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Universal Health Care Act (UHC) in the Philippines: Exam Questions and Answers, Exams of Insurance law

University of Houston – Clear Lake (UHCL)Insurance law

what filipinos can expect from the universal health care law? - ✔✔all filipinos will be granted health coverage but not everything will be free universal health care law - ✔✔- all Filipinos are covered - it is not completely free - PhilHealth will become the "national purchaser" of health goods and services - DOH will still be in charge of "population-based" health services - health systems will become city-wide and province-wide - A "Health Technology and Assessment Council" (HTAC) will be created - health information will be collected UHCL by NEDA - ✔✔policy issue 1: limited coverage of the national health insurance program 2: overlapping of functions of govt agencies

Typology: Exams

2023/2024

Available from 08/29/2024

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UHC Exam (2024/2025) | Actual Questions and Answers Latest Updated
2024/2025 (Graded A+)
what filipinos can expect from the universal health care law? - ✔✔all filipinos will be granted health
coverage but not everything will be free
universal health care law - ✔✔- all Filipinos are covered
- it is not completely free
- PhilHealth will become the "national purchaser" of health goods and services
- DOH will still be in charge of "population-based" health services
- health systems will become city-wide and province-wide
- A "Health Technology and Assessment Council" (HTAC) will be created
- health information will be collected
UHCL by NEDA - ✔✔policy issue 1: limited coverage of the national health insurance program
2: overlapping of functions of govt agencies
policy issue 1 - ✔✔- limited coverage of the national health insurance program
--- in 2017, about 54.5% of total health payment came from Filipinos' own pocket, with medicines and
drugs as the main contributors. Lack of PhilHealth coverage of medicines for outpatients and the high
cost of drugs and medicines in the country push the out-of-pocket expenditure up.
policy issue 2 - ✔✔- overlapping of functions of govt agencies
--- the Philippine health system has been operating on a devolved set-up. The Department of Health
supervises specialty, DOH-retained, and regional hospitals. The Department of National Defense runs
military hospitals. And local government units operate their respective health facilities.
clarified roles under the universal health care law - ✔✔- department of health and local government
units
- philhealth
pf3
pf4
pf5

Partial preview of the text

Download Universal Health Care Act (UHC) in the Philippines: Exam Questions and Answers and more Exams Insurance law in PDF only on Docsity!

UHC Exam ( 2024 /2025) | Actual Questions and Answers Latest Updated

2024 /2025 (Graded A+)

what filipinos can expect from the universal health care law? - ✔✔all filipinos will be granted health coverage but not everything will be free universal health care law - ✔✔- all Filipinos are covered

  • it is not completely free
  • PhilHealth will become the "national purchaser" of health goods and services
  • DOH will still be in charge of "population-based" health services
  • health systems will become city-wide and province-wide
  • A "Health Technology and Assessment Council" (HTAC) will be created
  • health information will be collected UHCL by NEDA - ✔✔policy issue 1: limited coverage of the national health insurance program 2: overlapping of functions of govt agencies policy issue 1 - ✔✔- limited coverage of the national health insurance program --- in 2017, about 54.5% of total health payment came from Filipinos' own pocket, with medicines and drugs as the main contributors. Lack of PhilHealth coverage of medicines for outpatients and the high cost of drugs and medicines in the country push the out-of-pocket expenditure up. policy issue 2 - ✔✔- overlapping of functions of govt agencies --- the Philippine health system has been operating on a devolved set-up. The Department of Health supervises specialty, DOH-retained, and regional hospitals. The Department of National Defense runs military hospitals. And local government units operate their respective health facilities. clarified roles under the universal health care law - ✔✔- department of health and local government units
  • philhealth

population based health services - ✔✔refers to interventions, such as health promotion, disease surveillance, and vector control, that address population-wide concerns. individual based health services - ✔✔refers to services that can be accessed within a health facility or remotely, and can be definitively traced back to one recipient Socioeconomic Planning Secretary - ✔✔Ernesto M. Pernia Republic Act. No 11223 - ✔✔Universal Health Care Act Universal Health Care Act - ✔✔it is the policy of the state to protect and promote the right to health of all Filipinos and instill health consciousness among them Universal Health Care Act - ✔✔An integrated and comprehensive approach to ensure that all Filipinos are health literate, provided with healthy living conditions, and protected from hazards and risks that could affect their health Universal Health Care Act - ✔✔A health care model that provides all Filipinos access to a comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative and palliative health services without causing financial hardship,, and prioritizes the needs of the population who cannot afford such services Universal Health Care Act - ✔✔A framework that fosters a whole-of-system, whole-of-government, and whole-ofsociety approach in the development, implementation, monitoring, and evaluation of health policies, programs and plans

system: Provided, That except in emergency or serious cases and when proximity is a concern, access to higher levels of care shall be coordinated by the primary care provider; Service coverage - ✔✔Every Filipino shall register with a public or private primary care provider of choice. The DOH shall promulgate the guidelines on the licensing of primary care providers and the registration of every Filipino to a primary care provider. Financial coverage - ✔✔population-based health services shall be financed by the National Government through the DOH and provided free of charge at point of service for all Filipinos Financial coverage - ✔✔individual-based health services shall be financed primarily through prepayment mechanisms such as social health insurance, private health insurance, and HMO plans to ensure predictability of health expenditures Program membership - ✔✔membership into the program shall be simplified into two types

  • direct contributors
  • indirect contributors direct contributors - ✔✔refer to those who have the capacity to pay premiums, are gainfully employed and are bound by an employer-employee relationship or are self-earning, professional practioners, migrant workers, including their qualified dependents, and lifetime members indirect contributors - ✔✔refer to all others not included as direct contributors, as well as their qualified dependents, whose premium shall be subsidized by the national government including those who are subsidized as a result of special laws administrative expense - ✔✔no more than 7.5% of the actual total premium collected from direct and indirect contributory members during the immediately preceding year shall be allotted for the administrative cost of implementing the program philhealth board of directors - ✔✔reconstituted to have a maximumof thirteen members

-- 5 ex officio members -- 3 expert panel members with expertise in publich health -- 5 sectoral panel members -- ex officio members - ✔✔- Secretary of Health

  • Secretary of Social Welfare and Development
  • Secretary of Finance
  • Secretary of Labor and Employment expert panel members with expertise in public health - ✔✔- management
  • finance
  • health economics sectoral panel members - ✔✔- representing the direct contributors, indirect contributors, employers group, health care providers to be endorsed by their national associations of health care institutions and health care professionals, and representative of the elected local chief executives to be endorsed by the League of Provinces of the Philippines, League of Cities of the Philippines and League of Municipalities of the Philippines: provided that at least one of the expert panel members and at least two of the sectoral panel members are women ex officio member - ✔✔is a member of a body (notably a board, committee, council) who is part of it by virtue of holding another office ex officio - ✔✔is Latin, meaning literally 'from the office', and the sense intended is 'by right of office' expert panel members must - ✔✔- be of recognized probity and independence and must have distinguished themselves professionally in public, civic or academic service
  • be in the active practice of their professions for at least seven years

health services delivery - ✔✔- population-based health services

  • individual-based health services population-based health services - ✔✔the DOH shall endeavor to contract province-wide and city-wide health systems for the delivery of population-based health services. population-based health services - ✔✔Province-wide and city-wide health systems shall have the minimum components -- primary care provider network with patient records accessible throughout the health system -- accurate, sensitive, and timely epidemiologic surveillance systems -- proactive and effective health promotion programs or campaigns individual-based health services - ✔✔PhilHealth shall endeavor to contract public, private, or mixed health care provider networks for the delivery of individual-based health services: individual-based health services - ✔✔PhilHealth shall endeavor to shift to paying providers using performance-driven, close-end, prospective payments based on disease or diagnosis related groupings and validated costing methodologies and without differentiating facility and professional fees; population-based health services - ✔✔ additional powers and functions of philhealth - ✔✔To adopt or approve the annual and supplemental budget of receipts and expenditures including salaries, allowances and early retirement of PhilHealth personnel and to authorize such capital and operating expenditures and disbursements as may be necessary and proper for the effective management and operation of PhilHealth