Providing protection against the financial risk of high outof-pocket
health spending is one of the main goals of the
Philippines’ health strategy. Yet, as this paper shows using
eight household surveys, health spending increased by 150
percent (real) from 2000 to 2012, with the sharpest increases
occurring in recent years. The main driver of health spending
is medicines, accounting for almost two-thirds of total
health spending, and as much as three-quarters among the
poor. The incidence of catastrophic payments has trebled
since 2000, from 2.5 to 7.7 percent. The percentage of people
impoverished by health spending has also increased and, in
2012, out-of-pocket spending on health added 1.5 percentage
points to the poverty rate. In light of these findings,
recent policies to enhance financial risk protection—such
as the expansion of government-subsidized health insurance
for the poor, a deepening of the benefit package, and
provider payment reform aimed at cost-containment—are
to be applauded. Between 2008 and 2013, self-reported
health insurance coverage increased across all quintiles and
its distribution became more pro-poor. To speed progress
toward financial protection goals, possible quick wins
could include issuing health insurance cards for the poor
to increase awareness of coverage and introducing a fixed
copayment for non-poor members. Over the medium term,
complementary investments in supply-side readiness are
essential. Finally, an in-depth analysis of the pharmaceutical
sector would help to shed light on why medicines continue
to place such a large financial burden on households