Public-private sector collaboration key to sustaining UHC progress

Universal Health Care (UHC) represents one of the Philippines’ most ambitious social reforms. Its promise is simple yet transformative: every Filipino should have equitable access to quality healthcare without suffering financial hardship. Achieving that vision, however, requires more than legislation alone. It demands sustained investments, sound governance, and strong collaboration between the public and private sectors to ensure that quality healthcare remains accessible and financially sustainable for generations to come.

The Universal Health Care Act provides the framework for realizing this vision by automatically enrolling all Filipino citizens in the National Health Insurance Program (NHIP) administered by the Philippine Health Insurance Corp. or PhilHealth. Since the law’s enactment, PhilHealth has made significant strides in expanding health coverage while reducing the financial burden on Filipino families.

PhilHealth has substantially increased coverage for maternity care, including normal spontaneous deliveries, cesarean sections, prenatal checkups, and postnatal visits, as well as for catastrophic illnesses such as breast cancer and kidney disease. Through its upgraded YAKAP (Yaman ng Kalusugan) Program, members now have access to primary care consultations, selected maintenance medicines for chronic conditions such as asthma and hypertension, and basic laboratory services. An increasing number of private hospitals are likewise providing YAKAP primary care benefits, dialysis, and cancer treatment services.

The state health insurer has also accelerated its digital transformation to improve efficiency and reduce administrative burdens. By minimizing paperwork errors and streamlining claims processing, PhilHealth has reduced claims payment turnaround time from as long as 60 days to only 10 to 11 days, even while handling a growing volume of claims.

These accomplishments demonstrate the progress that can be achieved through sustained policy reforms. Yet preserving and expanding these gains will require more than government action alone. Universal Health Care succeeds when government agencies, healthcare providers, the private sector, patients, and development partners work together toward the shared goal of building a stronger, more responsive health system.

Sustaining these gains likewise requires responsive financing mechanisms, prudent fiscal management, and continued investments in healthcare infrastructure and the health workforce. Government financing should remain aligned with national development priorities, ensure the efficient and equitable allocation of resources, strengthen primary healthcare, and prioritize prevention, early diagnosis, and timely treatment—investments that improve health outcomes while helping reduce the long-term costs of illness.

PhilHealth President and Chief Executive Officer Dr. Edwin Mercado emphasized that expanded benefit packages and universal NHIP eligibility provide the foundation for the UHC Act. Looking ahead, he said the agency’s focus must shift toward smarter purchasing and more targeted interventions that maximize the value of every healthcare peso while ensuring long-term financial sustainability. He likewise underscored that healthcare investments should be viewed as drivers of national development rather than merely government expenditures, as healthier Filipinos contribute to a more productive workforce and stronger communities.

These themes were explored during a recent health forum at Healthway Cancer Care Hospital in Taguig City, which brought together health policy experts, healthcare leaders, and development partners from PhilHealth, the Philippine Institute for Development Studies (PIDS), the Private Sector Advisory Council (PSAC), and the healthcare sector to examine the progress of UHC implementation and the challenges that must be addressed to sustain it.

Forum participants agreed that the continued success of Universal Health Care will depend on sustainable financing, institutional resilience, and long-term policy commitment. PIDS Senior Research Fellow Dr. Valerie Gilbert Ulep emphasized that expanding healthcare access must always be balanced with sound fiscal planning to preserve PhilHealth’s financial sustainability and maintain public confidence in the healthcare system.

Paolo Borromeo, PSAC Health Sector Lead and Ayala Corporation Chief Social Infrastructure Officer, cited PhilHealth’s increase in breast cancer coverage from P100,000 to as much as P1.4 million as an example of how targeted public investments can provide meaningful financial protection. He also highlighted the PhilHealth GAMOT (Guaranteed and Accessible Medications for Outpatient Treatment) Program as a model for expanding access to medicines, promoting affordability, and strengthening preventive healthcare. The program provides members and their qualified dependents with up to P20,000 worth of outpatient medicines annually, covering 75 essential medicines for common chronic conditions such as diabetes, hypertension, asthma, and infections.

Dr. Mercado, meanwhile, stressed that making healthcare affordable is a shared responsibility. He pointed to pooled procurement, volume-based negotiations, and stronger coordination among government agencies as practical strategies for making healthcare more affordable and accessible.

Dr. Diana Edralin, president of the Pharmaceutical and Healthcare Association of the Philippines (PHAP) and general manager of Roche Philippines, agreed that medicines are often perceived as expensive because many Filipinos continue to pay for them directly out of pocket. She noted that innovative access arrangements — including pooled procurement and volume-based negotiations — have enabled many countries such as Australia, Malaysia, New Zealand, South Korea, Thailand, and the United Kingdom to negotiate better prices, expand patient access, and significantly reduce out-of-pocket healthcare spending.

Mr. Borromeo further emphasized that sustained public-private collaboration, innovative healthcare financing, and institutional partnerships will be indispensable as the country’s healthcare needs continue to evolve. The challenge, he said, is not simply to expand access today, but to build resilient and sustainable health systems capable of serving future generations.

Public financing remains the cornerstone of Universal Health Care, but international experience demonstrates that government does not have to provide every health service directly. Countries such as Canada, France, Germany, Taiwan, and Spain have achieved universal health coverage by combining public financing with services delivered by both public and private healthcare providers. These systems harness the strengths of each sector — government’s stewardship and financing together with the private sector’s capacity, innovation, and efficiency — to expand access while maintaining quality and long-term sustainability.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines, which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of developing, investing and delivering innovative medicines, vaccines, and diagnostics for Filipinos to live healthier and more productive lives.