The Philippines as a country has a population composed of various ethnic and racial origins. Differences in ethnic and racial backgrounds have been reported to result in disparities in the various sectors of governance in many countries across the globe, with the minority groups suffering the most. The Philippines has more than 175 ethnolinguistic nations, distributed in the three major islands of Luzon in the north, the Visayas in the middle, and Mindanao in the south (Reyes, Mina, & Asis, 2017). This population is composed of Christians and Muslims. In essence, the disparities experienced can be categorized in the line of the indigenous and the non-indigenous Filipinos. There exist significant inequalities in the opportunities for accessing basic services among and within ethnic groups in the Philippines. One of these essential services is health care which has experienced disparities related to race and ethnic lines but which contains scant information. The aim of this paper is to address this problem by proposing policy changes in the health care system of the Philippines.
In essence, enjoyment of a certain service is determined by the accessibility and affordability level of the person seeking it. In most cases, the income level of an individual determines whether one can access quality health care services (Bustamante, Morales, & Ortega, 2014). Since 1998, the income inequality in the Philippines has been following a downward trend, largely reflecting the income distribution in urban areas, while the rural areas have had an upward trend. The decile dispersion ratio has not reduced for over thirty years, leaving the income of the richest at twenty times more than that of the poorest decile. As such, the poverty situation in the country has not improved in a significant way and geographical disparity still exists (Reyes et al, 2017). Social disparity and economic disadvantage have been the major contributors to health care disparities in the Philippines. This is because, with low income, it becomes a challenge to afford quality education, social amenities, as well as health care.
Despite the disparity reported to exist in the healthcare system in the Philippines, the sector has undergone significant changes over the past two decades through the institution of various reforms and policies by the government. As at April 2018, the Department of Health had listed 1,071 private hospitals that are licensed and 721 public hospitals (The Manila Times, April 2018). The department is in charge of seventy of the hospitals while the local government units and other agencies run by the state manage the rest. This is geared towards providing easy access to health benefits for all Filipinos. The private hospitals have better technical facilities as compared to the public hospitals thus those who can afford to visit them acquire better services. Despite the availability of those hospitals, there is a gap in the system since health care providers and educators are concentrated in the urban areas, creating a dearth of healthcare manpower in the rural areas.
Several policies changes can be adopted and implemented to reduce the racial and ethnic disparity in the Philippines health system. One of the policies would be on advocacy. This is a policy that will allow for lobbying on issues that are bringing about the disparity. This approach has been used in the past and has yielded positive reports by offering solutions. To effectively address the problem, the advocacy movement should be conducted in ways that strengthen the grass-root organizations that are concerned with the group being targeted. For instance, those responsible for implementing the policy can lobby for quality practitioners and technical facilities to be availed in the rural hospitals. This will ensure that the rural population receives similar services as those in the urban areas. The advocacy campaigns can also include the population that is affected by the inequality so that they can give direct voices to the affairs affecting them. Additionally, the organizations can offer strong professional advocacy which is likely to be heeded. Although such a movement may not achieve its immediate policy goals, getting it on the public agenda expands the possibility to be heard even in the political space.
Secondly, there is a need to formulate an accountability and effectiveness policy. This will aim at keeping the health care sector on the check on the services they offer to the people of all races and ethnic backgrounds. The policy effectiveness is measured in terms of the extent to which the policy goal is achieved through either direct or indirect influence on the stakeholders in the sector (Reyes et al, 2017). Accountability on the policy will include proper reports on the activities and any progress of the healthcare sector to all of its stakeholders including every Filipino citizen even in the most remote part of the country. Accountability and effectiveness would be an umbrella policy under which all the other policies fall. It would act as a watchdog to ensure that every plan of the department of health or any other organization that focuses on improved healthcare is implemented and available to all the people. Those mandated with supervising accountability and effectiveness policy should focus keenly on the gaps that have been identified resulting from racial and ethnic inequalities and concentrate on bridging the gap by emphasizing more on the disparities through the policy.
The third policy change is building task forces in the healthcare sector. The Philippines has had task forces in the past on various issues and they have been reported to yield positive impact as intended. For instance, the Urban Land Reform Task Force (ULRTF) resulted from community efforts to protect the rights of the urban poor. The Task Force for a Total Commercial Log Ban (TCLB) was formed with the aim of protecting remaining forest cover after much of the Philippine forests had been depleted (Reyes et al, 2017). Both task forces achieved the ultimate goal which they had had when forming them. In the same way, a task force in the health sector can be formed to address the major factors that contribute to the racial and ethnic disparities. The major factor is income which affects the access and affordability of quality education, healthcare, and other social services.
The fourth policy is the devolution of the health system. This policy is aimed at equalizing resources in the health system in all the parts of the country. With devolution, the local authorities are provided with the same opportunity to grow the health sector as that of the urban people. This policy should be closely linked with that of accountability and effectiveness to ensure that the resources are put into the intended use which is to improve the healthcare sector and bridging the gap between and among the different races and ethnic groups. Finally, a policy on extensive civic education is necessary. This will come in handy to enlighten the people on their rights and privileges. Equality in the access to healthcare is one of the human rights and this will increase vigilance on the demand for equality in this sector.
In summary, the Philippines, having different racial and ethnic groups experiences some disparities in the healthcare system. Although the sector has improved in the last two decades, the equality continues to be felt. Various policies can be implemented to better the situation in this country. These include advocacy, accountability and effectiveness, forming task forces, devolution, and conducting extensive civic education.
Bustamante, A. V., Morales, L. S., & Ortega, A. N. (2014). Racial and ethnic disparities in health care. Changing the US health care system: Key issues in health services policy and management, 103-134.
Reyes, C. M., Mina, C. D., & Asis, R. D. (2017). Inequality of opportunities among ethnic groups in the Philippines (No. DP 2017-42).
The Manila Times, April 2018: At a glance: The Philippine health care system
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