The European Journal of Health Economics

, Volume 9, Issue 4, pp 343–349 | Cite as

Lessons for health care reform from the less developed world: the case of the Philippines

  • Konrad Obermann
  • Matthew R. Jowett
  • Juanito D. Taleon
  • Melinda C. Mercado
Original paper


International technical and financial cooperation for health-sector reform is usually a one-way street: concepts, tools and experiences are transferred from more to less developed countries. Seldom, if ever, are experiences from less developed countries used to inform discussions on reforms in the developed world. There is, however, a case to be made for considering experiences in less developed countries. We report from the Philippines, a country with high population growth, slow economic development, a still immature democracy and alleged large-scale corruption, which has embarked on a long-term path of health care and health financing reforms. Based on qualitative health-related action research between 2002 and 2005, we have identified three crucial factors for achieving progress on reforms in a challenging political environment: (1) strive for local solutions, (2) make use of available technology and (3) work on the margins towards pragmatic solutions whilst having your ethical goals in mind. Some reflection on these factors might stimulate and inform the debate on how health care reforms could be pursued in developed countries.


Health care reform Philippines Decentralisation Technology Ethics 

JEL Classification

I 18 H 41 



The authors thank Dr. Maria Ofelia Alcantara, Dr. Eduardo Banzon and Dr. Claude Bodart for their stimulating discussions. The views expressed here, however, are entirely the authors and do not necessarily reflect the views of the institutions we work for. We also wish to thank two anonymous referees for very helpful comments.

Conflict of interest and funding

KO was a long-term advisor for GTZ Health in the Philippines between 2002 and 2004. MRJ works for GTZ Philippines as an advisor to PhilHealth and holds a visiting research position at the Department of Health Sciences, University of York, UK. JDT is responsible for the development of local health systems at the Department of Health. MCM is senior vice president, operations, for PhilHealth. There was no specific funding for writing this paper; no institution has had any influence in the preparation of this manuscript.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Konrad Obermann
    • 1
  • Matthew R. Jowett
    • 2
    • 3
  • Juanito D. Taleon
    • 4
  • Melinda C. Mercado
    • 5
  1. 1.University of Applied Sciences of the German Red CrossGöttingenGermany
  2. 2.GTZ Unified Health ProgrammePasig CityPhilippines
  3. 3.Department of Health SciencesUniversity of YorkYorkUK
  4. 4.Bureau of Local Health Development, Department of HealthMetro ManilaPhilippines
  5. 5.Philippine Health Insurance CorporationPasig CityPhilippines

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