Primary Care as a Realization of Universal Health Care

I find it ironic that on one hand, there’s a common statistic being touted saying that most Filipinos die
without seeing  or being attended by  a doctor, while on the other hand, there is  unregulated  direct
access to specialist care and overutilization of secondary and tertiary level facilities.  This underscores
the wide variance  and inequity in accessing  health care services,  partially  brought about by a  weak
primary care system in the country.
Admittedly, most of us would rather go straight to the subspecialists because of the  perception that
they provide better quality care. However, although our specialists have definite and important roles,
our healthcare system has become too complicated to navigate without a trusted gatekeeping primary
care physician. There are numerous horror stories on how patients have been passed on from specialty
to specialty without clear diagnosis or treatment at the patient’s expense.
Primary Care  is health  care that is effective, safe, person-centred, comprehensive, and integrated. By
having a regular and trusted provider as the entry point to the health system, continuity of patient care
is ensured. Health systems-wise, the world’s most excellent healthcare systems achieved their status by
strengthening their primary care system first and foremost.
We at  PhilHealth  aspire to help  revolutionize and transform the Philippine health system by
strengthening primary care. This goal, however, is constrained by the lack of primary care physicians in
the country – an offshoot of the lack of academic and monetary incentives for primary care practice.
To move the country towards primary care, we started implementing the Primary Care Benefit 1 (PCB1)
package for Sponsored Members in primary government healthcare facilities such as rural health units,
barangay health centers and government outpatient clinics.
PCB1 pays a per family payment rate (PFPR) for each assigned member to a primary care provider. The
PFPR pays the provision of obligated services to the assigned member and his/her dependents including
preventive health services, essential diagnostics and outpatient drugs for a number of acute illnesses.
PCB1 not only aims to expand the number of primary care services included in the package, but also
increase their use among members. It  incentivizes providers to promote healthy behaviour, espouse
prevention, and facilitate appropriate referral. It further motivates them to build and maintain a system
for complete and timely reporting of health data to back up better health decisions.
It is our dream that one day, each and every Filipino will be assigned to a primary care provider, who will
take care of his/her health needs. Bawat Pilipino miyembro. All Filipinos enrolled in PhilHealth.  Bawat
miyembro protektado. Because everyone is covered, every Filipino will have access to a quality Primary
Care Provider.  Kalusugan natin segurado. The primary care provider will  render preventive and
promotive services ensuring the health of members. Referral systems will be put in place to promote
system efficiency.
For us, this is universal health care realized.
PCB1 will be launched this month in a series of  cities to promote awareness of primary care and the
benefit  package. Last week, we  kicked off with a wonderful launch in Tabaco City in the province of
Albay where Mayor Krisel Lagman-Luistro championed enrolling all Tabaquenos into PhilHealth. Indeed, Governern Joey Salceda has aggresively expanded PhilHealth enrolment in Albay. Our next stop is Bislig
City in Surigao del Sur where Governor Johnny Pimentel has improved health facilities all over the
province. Later, we will be launching PCB1 in the Visayas and Northern Luzon.
We go to great lengths  to  emphasize that we are serious about  our goal to transform the system.
Wherever they are, we will soon have primary care providers to cater to the needs of our members. We
will never cease to enhance our packages to make them more responsive. In fact, we are now finalizing
the development of PCB2 or the outpatient drug benefit for chronic diseases to complement the first
package. While these tasks may be large and daunting, what’s important is that we’re already moving,
one step at a time, towards strengthening primary care and achieving universal health care for all.
Soon, we hope that no Filipino would ever die without seeing or being attended by his or her primary
care physician.