"The Health Secretary has stood through it all."
"The Health Secretary has stood through it all."
For the issues and challenges confronting him. Health Secretary Francisco T. Duque III, has to be the man of the hour. Stemming the dengue epidemic, implementing the Universal Health Care law and answering allegations of a mafia controlling the flow of funds in PhilHealth can be too much for a man of less inner strength.
But Duque has stood through it all. This is his second time at the Department of Health having been appointed once before as the country’s chief doctor.
“This Department of Health isn’t the same DoH I left in 2009 as the one I took over again in 2017,” he said.
Consider these facts and figures provided by sources at the DoH: The department went to three health secretaries—Ona, Garin and Ubial—who had diverse backgrounds: Dr. Enrique Ona, a top surgeon in the field of vascular surgery and organ transplantation, had a different priority. The DoH’s budget increased during his watch because of the passage of sin tax law and DoH went into a buying spree of hospital equipment. When Ona took a leave in 2014, Dr. Janette Garin, a politician from Iloilo, became OIC and a month after, was designated as Acting Secretary of Health. Her time was defined as the period of rushed procurement and construction from Dengvaxia, barangay health centers, Fabella, dental vans, among others. Most activities were business driven. She was the second secretary of health coming from Congress with the first being the late Hilarion Ramiro of Misamis Occidental who later on resigned due to alleged corruption.
Meanwhile, Dr. Paulyn Ubial was secretary for only 16 months but records showed she travelled every month. She initially opposed the Dengvaxia but was prodded to continue with the program when it was raised in her confirmation hearing. Ubial expanded Dengvaxia from school- to community-based roll out. It was likewise reported that she took in 50 consultants.
Duque’s Formula One was all about reforms in the health sector from governance, health regulation, sustainable health care financing and service delivery. He was actually laying down the building blocks of UHC. There was 86-percent coverage by PhilHealth for the entire country when he left in 2010. DOH was corruption-free then with a little budget of P11 billion to P34 billion.
Today, all indicators have been compromised due to the evolving role of the department. It’s all “fire fighting” against a well-oiled machine wanting to put a halt on UHC because of various issues. “We want to continue harnessing technology to build health metrics from national to local. We want to increase the public satisfaction rate of the Department which suffered because of the Dengvaxia mess. We want to reclaim the vaccination coverage to the high 90 percent just like before. The same with measles and polio. We are playing catch up on the supplemental immunization,” said Duque in several interviews.
Duque was again under fire for the roll out of the UHC at the House of Representatives during the department’s budget hearing. The issue was why limit the roll out to 33 local government units when the law says “universal”? Unfortunately, the legislators did not read the law they crafted. Republic Act 11223 provides for a six-year transition period for the integration of local provider networks into provincial and city health systems. The roll out remains national in scope (covering the 17 regions) but progressive in approach. “Every geographical area of the country is well represented under the 2020 program: 13 integration sites are located in Luzon, 10 in Mindanao, eight in Visayas, and two in the National Capital Region.
One key reform under the UHC Program which Duque expects to be completed by next year is the mandatory enrollment of all Filipinos in the National Health Insurance Program (NHIP) of the Philippine Health Insurance Corporation (PHIC). Duque is eyeing a 100-percent enrollment on the first year of UHC implementation. Once 100 percent enrollment is achieved, the individual-based medical services which PhilHealth reimburses or pays for will become available to all Filipinos at all PhilHealth-accredited facilities nationwide.
The Universal Health Care is one of the legacy agenda of President Rodrigo Duterte. Three of the six years of roll out will occur under Duque’s watch. It is both a challenge and an opportunity for the chief doctor of the country.