Resource
Case Studies of Community Based Health Insurance Schemes in the Philippines
- English
Summary (English)
Health care services are dependent not only on health care system supply factors but also on continued access to a balanced spectrum of health care for each member of the community, from the removal of financial barriers to seeking care. In many developing countries, government budgets for health have been significantly reduced leading to the implementation of mechanisms where government health care providers and institutions are allowed to apply user charges to all but the indigent population. In many of these developing countries, these services in public hospitals were the only source of care provided free of charge for the majority of the population. Moreover, in many countries the private health provider sector is to a large extent for-profit initiatives.
A system of user charges is currently being implemented in many developing countries as the mechanism to recover costs and augment decreasing government appropriations. However, the use of such a system has, over time, manifested some serious limitations. Poor families tend to delay seeking health care due to limited resources. User charges are generally a fixed amount for a specific service, and are therefore by nature not progressive. This amount may be an insignificant expense for some families but presents an excessive burden for others.
Many countries, like the Philippines, have also introduced social health insurance as part of a package of social protection measures to be provided for its citizens. The implementation of this program is usually done in phases, starting with the formally employed and salaried workers. However, a huge majority of its labor force does not fit into this category.
In response to the increasing need for access to health care services, a sizable number of communities and associations in the Philippines have implemented community-based initiatives to provide some social security for its members.
The case studies being presented are examples of such initiatives. The document presents studies on three health micro-insurance schemes, namely, ORT Health Plus Program in San Fernando, La Union; the NOVADECI Health Care Program in Novaliches, Quezon City and BICAO Investment Care & Administration Organization in Carmen, Bohol. The first two case studies are updates on the previous case studies done by the STEP Programme in year 2000. It deals more on the impact of the health micro-insurance schemes to the communities and lessons learned. BICAO is a very young scheme established by a cooperative of agrarian reform beneficiaries.
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