Fewer Filipinos can afford medical care, says ADB study

Fewer poor Filipinos are seeking treatment from private and government hospitals because of costlier medicines and healthcare services, an Asian Development Bank (ADB) study said.

The Manila-based lender said that utilization of healthcare in the Philippines declined at an annual rate of 4.7 percent from 1998 to 2007, or faster rate than the population growth of 2.3 percent.

The number of Filipinos going to government hospitals for treatment went down to 3.4 percent in 2007 from 3.70 in 1998; private hospitals, 2.25 percent from 3.06 percent; private clinics, 2.55 percent from 5.13 percent; rural health units (RHUs), 2.36 percent from 4.79 percent; and barangay (village) health stations (BHSs), 1.82 percent from 2.45 percent.

The ADB study said that the utilization of health services among the poor might have gone down more than among the rich because of “lack of ability to pay for health services.”

“Financial difficulties may have forced the poor to postpone seeking care until more severe stages of the illness, thus necessitating the bypass of primary basic-health facilities,” it added.

Costly medicines

Besides the higher cost of health services, ADB said that prices of medicines in the Philippines are among the highest in Asia.

“High pharmaceutical prices can deter people—particularly the poor who have lower capacity to pay—from utilizing healthcare,” it added.

ADB attributed the high prices of medicines to the relatively “monopolistic market” structure that is not countervailed by government and Philippine Health Insurance Corp. (PhilHealth) procurement policies on the demand side and by strong competition from generic drugs on the supply side.

Noting that the prices of drugs in the Philippines are among the highest in Asia, the ADB recommended to reduce prices of essential drugs to address the declining utilization of health services.

“Equally important is the improvement in the quality of services provided by primary health-care facilities such as BHSs and RHUs, which are largely utilized by the poor,” ADB said.

In addition, the lender said, databases of the social insurance system, PhilHealth, should be evaluated to have a more accurate picture of coverage.

“This will provide better data on the scope of expansion needed to achieve universal coverage,” the ADB added.

It said that advocacy to enroll the poor in PhilHealth should be continued, particularly in provinces and municipalities where coverage rates for the sponsored population are low. –Darwin G. Amojelar, Senior Reporter, Manila Times