Jan 3 how healthy is the filipino revised december 10

1

How healthy is the Filipino?

Dr. Ramon Lorenzo Luis R. GuintoIndependent Consultant

2

What is Health?

• “complete state of physical, mental, and social wellbeing, and not merely the absence of disease or infirmity “

World Health Organization

• “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family...”

Universal Declaration on Human Rights

• “The State shall protect and promote the right to health of the people and instill health consciousness among them”

1987 Constitution of the Philippines

3

How do we measure health?

• What are the changes affecting the Philippine population, including major causes of disease and death?

Health Outcomes

• What are the factors that influence the health of Filipinos, both at the individual and population level?

Health Determinants

• How do Filipinos gain access to health care when they need it?Health System

4


We are living longer, and the elderly population is

gradually increasing.

We get sick and we die more often than ever

from chronic noncommunicable

diseases.

The factors that lead to disease affect the

population differently.

People are not protected enough from financial risks that come with ill

health.

5





diseases.




health.

6

The Philippine population is continuously growing, expecting to reach 140 million by 2040.

2000 2005 2010 2015 2020 2025 2030 2035 20400

20000000

40000000

60000000

80000000

100000000

120000000

140000000

160000000

76946500

85261000 94013200

102965300 111784600

120224500 128110000

135301100 141669900

Year

Popu

latio

n

Summary of Projected Population, Philippines: 2000-2040 (Medium Assumption) Source: National Statistics Coordinating Board

Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

7

The Philippines remains to be a generally young population, but the number of elderly people is

expected to further increase.

Source: UN DESA


8Source: Chongsuvivatwong, et al, 2011

While life expectancy across the ASEAN region has generally increased over the past fifty years, Philippines remained in the

middle, with Vietnam recently catching up.


9

While generally, Filipinos are now living longer lives, men still die earlier than women.

1960 1970 1980 1990 2000 201150

55

60

65

70

75

53

57

61

66

69 69

51

55

59

63

67 66

55

59

63

70 7173

BothMaleFemale

Year

Life

Exp

ecta

ncy

at B

irth

But retirement age stays at 65 – hence, more life years as an elderly!


10

Projected Population, by Five-Year Interval, Philippines: 2000-2040 (Medium Assumption)Source: National Statistics Coordinating Board

2000-2005 2005-2010 2010-2015 2015-2020 2020-2025 2025-2030 2030-2035 2035-204050

55

60

65

70

75

80

Male Female Both

Year Interval

Life

Exp

ecta

ncy

at B

irth

Life expectancy is projected to further increase, with females still living longer than males.


11

Longer Lives: Implications

1Individuals need to

ensure financial security as their

chances of joining the elderly

population increase

2In the long run,

health systems will need more resources,

especially health workforce, to meet

the needs of the aging population

3Cautionary tale: Today’s younger

generation has to consider this

transition as they prepare for future

life


12





diseases.




health.

13

Infectious Diseases

• caused by disease-causing microorganisms, such as bacteria, viruses, parasites or fungi

• can be spread, directly or indirectly, from one person to another

• generally treated with antimicrobial agents that eradicate microbes

Noncommunicable Diseases

• not caused by a pathogen and cannot be shared from one person to another

• caused by either the environment, nutritional deficiencies, lifestyle choices, or genetic inheritances

• not communicable or contagious, although some kinds can be passed down genetically to the children of a carrier

• treated with a wide range of drugs, mostly to delay progression


14Source: Philippine Health Statistics, various yearsLeading Causes of Disease

For the past three decades, Filipinos have been getting sick of infectious disease, but chronic hypertension is

rising as a leading cause of illness.


15Source: Philippine Health Statistics, various yearsLeading Causes of Death

While we still get sick of infectious disease, today we Filipinos die more of chronic, noncommunicable diseases

– like heart disease and cancer.


16

Transition in Causes of Death:More people have been dying of lifestyle-related diseases.

19591961

19631965

19671969

19711973

19751977

19791981

19831985

19871989

19911993

19951997

19992001

20032005

20072009

0

30

60

90

120

150

180

210

240

270

300

330

360

390

420

0

10

20

30

40

50

60

70

80

90

100

110

120Communicable Diseases

Cancer

Diseases of the Heart

Rate

(per

100

,000

) of C

omm

unic

able

Dise

ases

Year

Rate

(per

100

,000

) of M

alig

nant

Neo

plas

m a

nd D

isea

ses

of th

e H

eart

Source: Philippine Health Statistics, 1959-2009


17

NONCOMMUNICABLE DISEASES comprise 61% of total deaths in 2010.

Communicable, ma-ternal, pregnancy-re-lated, and nutritional

conditions, 30

Injuries; 8

Cardiovascular diseases; 30

Cancers; 10

Respiratory diseases; 5

Diabetes; 4

Other NCDs; 13

Source: WHO, 2010


18

We get more sick because of our LUNGS, but we die because of our HEART.

Morbidity MortalityCause Per 100,000 Cause Per 100,000

1. Acute Respiratory Infection 1203.0 1. Diseases of the heart 109.4

2. Acute Lower Respiratory Tract Infection and Pneumonia

612.6 2. Diseases of the vascular system 71.0

3. Bronchitis / Bronchiolitis 380.7 3. Cancer 51.8

4. Hypertension 366.3 4. Pneumonia 46.2

5. Acute Watery Diarrhea 354.5 5. Accidents 39.0

6. Influenza 297.7 6. Tuberculosis, all forms 27.6

7. Urinary Tract Infection 91.0 7. Chronic lower respiratory disease

24.7

8. TB Respiratory 80.9 8. Diabetes mellitus 24.2

9. Injuries 38.9 9. Nephritis, nephrotic syndrome and nephrosis

15.0

10. Acute Febrile Illness 22.2 10. Certain conditions originating in the perinatal period

12.5

Source: Philippine Health Statistics, 2009Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

19

HEART DISEASES are affecting both men and women.

Stroke

Myocardial Infarction

Disease of pulmonary circulation and other heart diseases

Hypertension without heart involvement

Atherosclerosis

Aortic aneurysm and dissection

Angina Pectoris

Hypertension with heart involvement

5,000 15,000 25,000 35,000 45,000 55,000Stroke Myocardial

InfarctionDisease of pulmonary circulation and other heart dis-

eases

Hyperten-sion without

heart in-volvement

Atheroscle-rosis

Aortic aneurysm

and dissec-tion

Angina Pec-toris

Hyperten-sion with heart in-

volvement

Male 28911 23440 10322 9959 889 343 255 58

Female 22364 12759 9209 8119 1217 211 185 38


20

In general, elderly people experience more HEART ATTACKS, but females past midlife are at increased risk.

Distribution of population diagnosed with myocardial infarction, by age, 2008 Source: Ulep, et al., 2012

Male Female0

1

2

3

4

5

6

0.1 0.20.2

0.80.6

0.80.7

2.4

3.6

2

3.4

5.1

0.8

1.3

20-2930-3940-4950-5960-6970 and aboveTotal

Perc

enta

ge (%

)


21

While prevalence of CORONARY HEART DISEASE increases with age, more males are affected by the disease.

Male Female0

1

2

3

4

5

6

0.2 0.30.3

1.2

0.8

1.3

2.3 2.4

5

2

3

2.6

1.3 1.4

20-2930-3940-4950-5960-6970 and aboveTotal

Perc

enta

ge (%

)

Distribution of population diagnosed with coronary heart disease, by age, 2008 Source: Ulep, et al., 2012


22

While BREAST CANCER is the leading cause of death among women, LUNG CANCER is the leading cause of

death for both sexes.

Others41%

Lungs and respi-ratory22%

Prostate6%

Leukemia

7%

Colon9%

Breast15%

Trachea, Bronchus

Lungs33%

Prostate12%

Colon11%

Lip, Oral Cavity and Pharynx

8%

Leukemia7%

Others29%

Breast29%

Trachea, bronchus,

lungs11%Colon

8%Cervix7%

Other Female Genitalia

7%

Leukemia7%

Others31%

BOTH SEXES

MALES

FEMALES

Source: NSO Mortality Data, 2008Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

23

10 Most Common Cancers in 2010Breast

Lung

Liver

Colon/Rectum

Cervix Uteri

Leukemia

Stomach

Prostate

Brain/Nervous System

Ovary

0 2000 4000 6000 8000 10000 12000 14000

12262

11458

7331

5787

4812

3153

3129

2712

2236

2165

4371

9184

6819

3060

1984

2609

2274

1410

1855

1016

Death New Cases

Number

Source: GLOBOCAN, 2008Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

10 Most Common Cancers among Males, 2010

Source: GLOBOCAN, 2008

Lung

Liver

Colon/Rectum

Prostate

Stomach

Leukemia

Brain/Nervous System

Other Pharynx

Non-Hodgkin Lymphona

Kidney

0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000

8772

5522

3208

2712

1920

1669

1236

1145

982

848

6987

5102

1690

1410

1340

1381

1069

804

598

389

Deaths New Cases

Number


24

10 Most Common Cancers among Females, 2010

Source: GLOBOCAN, 2008

Breast

Cervix Uteri

Lung

Colon/Rectum

Ovary

Liver

Corpust Uteri

Leukemia

Thyroid

Stomach

0 2000 4000 6000 8000 10000 12000 14000

12262

4812

2686

2579

2165

1809

1760

1484

1474

1209

4371

1984

2197

1370

1016

1717

796

1228

450

934

Deaths New Cases

Number


25

26

Q & A: Diabetes Checklist

Sex

• Male• Female

Residence

• Urban• Rural

Income Group

• Poorest• Poor• Middle• Rich• Richest

Education

• No formal education

• Elementary• Secondary• Tertiary


27

Diabetes Mellitus in Focus:You’re more likely to get diabetes if you are female, rich, based in an

urban city, and college-educated.

Poorest Poor Middle Rich RichestSocio-economic Status

0

1

2

3

4

5

6

7

8

9

1.8

33.5

6.4

8.1

Rural UrbanUrbanization

0

1

2

3

4

5

6

7

8

9

3.7

5.6

No Education Elementary Secondary TertiaryEducational Attianment

0

1

2

3

4

5

6

7

8

9

2.6

4.6 4.4

5.3

Male Female TotalSex

0

1

2

3

4

5

6

7

8

9

4.85.5

4

Source: National Nutrition Survey 2008Y-axis – prevalence (in percent)Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

Non-communicable diseases: Common characteristics

Require long-term treatment

May require acute care for complications

Require more than one drug

Can be debilitating and disabling Limit productivity Cost financial burden

to entire household

Necessitate involvement of family

and friends in providing holistic care

Require management by more than one

healthcare provider

But – preventable, avoidable, and

manageable

29





diseases.




health.

How are NCDs produced?

GlobalizationUrbanization

PovertyLow Education

AgingStress

Culture

Tobacco useUnhealthy diet

Physical inactivityAlcohol intake

High blood pressureHigh blood glucose

Abnormal blood lipids

Central obesityAbnormal lung

function

Heart diseaseStroke

DiabetesCancer

Chronic lung disease

Modified from WHO, 2005

Social and environmental determinants

Behavioral/ lifestyle factors

Biological risk factors

Chronic noncommunicable

diseases


30

31

Biological Risk Factors

High blood pressureHigh blood glucose

Abnormal blood lipidsCentral obesity

Heart diseaseStroke

DiabetesCancer

Biological risk factors Chronic noncommunicable diseases


32

Prevalence of Selected Risk Factors, by Sex, Philippines 2008

Hypertensio

n

High Total Choleste

rol

High Bad Cholestero

l

Low Good Choleste

rol

High Triclyce

ride

0

10

20

30

40

50

60

70

80

29.1

7.3 8.1

71.1

18.522.2

12.8 15

57.8

11.2

Males Females

Risk Factors

Perc

enta

ge

Source: National Nutrition Survey, 2008


33

While risk for HYPERTENSION increases with age, nearly half of Filipinos in early adulthood have blood pressures above normal.

20-29 30-39 40-49 50-59 60-69 70 and above

0

10

20

30

40

50

60

70

80

90

100

53.943.7

32.522.6

17.8 14.7

28.3

27.2

26.1

18.217.8

17.8

7.4

11.6

10.3

14.315.6

14.1

8.413.8

19.5

26.727.1

24.7

2 3.711.5

18.3 21.828.8

Hypertension Stage 2Hypertension Stage 1Pre-HypertensionHigh NormalNormal

Age Group

Perc

enta

ge (%

)

Percent distribution of blood pressure readings based on a single visit among adults, by age Source: National Nutrition Survey, 2008


34

1 out of 4 Filipinos are HYPERTENSIVE.

1993 1998 2003 20080

5

10

15

20

25

30

22 2122.5

25.3

Year

Prevalence of hypertension among adults based on a single Visit, Philippines 1993-2008 Source: National Nutrition Survey, 2008


35

1 out of 20 Filipinos have HIGH FASTING BLOOD SUGAR.

Prevalence of High Fasting Blood Sugar among Adults, Philippines 1998-2008 Source: National Nutrition Survey, 2008

1998 2003 20080

1

2

3

4

5

6

3.9

3.4

4.8

Year


36

Nearly 1 out of 4 Filipinos are either OVERWEIGHT or OBESE.

Male Female Both0

10

20

30

40

50

60

70

80

9.2 10.7 10

66.1

57.361.6

20.124.4

22.3

4.57.6 6.1

UnderweightNormalOverweightObese

Nutritional Status of Adults, 20 years old and over, by sex based on BMI classification, Philippines 2011



37

The proportion of overweight and obese Filipinos is increasing over the years.

1993 1998 2003 2008 20110

5

10

15

20

25

30

13.9 13.2 12.3 11.610

16.6

20.2

24

26.628.4

Underweight Overweight/Obese

Prev

alen

ce (%

)

Trends in the Prevalence of Underweight and Overweight among Adults 20 years old and over based on BMI, Philippines 1993-2011



38

Females are roughly 6 times more likely to have a high WAIST CIRCUMFERENCE than males.

1998 2003 2008 20110

5

10

15

20

25

2.7 2.4 3.1 3.2

10.7

1719

19.9

Male Female

Year

Prev

alen

ce (%

)

Trends in the High Waist Circumference Prevalence among Adults, 20 years old and over, Philippines 1998-2011



39

Females are roughly 10 times more likely to have a high WAIST TO HIP RATIO than males.

1998 2003 2008 20110

10

20

30

40

50

60

70

7.912.1 11.1

6.9

39.5

54.8

65.562.5

Male Female

Year

Prev

alen

ce (%

)

Trends in High Waist to Hip Ratio (WHR) Prevalence among Adults, 20 years old and over, Philippines 1998-2011



40

The people who are most likely to have diabetes – female, rich, urban, and college-educated – are the same people most likely

to become OBESE.


0

1

2

3

4

5

6

7

8

9

3.7

6.6

5.2


0

1

2

3

4

5

6

7

8

9

1.1

2.5

5

6.2

7.9


0

1

2

3

4

5

6

7

8

9

0.5

3.6

4.9

6.3

Source: National Nutrition Survey 2008


0

1

2

3

4

5

6

7

8

9

3.6

5.7

Y-axis – prevalence (in percent)Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

41

The people who are most likely to have diabetes and obesity – female, rich, urban, and college-educated – are the same people most likely to acquire

HIGH CHOLESTEROL levels in the blood.

Source: National Nutrition Survey 2008


0

2

4

6

8

10

12

14

16

18

20

7.3

12.8

10.2


0

2

4

6

8

10

12

14

16

18

20

4.7

6.78.1

12.5

17.3


0

2

4

6

8

10

12

14

16

18

20

8

11.9


0

2

4

6

8

10

12

14

16

18

20

5.8

8.39.6

13.1


42

Metabolic Syndrome

Central Obesity

Raised triglycerides

Reduced HDL cholesterol

Raised blood pressure

Raised fasting plasma glucose


43

Behavioral/Lifestyle Factors

Tobacco useUnhealthy diet

Physical inactivityAlcohol intake

High blood glucoseHigh blood pressure

Abnormal blood lipidsCentral obesity

Behavioral/lifestyle factors Biological risk factors


44

Men smoke five times more than women.

Current Smoker Current Daily Smoker0

10

20

30

40

50

60

47.7

38.2

96.9

28.3

22.5MenWomenOverall

Smoking Status

Perc

enta

ge (%

)

Percentage Distribution of Adults 15 years and older by Smoking Status and Sex, Philippines Source: Global Adult Tobacco Survey (GATS), 2009


45

1998 2003 20080

10

20

30

40

50

60

70

5457.4

53.2

12.610.9 12.5

32.735.2

31 MalesFemalesBoth

Year

Perc

enta

ge (%

)

Prevalence Trend of Cigarette Smoking, by Sex in the Philippines Source: National Nutrition Survey, 2008

Men smoke five times more than women.


46Source: National Nutrition Survey 2008


0

10

20

30

40

50

6053.2

12.5

31


0

10

20

30

40

50

60

39.936.4

29.725.3 24.8


0

10

20

30

40

50

60

33.128.9


0

10

20

30

40

50

60

41.3

35.131.5

23.7

SMOKING is most prevalent among males, the poor, those who live in rural areas, and those who never went to school.




0

2

4

6

8

10

12

14

108.8

9.4


0

2

4

6

8

10

12

14

8.19 8.9 8.9

11.7


0

2

4

6

8

10

12

14

8.710


0

2

4

6

8

10

12

14

7.28

9.4

11.4

Who consumes the highest level of SATURATED OILS in their diet? The males, the rich, the urbanized, and the college-educated

Y-axis – grams per dayLiving longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

48

Unhealthy diets: Filipinos are #3 consumers of take-away food

Source: AC Nielsen Consumer Survey Report, 2004

Hong Kong Malaysia Philippines Singapore Thailand China India U.S.A Australia New Zealand0%

10%

20%

30%

40%

50%

60%

70%

61%59%

54%

50%

44%41%

37%35%

30% 29%

Percentage of population that eats at take-away restaurants at least once a week, by selected countries, 2004.




0

10

20

30

40

50

60

70

80

90

100

53.447.4 50.3


0

10

20

30

40

50

60

70

80

90

100

19.2

33.5

44.1

59.4

86.5


0

10

20

30

40

50

60

70

80

90

100

39

60.3


0

10

20

30

40

50

60

70

80

90

100

12.5

25.1

53

81.8

Who consumes the highest level of SOFTDRINKS? The males, the rich, the urbanized, and the college-educated




0

2

4

6

8

10

12

14

3.63 3.3


0

2

4

6

8

10

12

1412.6

1.4 1.1 1.6 1.3


0

2

4

6

8

10

12

14

5.8

1


0

2

4

6

8

10

12

14

10.3

6.2

1.6 1.1

Who consumes the highest level of SALT in their diet? The poor, those who live in rural areas, and those who did not

undergo any formal education


51

1998 2003 20080

10

20

30

40

50

60

70

80

90

53.3

78.2

47.5

11.1

25.6

9.8

30.6

53

26.9

MalesFemalesBoth

Year

Perc

enta

ge

Prevalence Trend of Alcohol Drinking, by Sex in the Philippines Source: National Nutrition Survey, 2008

Men consume alcohol nearly five times more than women.


52

In general, Filipinos have low physical activity, regardless of the purpose.

2003 20080

10

20

30

40

50

60

70

80

90

100

72.276.3

92.6 94.592.6 92.7

Work-related PATravel-related PALeisure-related PA

Year

Perc

enta

ge (%

)

Comparison of Low Physical Activity (PA) by Domain, Philippines: 2003 and 2008 Source: National Nutrition Survey, 2008


53

While in general, Filipinos are physically inactive, males are a bit more physically active than females.

Liesure-related PA

Travel-related PA

Nonwork-related PA

Work-related PA

Liesure-related PA

Travel-related PA

Nonwork-related PA

Work-related PA

Mal

eFe

mal

e

0 10 20 30 40 50 60 70 80 90 100

89.1

93.8

83

76.3

95.7

95.2

70

76.2

10.9

6.2

17

23.7

4.3

4.8

30

23.8

LowHigh

Prevalence (Percentage)

Percent distribution of adults 20 years and over, by Physical Activity (PA) and by Sex, Philippine 2008



54

Increasing URBANIZATION in the Philippines has a role to play in limiting physical activity and shaping lifestyles

that lead to chronic noncommunicable disease.

1970 1890 1990 2000 20080

10

20

30

40

50

60

31.837.3

47 48 50.3

Total Population

Year

Leve

l of U

rban

izati

on (i

n Pe

rcen

t)


55

Poorest

5,958

Poor

8,594

Middle Income

12,269

Rich

18,497

Richest

40,590

Social Determinants of HealthThe poorest pay the most as a share of their monthly income

for food, which is a critical determinant of health.

57%67% 49%

AVERAGE HOUSEHOLD MONTHLY INCOME

40% 27%

FOOD EXPENDITURE SHARE

Source: Family Income and Expenditure Survey, 2009


56

The Vulnerable Filipino Woman

• Predilection for diabetes• Risk factors: Obesity, High cholesterol levels, Physically inactivity

Biological Risk Factors

• What more – the poor, uneducated woman who lives in the province?

Social Determinants of Health

• Social factors will further complicate the situation: limited employment opportunities, less working years, role in child rearing, gender violence, access to reproductive health services

Other Social Issues Confronting Women


57





diseases.




health.

58

As of 2011. the Philippines spends 4.4% of its GDP for health – still short of the 5% WHO recommendation.

2005 2006 2007 2008 2009 2010 20110

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

3.1 3.1 3.1 3.1 3.2 3.2 3.3

3.9 4 3.9 3.9

4.3 4.24.4

Share to GNI Share to GDP

Year

Perc

enta

ge (%

)

Share of Health Expenditure to GDP and GNI, 2005-2011Source: Philippine National Health Accounts, 2011


59

In 2011, the Philippines spent only PhP 4,577 per person for health care for the entire year.

2005 2006 2007 2008 2009 2010 20110

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

26242783

3061

3377

3759

4112

4577

2022 2083 2159 21792298

24422639

At Current Prices At Constant 2000 prices

Year

In P

hilip

pine

Pes

os

Per capita health expenditure, 2003-2011Source: Philippine National Health Accounts, 2011


60

The Philippines is financing a predominantly “disease care” system, with little funding allotted for health promotion and

disease prevention.

Personal Care79%

Public Health12%

Others9%

Total Health Expenditure by Use of Funds, 2011Source: Philippine National Health Accounts, 2011


61

In 2011, Filipinos spent more from OUT-OF-POCKET sources for health care than any other source.

12%

15%

9%

53%

2%

6%4% National Government

Local Government

Social Insurance

Out-of-Pocket

Private Insurance

Health Maintenance Orga-nizations

Others

Source: Philippine National Health Accounts, 2011Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

62

HEALTH INSURANCE COVERAGE increases with income, with private health insurance only comprising

2.1% of the total population.

Lowest Second Third Fourth Highest Total0

10

20

30

40

50

60

70

20.6

31

39.4

53.8

65

42

19.6

28.6

35.3

48.2

57

37.3

0.2 0.3 1.1 27

2.1

Any Insurance PhilHealth Private Insurance/HMO

Wealth Quintiles

Perc

enta

ge

Source: National Demographic and Health Survey, 2008Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

63

Even with PRIVATE HEALTH INSURANCE, there is very little coverage among the middle and upper class.

NCRCAR

III

IIIIVAIVB

VVI

VIIVIII

IXX

XIXII

XIIIARMM

0 10 20 30 40 50 60 70 80 90 100

Population covered with private insurance Uncovered population from 3rd to 5th wealth quintiles

Source: National Demographic and Health Survey, 2008Living longer and older Getting sick and dying of NCDs How disease factors affect people Health financing

64

The elderly spend the most for health care, and they pay mostly from out of their pockets.

Health expenditures by financing agent and by population age group, 2003Source: Racelis, et al., 2007

0-4y 5-9y 10-14y 15-19y 20-39y 40-49y 50-64y 65y and above0

5

10

15

20

25

Natl Govt Local Govt Philhealth Out of Pocket

In B

illio

n Pe

sos


65

The rich pays the most for health care, and mostly from out of their pockets – because the poor has no pocket at all.

Health expenditures by financing agent and by income quintile, 2003Source: Racelis, et al., 2007

Poorest Poor Middle Rich Richest0

10

20

30

40

50

60

Natl Govt Local Govt Philhealth Out of Pocket

In B

illio

n Pe

sos


66

68.00%

4.10%

8.00%

4.30%

15.60%

Drugs and Medicine

Hospital Charges

Professional fees

Contraceptives

Others

Households' out-of-pocket payments, by expenditure item, 2006Source: Family Income and Expenditure Survey, 2006

Filipino households spend 68% of its out-of-pocket payments for health care just for DRUGS AND

MEDICINES alone.


67

Despite the Cheaper Medicines Act, there is still a wide variation of medicine prices at retail.

Product Unit GENERIKA Generics Pharmacy

Watson's Pharmacy

Mercury Drug Store

Current Price

Amlodipine tablet peso/10mg 3.25-19.65 3.25-8.00 7.25-38.50 5.00-38.50 3.25-38.50

Losartan tablet peso/50mg 4.75-19.50 5.00-8.75 11.00-24.00 10.75-24.50 4.75-24.50

Metoprolol tablet peso/50mg 1.75-3.10 1.75-2.50 2.42-15.00 2.75-18.75 1.75-18.75

Telmisartan tablet peso/40mg 25.00-25.75 NA 25.75 25 25.00-25.75

Warfarin Na tablet peso/1mg 14.75-18.00 NA 21.75 14.75-21.75 14.75-21.75

Aspirin tablet

peso/ 100mg 1.25-1.75 1.8 2.50-2.75 1.90-4.50 1.25-4.50

Source: DOH Price Monitoring Chart, July 2013


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While the COST OF HEALTH CARE is higher in private facilities, the Filipino still cannot pay for health care

without incurring the risk of impoverishment.Type of care Both Types Public Facility Private Facility

Person visited a health facility in the past 30 days

Average cost of transport 109 80 134

Average cost of treatment 1,872 1,051 2,864

Person confined in a hospital or clinic in past 12 months

Average cost of confinement 16,802 9,849 24,278

Source: National Demographic and Health Survey, 2008

* In Philippine Pesos


69

Paying for Health Care in the Philippines

Filipinos still pay mostly from out of

their pockets for health care, which oftentimes leads to impoverishment.

Health care costs remain high, with

the bulk being spent to cover for

medicines and drugs.

There is a role for both publicly-

administered and privately-provided insurance schemes to ensure financial

risk protection during times of

illness.


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diseases.




health.

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Are we ready to address their health needs?

40 year old single mother, obese, with a history of diabetes, working in the

corporate sector

20 year old fresh graduate, chain smoker,

working in his first job in a call center

65 year old grandmother, widow, with high blood pressure and history of heart disease, about to

retire

34 year old businessman, with wife and three

children, heavy eater and drinker, running his restaurant business

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corporate sector




retire



73



corporate sector




retire



74



corporate sector




retire



75

Thank you for listening!

Jan 3 how healthy is the filipino revised december 10

Health & Medicine

Transcript of Jan 3 how healthy is the filipino revised december 10