Financing and Resource Constraints Hindering the Optimal Implementation of the Universal Health Care Act in the Philippines

The Universal Health Care (UHC) Act in the Philippines aims to provide equitable access to quality and affordable health care. However, its implementation is hampered by significant financing and resource constraints. This study explores these challenges from the perspectives of various stakeholders, aiming to inform policy and improve the execution of the UHC Act. In this qualitative study, we conducted 17 focus group discussions and 19 key informant interviews between September 2023 and May 2024. Participants included national and local policymakers, public and private healthcare providers, and patients. The data were analyzed using the WHO's health system financing framework, focusing on revenue raising, pooling, and purchasing. The findings reveal critical issues across all financing functions. Revenue-raising is undermined by a lack of funding for local government units and challenges in PhilHealth premium collection from the informal sector. In terms of pooling, the Special Health Fund is hindered by the absence of clear guidelines and delays in fund transfers. Purchasing is plagued by bureaucratic procurement processes, shortages of suppliers, and significant delays and issues in PhilHealth reimbursements. The optimal implementation of the UHC Act in the Philippines is impeded by interrelated financing and resource challenges. Addressing these challenges requires comprehensive reforms, including strengthening local health system integration, finalizing guidelines for local governments, and reforming procurement and PhilHealth's payment systems.