1. Health Financing Summit
04.14.10

2. World Bank Sector Assessment Team (Sarbani Chakraborty,
George Scheiber, Ajay Tandon, Oscar Picazo, Eduardo Banzon
et al)
Presented by: Dr. Eduardo Banzon
Senior Health Specialist
World Bank

3. Methodology
• Trends over time on readily measurable performance
indicators and health systems inputs against other
comparable income and health spending countries
• Assessing the country against global averages
– Nothing right or wrong about a global average
– But large deviations indicate areas that may require changes in
health policies.
Three areas
• HEALTH SPENDING
– total, public or government , private, and out-of-pocket (OOP)
health spending
• HEALTH OUTCOMES
– Life expectancy, IMR and MMR
• HEALTH INPUTS
– Health workers and Hospital beds

4. HEALTH FINANCING

5. TOTAL HEALTH SPENDING PER CAPITA
HEALTH FINANCING

6. Total spending for health per capita in constant pesos (1995-2007)
3.9% growth

7. Composition of total spending for health (1995-2007)

8. Total spending for health per capita in US$ PPP in selected comparators
(1995-2007)

9. HEALTH SPENDING AS SHARE of GDP
HEALTH FINANCING

10. Health spending component share of GDP (1995-2007)
3.4%
3.9%

11. Total spending for health as share of GDP in selected comparators
(1995-2007)

12. GOVERNMENT HEALTH SPENDING
HEALTH FINANCING

13. Department of Health budget (2005-2010)
Source: General Appropriations Acts 2005 to 2010

14. Government spending for health as share of GDP (1995-2007)

15. Real Per Capita Government Health Expenditures (1997-2008)
Source: Sicat et al 2010

16. SOCIAL HEALTH INSURANCE
HEALTH FINANCING

17. % of uninsured Filipinos (based on PhilHealth reports
2000-2008)
Source: PhilHealth annual reports

18. Out of pocket spending for health as share of total health spending vs. GDP per capita (1995-2007)
> 50%

19. Private spending for health as share of total health spending vs. income per capita
(1995-2007)
65%

20. Catastrophic Health Expenditure Headcounts, by Various Thresholds
OOP as % of Total Income
12%
10%
8%
5%
10%
6%
15%
20%
25%
5%
4%
3%
3% 3%
3% 3%
2%
2% 2%
0%
1985 1988 1991 1994 1997 2000 2003 2006
Source: Lavado et al 2010

21. HEALTH OUTCOMES

22. POPULATION HEALTH INDICATORS, 1960-2007

23. INFANT MORTALITY RATE
HEALTH OUTCOMES

24. INFANT MORTALITY RATE as to INCOME and TOTAL HEALTH SPENDING,
2007

25. FEMALE LITERACY versus INCOME, 2000-2007

26. IMR (2007) as to YEARS of FEMALE EDUCATION

27. INFANT MORTALITY RATE, 1960-2007

28. INFANT MORTALITY RATE (2007)

29. LIFE EXPECTANCY
HEALTH OUTCOMES

30. LIFE EXPECTANCY at birth in selected Asian countries (1960-2008)
53 years
72 years

31. LIFE EXPECTANCY versus INCOME and TOTAL HEALTH SPENDING, 2007

32. LIFE EXPECTANCY (2006)

33. MATERNAL MORTALITY
HEALTH OUTCOMES

34. MATERNAL MORTALITY versus INCOME and TOTAL HEALTH SPENDING, 2005

35. MMR (2005) as to YEARS of FEMALE EDUCATION
Source: WDI; Barro-Lee

36. Skilled birth attendance relative to income and spending,
2003-2007

37. % of Births attended by health professionals (comparison across countries and Philippine regions),
2008

38. HEALTH INPUTS

39. Physician to Population ratio in selected Asian countries (1960- available
current year)

40. Total Health Worker to Population ratio Relative to Total Health Spending and
Income

41. Hospital Beds to Population ratio in selected Asian countries (1960- available
current year)

42. Total Hospital Bed to Population ratio Relative to Total Health Spending and
Income

43. Hospital/inpatient facility as Place of Death for Filipinos
Source: National Statistics Office

44. TOWARDS MORE VALUE FOR MONEY:
IMPLEMENT A-B-C

45. IMPLEMENT:
• A-O 29 series of 2008 or the Rapid Reduction of
Maternal and Neonatal Mortality particularly promotion of
facility-based deliveries
• B-enefits Reforms in PhilHealth
– Converting PhilHealth into an Active Purchaser of health
services (thru contracts and case payments)
– Expansion of primary care benefits to the entire enrolled
population
– PhilHealth coverage of P100 drugs
• C-overage for all Filipinos in the PhilHealth Sponsored
Program with National Government financing using the
DSWD’s proxy means test from its National Household
Targeting System for Poverty Reduction or the NHTS-PR
PMT
– TEACH the member of the poor (SP members) utilize their
benefits

46. IMPLEMENT:
• D- ata dictionaries (for health) towards a national
health IT system/ improved PhilHealth IT system
• E- xpansion of Results-based Financing
– Needs-based facilities and health personnel master
plan to guide future investments in the health sector
by expanding capacity in underserved areas of the
country
– Performance –based budgets/grants
– Hold LGUs, hospitals and PhilHealth accountable
for services and outputs
• F-acility autonomy reforms
• G-ame plan against Non-Communicable Diseases

47. Health Financing Summit
04.14.10