On health spending and insurance in the Philippines

The Philippine Statistics Authority (PSA) released last week a set of very interesting data — a total of 48 tables and Excel sheets, on Philippines health expenditures, insurance, and relevant health ratios. The numbers somehow dispel a number of health claims and myths like “government health spending is declining,” “out of pocket health spending is almost 10% of household consumption,” and so on.

Out of those 48 tables I chose six and compressed them into three tables here. The various indicators cover 12 years, from 2014 to 2025. I chose five periods, with gaps of two years between the periods. Here are the results.

Our total current health expenditures have expanded from P489 billion in 2014 to P1.73 trillion in 2025 or 3.5 times expansion. Nearly one third, or 32% of it, is from government, national and local, then social insurance contributions with a 12.6% share. Various domestic revenues including household out of pocket payment (OOP) have declined, from 54% of the total in 2014 to 42% in 2025 (see Table 1).

By institutional sources of revenues for health, the bulk is from households with P847 billion in 2025 followed by government with P557 billion.

By health financing schemes, the government ones including mandatory contributions like PhilHealth are the largest with P806 billion in 2025, followed by OOP with P715 billion (see Table 2).

Now for the juicy part. Total health spending by both government (national and local) and private (corporate and household) is actually rising — the share in relation to GDP size increased from 4% in 2014 to 6.7% in 2025.

Within household and private funding, the share of OOP is indeed rising, from 2.7% of household consumption in 2014 to 3.3% in 2025. But this is far less than the claims that it is 5% to 10% of household spending (see Table 3).

This is because people are now spending more on non-infectious or non-communicable diseases (NCDs). The share of spending for NCDs increased from 33.9% of current health expenditures (CHE) in 2014 to 50.4% in 2025 — a big jump. The share of spending for infectious or communicable diseases has declined, from 24.2% of CHE in 2014 to only 12.4% in 2025.

Meaning people are spending more on prevention and the treatment of cancer, stroke, hypertension and other NCDs, than pneumonia, COVID, malaria, and other infectious diseases.

On a related issue, that of former Finance Secretary Ralph Recto’s transfer of excess PhilHealth funds to the National Treasury in 2023, this was the transfer of P60 billion from one government agency to another government agency to be used for spending by other agencies without resorting to additional borrowing.

The health activists and petitioners lost their Supreme Court case against Recto, PhilHealth President Emmanuel Ledesma, Jr., and other officials. The court ruled that there was no plunder involved (which is the transfer of a large amount of public money to government or private individuals, their families and friends), that there was no “illegal use of public funds.” The court simply ordered the Finance department to return the money from National Treasury to PhilHealth and this has been done — 100% of the P60 billion was returned in 2025.

Another group of emotional petitioners went to the Ombudsman early this year urging it to penalize Mr. Recto and Mr. Ledesma for the same charges and accusations. The Ombudsman ruled early this month against the petitioners, saying that there was “no plunder” and “no illegal use of public funds.” Strike two, or 0-2 for the petitioners.

One “health reform advocate” physician has pursued the same case against the same government officials at the same court, the Ombudsman. It is not clear if the Ombudsman will pay attention to the same case when it has already issued its decision and ruling.

Bienvenido S. Oplas, Jr. is the president of Bienvenido S. Oplas, Jr. Research Consultancy Services, and Minimal Government Thinkers. He is an international fellow of the Tholos Foundation.

minimalgovernment@gmail.com