It has been a great year. I cannot thank enough the people who have been part of this amazing 2019!

In the past, I wrote top lessons I learned during the year. For this year, I will have to put them aside and share with you nine questions I had in 2019 that remain unanswered (or partially answered). I hope to find answers in the coming new year.

1. Can the healthcare system achieve both equity and efficiency at the same time? Or are the two concepts contradictory in healthcare? Should one be achieved before the other?
2. How can we make the procurement process be more flexible and less corrupt while being strict on the quality of materials procured?
3. What incentives could eventually reconcile self-interest and social interest?
4. Should state-funded health care be rationed? How should the government ration health care to meet the current demand? How does rationing of care contribute to universal health care?
5. Does the current national social health insurance program increase or decrease the efficiency of the use of scarce resources?  Is ‘access’ rather than ‘utilization’ of health services a better measure of equity in health care?
6. Do patients’ preferences affect the supply of health care services? Or are variations in the supply of health care services in various settings simply a response to high levels of patient demand? If not, how much do patients’ preferences contribute to utilization of health care services?
7. How do we go about the Filipino culture of putting too much trust on one’s doctor to the extent that we lose exercising our right to participate in decision-making?
8. Do we cast our nurses as “global goods” rather than “domestic providers” of health care, implicating them as sources of remittance income rather than for their potential contributions to the local health system? Is this kind of trade (trade in health services/providers) not only motivated by the desire for revenue, but also by the desire to cope with overproduction and lack of opportunities for nurses in the Philippines?
9. Do people’s preferences and tastes change in situations where there are very few choices? Or do they develop an acquired taste/preference because of limitations posed by societal inequities?