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

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Abstract

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.

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Acknowledgments

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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Authors and Affiliations

  1. University of Applied Sciences of the German Red Cross, Reinhaeuser Landstr. 19-21, 37083, Göttingen, Germany

    Konrad Obermann

  2. GTZ Unified Health Programme, c/o PhilHealth 709 Shaw Boulevard, Pasig City, Philippines

    Matthew R. Jowett

  3. Department of Health Sciences, University of York, York, UK

    Matthew R. Jowett

  4. Bureau of Local Health Development, Department of Health, Sta. Cruz Compound, Metro Manila, Philippines

    Juanito D. Taleon

  5. Philippine Health Insurance Corporation, City State Tower, 709 Shaw Boulevard, Pasig City, Philippines

    Melinda C. Mercado

Authors
  1. Konrad Obermann
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  2. Matthew R. Jowett
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  3. Juanito D. Taleon
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  4. Melinda C. Mercado
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Corresponding author

Correspondence to Konrad Obermann.

Additional information

Konrad Obermann and Matthew R. Jowett had the original idea for the paper and carried out initial research. Juanito D. Taleon and Melinda C. Mercado contributed additional expertise and gave detailed comments. All authors contributed to the write-up of the paper.

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Obermann, K., Jowett, M.R., Taleon, J.D. et al. Lessons for health care reform from the less developed world: the case of the Philippines. Eur J Health Econ 9, 343–349 (2008). https://doi.org/10.1007/s10198-007-0081-2

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  • DOI: https://doi.org/10.1007/s10198-007-0081-2

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