2nd National Staff Meeting April 19-21, 2006 Tagaytay City 2nd National Staff Meeting April 19-21, 2006 Tagaytay City

Asec. MARIO C. VILLAVERDE, MD, MPH, MPMSectoral Management and Coordination Team Leader

HEALTH CARE FINANCING HEALTH CARE FINANCING SITUATION:SITUATION:The Philippine National Health Accounts, 1991-The Philippine National Health Accounts, 1991-20042004and the DOH Budget 2000 - 2006and the DOH Budget 2000 - 2006

                                                       

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Philippine National Health Philippine National Health AccountsAccounts

• A framework for the compilation of information on the country’s health expenditures

• Health Accounts answers . . .– who pays for health care (sources)

– where health financing is being spent (uses)

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Total Health Expenditures Total Health Expenditures as a % share of GNPas a % share of GNP

GNP (in billion pesos current prices, 2004) 5,167.6

GDP (in billion pesos current prices, 2004) 4,826.3

2004 Total Health Expenditures = P165.2 B

THE as % share of GNP3.2%

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Per Capita Spending for Per Capita Spending for Health 2004Health 2004

Current Prices

(2004)

P1,979

Real Prices (1985) P494

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Sources of Funds for Sources of Funds for Health 2004Health 2004

Social Health Insurance

9.5%

Out-of-pocket

47%

Others12%

National

16%

Local14%

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Uses of Funds for Health Uses of Funds for Health 20042004

Others11.4%

Personal 78.3%

Public10.3%

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Trends of Total Health Trends of Total Health Expenditures, 1991-2004Expenditures, 1991-2004

41,300

165,000

38,900

32,01533,356

34,85833,194

31,89932,514

30,17028,123

25,38623,838

21,32720,924

148,600

36,00639,839

47,62454,947

65,74276,927

87,83194,454

104,827114,911

116,602115,448

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 20002001 2002 2003 2004

Year

(in

billion

pesos)

at 1985 prices at current prices

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Trends of Per Capita Health Trends of Per Capita Health Spending, 1991-2004Spending, 1991-2004

494

475398424454442435454431411380365334336

1,979

1,817

1,4351,4841,4961,3971,288

1,2261,099

961822

729624577

0

500

1,000

1,500

2,000

2,500

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Year

(in m

illi

on p

eso

s)

at 1985 prices at current prices

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Share of Health Share of Health Expenditures to GNP , 1991-Expenditures to GNP , 1991-

20042004

2.92.9

3.2 3.23.4 3.4 3.5

3.4 3.3 3.2 3.02.7

3.24 3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

Perc

ent

1991 1993 1995 1997 1999 2001 2003

Year

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Health Expenditures by Source of Health Expenditures by Source of Funds, 1991-2004Funds, 1991-2004

97.5

2.3 3.0 3.1 2.9 3.8 4.4 3.5 5.28.0 9.2 10.5 12.9

15.7

86.4

68.663.5

58.757.052.9

49.244.6

39.2

31.127.0

23.320.1

50.1

43.7

34.5

42.2

46.6

41.036.9

33.327.6

23.020.317.313.913.8

1.90.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Year

(in b

illi

on p

esos)

Line 1 Line 2 Line 3

Private Sources

Government

Social Insurance

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Health Expenditures by Use of Health Expenditures by Use of Funds, 1991-2004Funds, 1991-2004

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

Year

(in m

illi

on p

eso

s)

Personal Public Others

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Sources of Government Sources of Government Health Expenditures, 2003Health Expenditures, 2003

Sources (In Billion) (Percent)

National 26.3 16%

– DOH 15.4 59%

– Other Agencies 5.0 20%

– Loan 1.7 6%

– Grants 4.2 16%

Local Gov’t. 23.8 14%

TOTAL GOV’T. 50.1 30%

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Uses of Government Uses of Government Health Expenditures, 2004Health Expenditures, 2004

DOHPS MOOE CO Total

(in B)

% (in B)

% (in B)

% (in B)

%

Personal 5.5 55.0 4.1 41.7 0.3 13.2

9.9 100

Public 0.40 18.8 1.7 79.8 0.03 1.4 2.1 100

Others 1.7 53.1 1.3 42.4 0.1 4.5 3.2 100

Total 7.5 49.6

7.2 47.2

0.5 3.2 15.2*

100

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Uses of Government Uses of Government Health Expenditures, 2003Health Expenditures, 2003

LGUPS MOOE CO Total

(in

B)

% (in

B)

% (in

B)

% (in

B)

%

Personal 4.3 49.

2

4.2 48.

9

0.2 1.

9

8.7 10

0

Public 7.8 69.

4

3.1 27.

5

0.3 3.

1

11.2 10

0

Others .00 .00 .00 .00 .00 .0

0

.00 00

Total 12.0 60.

6

7.3 36.

8

0.5 2.

6

19.8

*

10

0

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Total Health ExpendituresTotal Health ExpendituresNational VS Local GovtNational VS Local Govt

0

5,000

10,000

15,000

20,000

25,000

30,000

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Year

(in m

illi

on p

eso

s)

National Local

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

DOH Health ExpendituresDOH Health ExpendituresVS Local GovtVS Local Govt

0

5,000

10,000

15,000

20,000

25,000

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Year

(in m

illi

on p

eso

s)

DOH Local

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

DOH Expenditures by Use DOH Expenditures by Use of Fundsof Funds

6.1 6.2

3.8

5.34.8

6.16.6

8.1 8.4

10.3

7.8 8.1

10.610.2

2.2 2

3.22.41.81.6

2.62.0

2.53.0

2.11.81.31.11.32.32.1

1.52.2

1.91.7

2.4

1.31.50.91.31.41.30.0

2.0

4.0

6.0

8.0

10.0

12.0

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Year

(in m

illi

on p

eso

s)

Personal Public Others

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Local Government Health Local Government Health Expenditures by Use of Expenditures by Use of

FundsFunds

0.3 0.3

1.72.3

2.83.4

3.94.7

5.1 5.45.9

4.4

6.2 6

2.9

11.1

6.2

11.1

8.1

10.710.7

9.2

8.47.8

6.15.2

4.4

0.90.7

6.5

5.35.76.0

5.1

4.23.7

2.92.42.1

1.40.50.40.0

2.0

4.0

6.0

8.0

10.0

12.0

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Year

(in b

illi

on p

eso

s)

Personal Public Others

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Target VS Actual 2004 Health Target VS Actual 2004 Health Care Spending PatternsCare Spending Patterns

Use of Funds

SOURCE OF FUNDSTotal

by UseGov’t. SHI Private Sector

Out-of-pocket

Others

Target

Actual

Target

Actual

Target

Actual

Target

Actual

Target

Actual

Personal Health Care 10 14 25 8 20 47 7 11 62 80

Public Health Care 20 10 0 0 0 0 0 0 20 10

Others10 7 5 1 0 0 3 3 18 11

Total by Source 40 31 30 9 20 47 7 14 100 100

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Policy Areas for Health Policy Areas for Health Financing InterventionsFinancing Interventions

Areas Goals

Resource Mobilization

Increase total resources (quantity/amount)

Resource Allocation

Increase proportion for preventive & promotive (allocative efficiency)

Efficiency of Production

Increase products & services out of the existing resources (operational efficiency)

Equity of Distribution

Decrease gaps in terms of access & utilization (equity)

2nd National Staff Meeting April 19-21, 2006 Tagaytay City 2nd National Staff Meeting April 19-21, 2006 Tagaytay City

DOH BudgetDOH Budget Through The Through The

Years Years (CY 2000-2006)(CY 2000-2006)

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Budget Appropriation CY 2000-2006, In Billion Pesos

10.74

9.46

11.42

9.91 9.56 9.73 9.98

0.00

2.00

4.00

6.00

8.00

10.00

12.00

CY 2000 CY 2001 CY 2002 CY 2003 CY 2004 CY 2005 CY 2006

YEARS

AM

OU

NT

IN

BIL

LIO

N P

ES

OS

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Auto + Unobligated

63%DepEd

11%

DPWH6%

DND4%DILG

4%DOTC

1%SUCs

2%

Other Agencies

8%7th

DOH 1%

Share of DOH Budget from the Total Proposed National Expenditure Program

CY 2006

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Calendar Year

DOH GAA Appropriation

National Government

Budget (NGB)

% DOH Budget to

NGB

Gross Domestic

Product (GDP)

% Share of DOH Budget

to GDP

2000 10.74 665.10 1.61 3,354.73 0.322001 9.46 694.40 1.36 3,631.47 0.262002 11.42 575.12 1.99 3,959.65 0.292003 9.91 609.43 1.63 4,293.03 0.232004 9.56 575.84 1.66 4,826.34 0.202005 9.73 597.66 1.63 5,379.25 0.182006 9.98 734.09 1.36 5,656.40 0.18

NOTE: NEDA's low-end target was used for CY 2006.

Sources: General Appropriation Act CY 2000-2006 (NEP) National Statistical Yearbook 2004 for CY 2000-2002 GDP. www.nscb.gov.ph for CY 2003-2005 GDP. NEDA - National Planning and Policy Staff for CY 2006 GDP estimates

SUMMARY TABLE OF DOH BUDGET SUMMARY TABLE OF DOH BUDGET VS.NATIONAL GOVERNMENT BUDGET AND VS.NATIONAL GOVERNMENT BUDGET AND

GROSS DOMESTIC PRODUCTGROSS DOMESTIC PRODUCT(In Billion Pesos(In Billion Pesos))

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

DOH & ATTACHED AGENCIES DOH & ATTACHED AGENCIES BUDGET, CY 2006BUDGET, CY 2006

DEPARTMENT OF HEALTH AND ATTACHED AGENCIES

CY 2006(thousand pesos)

Department of Health 9,977,384

Commission on Population 104,981

Lung Center of the Philippines 217,560

National Kidney and Transplant Institute 185,000

Philippine Children's and Medical Center 236,000

Philippine Heart Center 170,500

Phil. Inst. for Traditional & Alternative Health Care 40,000

TOTAL 10,931,425

Philippine Health Insurance Corporation 2,900,000

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Distribution of Budget by Expense Class CY 2006

CO(O.53B) 5%MOOE

(4.04B) 41% PS(5.41B) 54%

CO(O.53B) 5%MOOE

(4.04B) 41% PS(5.41B) 54%

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Budget Allocation By Expense Class

CY 2000-2006, In Billion Pesos

5.03 5.02

5.40 5.37 5.37 5.40 5.415.31

4.39

5.12

3.81 3.793.94 4.04

0.40

0.04

0.900.73

0.41 0.390.53

0.00

1.00

2.00

3.00

4.00

5.00

6.00

CY 2000 CY 2001 CY 2002 CY 2003 CY 2004 CY 2005 CY 2006

Years

Am

ou

nt

In B

illi

on

Pes

os

PS MOOE CO

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

PER CAPITA DISTRIBUTION OF PER CAPITA DISTRIBUTION OF MOOE* By Geographical Area, CY MOOE* By Geographical Area, CY

20062006Area Est. 2005

PopulationMOOE

(Thousand Pesos)

Percent Allocation

Per Capita

Allocation (Pesos)

NCR 11,240,743 77,876 4 6.93

Luzon 35,607,663 769,360 46 21.61

Visayas 17,103,869 337,606 20 19.74

Mindanao 20,289,100 505,857 30 24.93

Philippines 84,241,375 1,690,699 100 20.07

*CHD Offices & CHD Hospitals

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

PER CAPITA DISTRIBUTION OF PER CAPITA DISTRIBUTION OF MOOE* By Geographical Area, CY MOOE* By Geographical Area, CY

20062006Area Est. 2005

PopulationMOOE

(Thousand Pesos)

Percent Allocation

Per Capita

Allocation (Pesos)

NCR 11,240,743 822,413 33.7 73.16

Luzon 35,607,663 769,360 31.6 21.61

Visayas 17,103,869 337,606 13.9 19.74

Mindanao 20,289,100 505,857 20.8 24.93

Philippines 84,241,375 2,435,236 100.0 28.91

*NCR includes 12 MM Special Hospitals (referrals)

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Public Health

(1.06B) 26%

Admin. & Regulation(0.52B) 13%

Hospital Services

(2.46B) 61%

Distribution of MOOE by Distribution of MOOE by FunctionFunctionCY 2006CY 2006

Sectoral Management and Coordination TeamSectoral Management and Coordination Team

Department of Health Department of Health MOOE Distribution by FunctionMOOE Distribution by Function

CY 2000 – 2006 (In Billion CY 2000 – 2006 (In Billion Pesos)Pesos)

Department of Health Department of Health MOOE Distribution by FunctionMOOE Distribution by Function

CY 2000 – 2006 (In Billion CY 2000 – 2006 (In Billion Pesos)Pesos)

Amount%

ShareAmount

%Share

Amount%

ShareAmount

%Share

Amount%

ShareAmount

%Share

Amount%

Share

Admin. &Regulation

0.51 10% 0.46 11% 0.5 10% 0.38 11% 0.38 10% 0.41 11% 0.52 13%

PublicHealth

1.56 31% 1.45 33% 1.66 32% 1.24 33% 1.24 33% 1.00 25% 1.06 26%

HospitalServices

2.99 59% 2.34 57% 2.96 58% 2.18 57% 2.17 57% 2.53 64% 2.46 61%

TOTAL 5.06 B 100% 4.25 B 100% 5.12 B 100% 3.80 B 100% 3.79 B 100% 3.94 B 100% 4.04 B 100%

2005 2006Particulars

2002 2003 20042000 2001

2nd National Staff Meeting April 19-21, 2006 Tagaytay City 2nd National Staff Meeting April 19-21, 2006 Tagaytay City

Thank You!Thank You!

Sectoral Management and Coordination Team