Social health insurance for the Filipino indigents: a study of the utilization of Philhealth benefits of the indigent members of Marinduque.

Abstract

The Philippine government is mandated to promote the right to health care of all Filipinos. In order to do so, the National Health Insurance Program of the Philippines was created which aims to provide and ensure that Filipinos, especially those from the lowest quintile of society, have access to affordable and acceptable health care services. However, not all members of the NHIP are able to fully utilize their social health insurances by availing the benefits under the packages provided by PhilHealth. This study discusses how the indigent members of the NHIP utilize their social health insurances and what factors hinder their utilization. Statistical analyses show that the indigent members underutilize their social health insurances. A case study of the indigent members of the NHIP seeking medical treatment at the Dr. Damian Reyes Provincial Hospital in Marinduque show that factors such as the accessibility of PhilHealth accredited health care facilities, availability of health care services, awareness about social health insurance benefits and health-seeking behavior contribute to this underutilization.