Getting serious about the dirty little secrets of health care reform to guarantee true Universal Health Care for all Filipinos

Republic Act 11223, known as the Universal Health Care (UHC) Act, has a triple goal of providing quality healthcare services that are equitable, accessible and cost-effective for all Filipinos. At long last, no longer would health care reform have to be re-invented as new DOH Administrative Orders or Executive Orders, which changes not only with every new Presidency, but in fact with every new Secretary of Health (recall the “Integrated Public Health System of 1983”, “Health Sector Reform Agenda of 1999”, the “FOURmula ONE for Health of 2005”, the “FOURmula ONE Plus for Health of 2019” programs). Finally, we now have a law that mandates lasting health care reform which are multi-administration in length, and multi-sectoral in scope. With this new law, however, we now have to accept the dirty little secrets that all past health care reform programs have learned. That medical science alone is not enough to bring about lasting improvements in the mortalities and morbidities for every Filipino man, woman, and child. That every new advancement in medicine, vaccination, therapy, or diagnostics, have actually been met with: new schemes for fraud; new opportunities for program failures due to increasing infrastructure demands including more electricity, more expensive machines, faster internet access, and others; and new healthcare workers who become overworked, under-compensated, and even under-protected from politicians and patients who attack the new advances due to ignorance or unfounded fears. As the old adage goes, the correct naming of a problem is 50% of the solution. Fortunately, just as the dirty little secret have metamorphosed with each medical science improvement, so have Information Technology, Behavior Science, Management Science, Economic Evaluation science, and Criminology also improved. Thus, the modern Evidence-Based Policy (EBP) development must actively supplement medical science with these other sciences to ensure that the promise of better, safer, and more cost-effective improvements in mortality and morbidity is actually enjoyed by all beneficiaries. As the main steward of health, the Department of Health (DOH) takes the lead in detailing the operationalization of the Law, hence, formulating the prescribed provisions of the Implementing Rules and Regulations (IRR). Because we need to ensure the success of this Law, it is imperative for DOH to use evidence-based policy tools and papers, and to yield consensus recommendations from all involve