The ethical principle of autonomy, one that is widely used for guiding the professional conduct of health care workers, is relevant in the issue of COVID-19 vaccination. While utilitarianism would suggest that mandating vaccination among health workers will bring about the greatest good for the largest number of people, this could affect respect for autonomy. … Continue reading Mandatory vaccination and ethics
In the face of limited resources in a world with unlimited health demands, the need to sustain the viability and sustainability of health financing systems is paramount. Legislators must carefully examine the design of health policies that influence the realization of universal health care and to consider interventions that have the greatest effect on the … Continue reading Pen Point 52
Price negotiation will help determine the prices of drugs to be included in PhilHealth benefit packages. However, these prices, based on my understanding of the JAO, are applicable to providers under the jurisdiction of DOH. As such, providers who are either private or LGU-sponsored may not directly benefit from it. A consolidated/pooled volume will drive … Continue reading Should PhilHealth use the centrally negotiated price of drugs in the development of benefit packages?
This definition of "overpayment" in the context of FFS is outright wrong. We are accustomed to thinking that paying a peso for every peso is the only right thing to do in a country that is deluged by cases of graft and corruption. Our past has conditioned us to think that paying over or under … Continue reading Is the government paying more than it should?
Efficiency gains should NOT be criminalized because they encourage the health care system to provide the best care we all deserve. At one point in time, HCPs paid under the ACR system will achieve efficiency gains by decreasing the overall cost of health care. HCPs do this by meticulously deciding on what and what not … Continue reading Should the government “criminalize” efficiency gains?
Paying for amounts printed on receipts is tantamount to subscribing to FFS rather than ACR. As illustrated above, this is inefficient and could likely promote external fraud. ACR, however, is far from perfect but averaging should've been the best method to determine the average cost of care needed for a specific case or procedure. The … Continue reading Should the government pay for whatever is on the receipt?
"Paying whichever is lower does not change the payment mechanism from ACR to FFS." This is true. Choosing to pay whichever is lower will not automatically change the payment mechanism from All Case Rates (Case-based payment) to Fee-for-Service. The "change" in payment mechanism does not depend on how we choose to pay, but on what … Continue reading Bill vs. ACR: Should the government pay for whichever is lower?
I agree that PhilHealth, as the implementer of the NHIP, should continue providing FP to all Filipinos by reimbursing claims. PHILHEALTH SHOULD NOT DENY CLAIMS JUST SO IT CAN PRESERVE FUNDS and have a longer actuarial life. IMHO, PhilHealth's role as a strategic purchaser of healthcare services/goods is the fulcrum that balances the health and … Continue reading Government should provide financial support to PhilHealth
During the Committee Hearing on August 17, Marikina Rep. Quimbo was surprised to know that hospitals are allowed to use funds from the Interim Reimbursement Mechanism (IRM) for other operational expenses (e.g. salary). Let me reiterate that the same mechanism is expected when "prospective payments" (in the form of global budgets) will be provided to hospitals … Continue reading Principle behind IRM is good
Congressional Hearing 5 August 2020 1) I do not agree with Cong. Defensor when he said that investing in an IT system while still using the All Case Rate (ACR) system will "computerize" corruption in PhilHealth. Regardless of the provider payment system, an IT system will actually help the Corporation and health care providers … Continue reading Congressional hearing: Corruption allegations against PhilHealth