• Spending overview
• Policy overview
• Diseases overview

Spending overview

Healthcare spending per head in the Philippines is comparatively low: it is above the levels in Indonesia and Vietnam in that year, but below those in Singapore, Malaysia and Thailand. After experiencing slower growth in local-currency terms and falling in US dollar terms in 2009, total health spending is expected to reach US$12.5bn in 2014. The Philippine Health Insurance Corporation (PhilHealth) operates the National Health Insurance Programme. Government expenditure is constrained by the country's poor fiscal position, and private healthcare expenditure exceeds spending by the state. As of June 2009 PhilHealth had 81m beneficiaries, thus covering around eight out of ten Filipinos.

About 23% of PhilHealth's beneficiaries (19m people) were enrolled under a sponsorship scheme for the poor, but many poorer families still do not have PhilHealth cards entitling them to health services. In private hospitals most expenditure is out of pocket, with the remainder being funded through insurance schemes. Out-of-pocket spending as a share of total health expenditure—an important indicator of inequality of healthcare provision between rich and poor—has increased in the past few years owing to budgetary constraints on government expenditure. The government will attempt to respond to the increasing need to improve healthcare coverage, although its capacity to do so will be limited, especially in the early years of the forecast period, owing to the weakness of the public finances. In 2009 the budget deficit widened to the equivalent of 3.9% of GDP, from 0.9% in 2008.

Policy overview

Eight out of ten of the hospitals licensed by the Department of Health are accredited by PhilHealth. Private hospitals account for 61% of those accredited by PhilHealth. According to the health department, there were 1,921 hospitals in the Philippines at the end of 2006 (the latest year for which data are available), with the private sector accounting for 1,202 of these. However, public hospitals are much larger than those in the private sector, and account for 51% of the country's hospital beds.
Primary healthcare services are of only a basic standard in rural areas, owing to a lack of infrastructure and investment. Outpatient care in urban areas is mainly provided by public hospitals, although some private hospitals also specialise in the provision of primary care. There is a shortage of qualified dentists in the Philippines, and access to proper dental treatment remains problematic.

The Philippines is a major provider of healthcare workers and medical staff internationally. A significant proportion of overseas Filipino workers are doctors and nurses, and the remittances that they send home play an important role in boosting economic growth in the country. However, the down side of this is that healthcare provision in the Philippines is being undermined by the departure of so many medical professionals to work abroad. Despite this, the government remains committed to sending healthcare professionals overseas, owing to the importance to the economy of remittances, which were equivalent to 10.7% of GDP in 2009.

Diseases overview

Demand for healthcare is expected to rise owing to a number of factors, including increasing life expectancy, the ageing of the country's population and the growth of the urban population. The average public hospital had 67 beds in 2006, compared with 38 in private hospitals. In 2006 there were 93,200 hospital beds in the country, equivalent to 1.2 beds per 1,000 population, the highest ratio since the mid-1990s, according to health department estimates. However, these estimates are based on the population level in 2000, and it is therefore more likely that the real ratio stands at around 1 per 1,000.

According to the Department of Health, diseases of the heart were the leading cause of mortality in 2005 (the latest year for which data are available), killing 77,060 people in that year. They were followed by diseases of the vascular system, cancer, pneumonia, accidents and tuberculosis. The leading causes of morbidity in that year were pneumonia and lower respiratory tract infections, bronchitis, diarrhoea, influenza, hypertension and tuberculosis.