A Descriptive Study on the Efficiency of the ‘Medicare Para sa Masa Program’ Implemented in Calapan City under R.A. 7875 otherwise known as the National Health Insurance Program act of 1995

Abstract

This study looked into the role of the Philippine Health Insurance Corporation or PHIC and the Local Government of Calapan City in improving the health situation in the area during the period 2000-20004. This study is seen to be very relevant due to the declining levels of health status in the area, amidst the government’s attempt of socializing health care through the Indigent program or “Medicare Para sa Masa Program”. This is particularly important with the focus of the local government towards achieving equity in health resources for its constituents. The creation and implementation of a socialized health insurance is necessary since health is now seen as a strategic action for sustainable development. With the trend of increasing incidence of poverty in the area and a declining health situation, socialized health insurance, which is of high demand, is expected to solve the worsening of the city’s health situation. With this there is a need to look into the processes involved in the implementation of the program. In 2000, the Indigent Program, also known as the Medicare Para sa Masa, of Philhealth was pioneered to enable the indigent population of Calapan, obtains equitable access to its health resources. It was approximated that 20% of the population was indigent. As a result of financial restriction, there is an evident level of poor health status. The program was deemed to address the problem. This study asserts that the implementation of the program, led by the city government and the coordinating office of Philippine Health Insurance Program Region IV-B, is inefficient in performing its vested functions of providing societal health insurance service. Using the descriptive design, this study describes the health situation of Calapan and locates the role of the Local government Unit and the PHIC from the period 2000- 2004.