Saturday, June 15, 2013

Women's Challenges in Universal Health Care

About halfway through the establishment of Kalusugang Pangkalahatan (Universal Health Care or UHC) as the Aquino Health Agenda, we have seen massive efforts to increase PhilHealth enrollments and enhance benefits for Filipinos belonging in the lowest income quintiles.

Private sector participation seeks to help address the remaining gaps and inequities in health care access by looking at unreached disadvantaged sectors such as the workers in informal sector who cannot be classified as poorest of the poor yet, are disempowered from accessing basic health services.

In my work at a foundation that helps said disadvantaged segment obtain sustainable access to quality health care through PhilHealth memberships, I came to realize that economically-disadvantaged women have yet to hurdle some challenges to a more inclusive health care system.

A Disconnect between Case Rates and Access
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In 2011, the PhilHealth released Special Benefits Packages, including case rates payments covering several cases for women such as maternity packages, mastectomy, dilatation and curettage, among others, and no balance billing (NBB). Under NBB, "no other fees shall be charged or paid for by PhilHealth patients beyond the identified case rates." (PhilHealth)

While these enhancements in member benefits are beneficial for women, the problem is they are not accessible to some, if not many. This situation prevents PhilHealth from fully realizing its intentions.

"Complicated Relationships"

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So what makes access still an issue for women?

Due to gender roles, men are often the ones who register as PhilHealth members -- especially when they sign up as paying members. In many cases, men in marginalized communities grapple with PhilHealth's documentary requirements. The only way they can include their partners as qualified dependents is if they can produce photocopies of marriage contracts. Sad to say that often, there are none.

It is true that among the poor, common marriages are rampant. Local government units seek to address this through kasalang bayans (mass weddings) but even so, "complicated relationships" where men live with a new partner or support more than just one family put women at a disadvantage.

PhilHealth should find a way to ease their documentary requirements or open opportunities for women to be part of its inclusive health agenda.

Windows of Opportunity

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PhilHealth and partners should find inspiration in pursuing initiatives to bring in women not only as qualified dependents of the working men, but also as registered members.

Studies show that women as homemakers are efficient domestic financial planners, indicating their ability to save for their own PhilHealth premium payments. Aside from this, they can take active roles in increasing awareness on PhilHealth benefits and availment procedures within their respective communities while their husbands are working and when their children are at school.

There is still plenty of time to make women count in UHC if we can already start now.