, and how they function in parallel to serve the population's health needs.

💡Public Health

Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. The video script mentions public health in the context of essential medicines and medical devices, as well as the monitoring and reporting of diseases like Dengue, tuberculosis, and HIV in the Philippines.

💡Private Healthcare

Private healthcare refers to medical services provided by non-governmental entities, often for a fee. The script contrasts private healthcare with public healthcare in the Philippines, highlighting the role of private clinics, pharmacies, and medical device resellers in supplementing the public sector's services.

💡Healthcare Workforce

The healthcare workforce encompasses all individuals employed in healthcare services, including doctors, nurses, and other medical professionals. The video script discusses the workforce in the context of the Philippines, noting the number of nurses, doctors, midwives, and medical technologists, and the challenges they face in providing care.

💡Essential Medicines

Essential medicines are those that satisfy the priority health needs of the population. The script discusses the availability of essential medicines in the public health sector in the Philippines, noting the variability in supply and the role of private pharmacies in filling gaps.

💡Telemedicine

Telemedicine is the remote diagnosis and treatment of patients via telecommunications technology. The video mentions the growth of telemedicine in the Philippines since the start of the pandemic, indicating a positive development in healthcare service delivery.

💡Health Information Systems

Health information systems are the resources and processes used to manage and analyze data in healthcare. The script touches on the attempts to modernize and digitize these systems in the Philippines, highlighting the challenges and the current state of electronic medical records and insurance claims.

💡Healthcare Finances

Healthcare finances refer to the funding and expenditure related to healthcare services. The video provides figures on the Philippines' annual healthcare costs, the percentage of out-of-pocket expenses, and government subsidies, illustrating the financial burden on individuals and the state.

💡Devolution

Devolution in the context of the video refers to the transfer of powers and responsibilities from the national government to local government units. The script discusses the implications of devolution for the Philippine healthcare system, including the distribution of leadership and potential issues with funding and resource allocation.

Highlights

The Philippines, an archipelago with over 7,000 islands, has a healthcare system serving more than 110 million people.

The Philippine Healthcare System is composed of six building blocks, each crucial for the system's functionality.

Service delivery includes both public and private healthcare providers, offering a range of services from barangay health stations to tertiary hospitals.

The country has over 22,000 public health stations and 1,900 licensed birthing homes, indicating a widespread service network.

Hospital beds are categorized into three levels based on the severity and complexity of care needed, with 750 level one hospitals, 327 level two, and 120 tertiary hospitals.

The Philippine Healthcare Workforce comprises over 90,000 nurses, 40,000 doctors, and 43,000 midwives as of 2017.

Essential medicines and medical devices are sometimes available inconsistently, with public health centers having essential medicines about 57-76% of the time.

The Philippines has a robust private sector with 29,000 private pharmacies to supplement public healthcare deficiencies.

Disease surveillance is a key aspect of the healthcare system, with a network for monitoring and reporting diseases like Dengue, tuberculosis, and HIV.

Healthcare financing in the Philippines accounts for 6% of the GDP, with significant personal out-of-pocket expenses.

Government schemes like PhilHealth cover a portion of healthcare costs, but out-of-pocket payments remain high at 41.5% of total health expenditure.

Healthcare infrastructure faces challenges with an average of 1.2 hospital beds per 1,000 people, leading to potential shortages.

Healthcare workers are in short supply, with many trained professionals choosing to work abroad or in non-medical sectors due to better pay and conditions.

The devolution of the healthcare system has led to a distribution of power from the national to local governments, with mixed outcomes.

Conflicts between politics and jurisdiction can affect the quality and accessibility of healthcare services.

The Philippine Healthcare System faces issues of funding, healthcare workforce, and leadership that impact the quality of care provided.

Transcripts

in an archipelago with over 7 000

Islands somewhere in Southeast Asia with

more than 110 million people we have the

Philippines and this video is about the

Philippine Healthcare System there are

six building blocks in any Healthcare

System and we will briefly discuss them

one by one but first let me introduce

you to a Filipino couple let us name

them

Jacob and Althea let's say Jacob and

Althea are planning to start a family

and just want to ask a professional how

reproductive Health Works what should

they do what to expect in the next

couple of months depending on the

severity and urgency of their Healthcare

concerns Jacob and Althea have several

providers to choose from this is where

the first building block in the

Philippine Healthcare System comes in

Service delivery the Philippines has

both public and private healthcare

providers functioning in parallel and

most of the time working together Gekko

Ben Althea could go to more than 22 000

Public barangay Health stations in 2500

Primary Healthcare facilities rural

Health units or barangay health centers

are issues and bhcs there are also

outpatient Departments of approximately

1200 hospitals of various capacity and

of course there are also Private health

clinics and private and public

teleconsultation services available in

the country after a couple of months and

Althea is already 38 weeks pregnant and

needed to give birth the Philippines has

over 1 900 licensed birthing homes that

could help her deliver her beef B if her

case was more complicated then she must

go to a hospital to give birth if Jacob

suddenly became sick for some reason

probably unrelated to the baby and he

needed to be hospitalized the

Philippines have hundreds of thousands

of hospital beds divided in three levels

of Hospital capacity and capability the

choice of level of hospitals depends on

the severity and complexity of Jacob's

condition for simple cases that only

require short-term admission and basic

care the Philippines have 750 level one

hospitals if Jacob needed intensive care

or procedures we have 327 level 2

hospitals and if he developed a really

severe or rare disease that would

require prologue or specialist treatment

the Philippines have 120 tertiary level

hospitals this is your end referral

facilities and the last option if Jacob

requires that level of care and of

course he could always go to another

country like Singapore if he wants to

get health care outside of the

Philippines

other important numbers in the

Philippine Health Services we have 30

psychiatric facilities 499 dialysis

centers 2000 general clinic Laboratories

or diagnostic Centers 1000 x-rays 400 CT

scans and 109 MRIs MRIs whatever eyes

these are the pre-pandemic numbers and

of course we're going to talk about

issues of the healthcare service

delivery in the Philippines and the

entire Philippine Healthcare System in

general but for now let's talk about the

second building block the Philippine

Healthcare Workforce

so going back Althea gave birth to a

baby let's name her baby Corona and both

mom and baby were healthy that's good

news they decided to bring baby Corona

to a barangay health station for a

well-chat visit because that's what

you're supposed to do even if you have a

normal delivery you still have to do a

well-child visit unfortunately not all

Health stations have healthcare workers

on duty only about 90 of the 22 000

Health stations have either a nurse or a

midwife on duty less than 10 percent of

them have an accompanying Doctors on

Duty our nurses and midwives on duty in

this barangay health stations can still

provide well baby care because they are

trained to provide them but if the

family wants baby Corona to be seen by a

doctor then they have to bring the baby

to the nearest bhcs or rhus this each

season are shoes have doctors specialist

nurses midwives medical technologists

and some even have pharmacies and

dentists on board and again there are

always hospitals and medical clinics if

that's what you prefer my point is as of

2017 the Philippines has over 90 000

nurses 40 000 doctors 43 000 midwives

and 13 000 med techs that are employed

in an institution there are more

healthcare workers that are not employed

in any institutions working in private

and these statistics are from five years

ago so the numbers probably changed and

practicing professionals probably

changed by then and of course the

healthcare workers in the Philippine

Health System have issues let's not talk

about it right now let's jump to the

next building block availability of

essential medicine and medical devices

or baby Corona would require medications

the public health service providers in

the Philippines sometimes have all the

essential medicines and medical devices

available sometimes there is this study

from a couple of years ago that states

majority of the primary health centers

have essential medicines available of

about 57 to 76 percent of the time for

level 2 hospitals or higher essential

drug availability was only about 23 to

77 percent if you ever work at a public

Hospital you would feel like sometimes

there are days when almost all medicines

are available and there are days where

no medicines are available at all like

literally nothing the hospital is just

like a building with no supplies

of course if Jacob and Althea cannot

obtain their medication or medical

devices from the public health sector

they can always purchase from the 29 000

private pharmacies and thousands of

medical device resellers in the country

I hope you are seeing a pattern here

whenever there is a deficiency in the

Philippine Public Health sector there is

usually a private provider that could at

least to some extent help alleviate that

Gap so remember when Jacob got sick

let's say he was diagnosed with Dengue

because of course it's Dengue and

there's a freaking Dengue outbreak in

the Philippines while I was researching

this video and nobody seems to be

talking about it Dengue some diseases

like Dengue tuberculosis HIV among

others are of special particular public

health concerns that the Philippine

Healthcare System have a network of

collecting statistics and reporting to

the local government the Doh and the

national government this is in theory to

monitor the possible outbreaks of

diseases epidemics and pandemics so the

public health officials can formulate an

early enough response to prevent and

manage the spread of these illnesses

this is where the care information comes

in the Port building block of the

Philippine Healthcare System we have

several bureaus under the Doh and

independent institutions to collect this

data the Philippines have several

attempts to modernize and digitize the

health information systems such as

ehealth Solutions and pillow Health's

electronic insurance claims

unfortunately electronic medical record

system in the Philippines are still

primitive and not as ubiquitous as those

in developed countries

telemedicine however has grown

considerably since the start of the

pandemic so that's a good thing maybe I

don't know

when it comes to health finances the

Philippines is spending 1.18 trillion

with a t trillion pesos every year for

its healthcare costs that is

approximately six percent of the

Philippines GTP and each Filipino spends

over 9800 every year for their personal

health care costs so how does Jacob and

Althea pay for their Family Healthcare

most likely from their own wallets with

subsidies from the government which is

basically taxes that is also from your

wallet 41.5 of Total Health expenditure

in the Philippines is out of pocket that

is easy to understand

then about 50.3 percent are government

schemes including peel Health where the

government takes money in the productive

members of society pulls it in a fund

and use it to reimburse healthcare

providers for service are built by Phil

Health members included in the

government schemes are the 270 billion

pesos of funding for the Department of

Health of the Philippines yes 270

billion with a B that is how much money

is allocated for the Department of

Health of the Philippines of course they

need to spend a lot of money because we

are still in the pandemic and they need

to buy their laptops and they need to

hire a new health secretary you know

Healthcare is really expensive a small

portion about 8.2 percent are funded by

Private health insurance that is if you

ask me has its own issues but let's talk

about it in another video so all these

numbers I had mentioned are used by the

Philippine government to make Jacob

ataya and baby Corona's Health promoted

restore and maintained because the

government are nice and good people and

it's mandated in the Philippine

Constitution or something okay that's

already five of the six building blocks

before we continue let's talk about some

of the problems with the health

infrastructure in the Philippines

you may think over 100 000 beds are a

lot but considering there are over 100

million Filipinos already that's only

approximately 1.2 beds per 1000 possible

patients are available so if Jacob and

Althea live in a bronchi of 1000 people

and both of them got sick the

unfortunate reality is they are going to

have to share the hospital bed along

with everyone else in the barangay that

will get sick especially in a pandemic a

hundred thousands of hospital beds are

not enough hospital beds for the

Philippines other issues about Health

Service delivery majority of our

facilities are found in the urban areas

especially in the cities of the national

capital region and adjacent provinces so

what usually happens is when a patient

from a remote region in the country

requires Health Service and they have to

travel more than 30 minutes to the

nearest facility they usually decide to

ignore the barangay health stations and

health centers and go straight to the

big hospital so you will see scenes like

this and this and this overwhelming the

secondary and tertiary level Hospital

girls and everyone suppers and since

this setup makes it so hard for some

people to seek professional help many

often decide not to get a consult or

seek help until they are already really

really sick or Worse sometimes they just

die without being seen by any Healthcare

professional like zero consult since

birth

okay about human resource side there is

a petrol shortage of healthcare workers

in the Philippines therefore it is in my

opinion that the Philippines has among

the best trained healthcare workers in

the world especially our nurses their

top tier well-trained export quality

they are sought after by many developed

countries because of reasons but the

problem is still there healthcare

workers are at a constant shortage we

train a lot of nurses and doctors and

other Allied health professionals but

most of them are either concentrated in

cities like in the Health Service

delivery problem all over again or the

trained professionals don't stay in the

Philippine healthcare industry they

would rather either go outside of the

country to practice their profession or

go to a BPO company because it makes

sense for them pay is higher work hours

are better I don't know if it's less

stressful or less toxic than being in a

hospital or not but if it's more

stressful and more toxic why are you

staying in that company

when it comes to essential medicines and

medical devices majority of the time

they are readily available like I

mentioned earlier except that one time

when there was a paracetamol shortage in

the Philippines because Filipinos are

humans that make human decision you

might also encounter issues for The

Uncommon medications especially the

breaded ones but if you make an effort

you're probably going to be able to get

the medications you might need

when it comes to prices I know it is

expensive but the Philippines already

have among the better price controls

compared to other countries maybe I

don't have evidence for this the main

problem is since the medication expense

are usually shouldered out of pocket by

the patients accumulating cost becomes

really really expensive really really

fast

with all the complexities and numbers

and issues we discussed that lead us to

the six building block of the Philippine

Healthcare System that is supposed to

solve majority of these issues

government and Leadership

since the Devolution of the Philippine

Healthcare System the structure of

leadership and power are distributed

more in the local side with guidelines

and standards set by the national

government Revolution does not

necessarily mean things are getting

better or worse Devolution in this

context just means the power is

transferred from the national government

to the local government and there are

several issues about that the Doh

Philippines only handles a few tertiary

level and Specialty hospitals while the

provincial government handles the

regional and District hospitals certain

cities in the Philippines have become so

large that they manage their own

independent city hospitals and the rural

Health units at barangay Health Centers

and stations are managed by the mayors

of municipalities concerns of this type

of leadership structure is that there is

often conflicts with politics and

jurisdiction why would the patient from

Imus Cavite go to a public Hospital in

Metro Manila for Health Services when

there is already public health

facilities in Imus those are just minor

issues publicly health workers would

still provide services to every patient

wherever they come from the problem is

certain facilities are over utilized and

under resource while other facilities

are underutilized and over resource

another possible issue that might arise

in this kind of system is that the

responsibility of providing healthcare

service to citizens are being

transferred to the lgu but the funding

is not being transferred to the lgu so

lack of funding lack of healthcare

Workforce means less healthcare for the

people

each building block probably deserves a

bit of its own if you want an in-depth

explanation maybe as some other content

creator could do a video about it or

wait maybe I'll do a video about it in

the future I don't know I guess that's

it a brief overview of the healthcare

system of the Philippines hope you like

it if you have any questions write it

down in the comment section if you have

ideas on how to fix the issues of the

Philippine Healthcare System maybe you

should be the health secretary or

something or run for the president maybe

I don't know you do you I'll just do me

thanks for watching goodbye

[Music]

we beat

it so congratulations Philippines