Health spending in the Philippines has more than doubled over the past decade, crossing P1 trillion in 2021 and projected to hit P1.4 trillion in 2024, but a fragmented system and uneven local implementation are holding back Universal Health Care (UHC) gains, experts warned at a recent forum.
The inconsistent priorities and varied capacities of local government units (LGUs) are causing inequities in access and inefficiencies in service delivery, according to a forum organized by the Philippine Institute for Development Studies (PIDS).
Senior research fellow and health economics and finance program (HEFP) director for PIDS Dr. Valerie Gilbert Ulep noted the fundamental shift in spending, with a four-fold real-terms increase in per-capita spending, from P3,000 in 2000 to nearly P12,000 today.
Ulep said this growth has not ensured equitable or efficient healthcare access, adding that the complex mix of financing streams—including LGU budgets, PhilHealth reimbursements and national grants—”exacerbate inequity” across the nation.
Experts pointed to structural weaknesses at the local level as the main reason health outcomes continue to diverge sharply.
Research specialist for PIDS-HEFP Therese Jules Tomas said that while overall health spending is up, infrastructure investments remain uneven.
She noted that bed capacity is not keeping pace with population growth, explaining that the reliance on LGUs for capital outlay has led to low local spending and inequitable access to hospitals and medical equipment due to varied financial and technical capacity.
The human resources for health (HRH) also remain thin and unevenly distributed. Technical specialist for PIDS-HEFP Louie Iyar Dagoy revealed that only 3 percent of the national workforce are health professionals, with over half working in the private sector.
Dagoy noted that “areas with higher poverty tend to have fewer health workers per 1,000 population,” urging the creation of a national HRH support system and a global budget approach for public facilities.
Undermining reforms are weak information systems, according to technical specialist for PIDS-HEFP Jomelle Wong.
Wong stressed the need for stronger health information systems (HIS) governance, interoperable systems and comprehensive support for facilities, noting that “The entire health sector is investing in HIS, but the technical unit in DOH for HIS is getting smaller.”
The panel discussion brought attention to persistent gaps.
Former Department of Health officer-in-charge Dr. Maria Rosario Singh-Vergeire said that many barangay health stations remain non-operational.
World Health Organization-Philippines health systems strengthening team coordinator and team lead Dr. Yu Lee Park cited the need for financing reform through pooled funding and strategic purchasing, drawing lessons from Thailand and Mongolia.
WeSolve Foundation president Kenneth Isaiah Ibasco Abante called for empowering civil society and LGUs to address corruption in health spending, describing it as a “cancer.”
Department of Health development bureau director Johanna Banzon said that achieving UHC requires stronger collaboration among national agencies, LGUs, civil society and development partners, along with more coherent and accountable financing to build a system that is fair, responsive, and centered on the needs of every Filipino.
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