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An Expat Guide To Healthcare In The Philippines

Medical tourism is gaining prominence with people from around the world. Many people, especially those from the US, UK, Canada and Australia, travel to certain Asian and European countries to undergo long-term treatment or take advantage of an inclusive system with lower rates. Here, patients can spend a mere fraction for their treatments than what they would back home.One country that is particularly popular due to the high standard of its healthcare is the Philippines.

If you ask the locals and expats about the medical services and facilities available in the Philippines, you are bound to get mixed reviews. This is only natural, since the quality of healthcare is variable, ranging from excellent to poor, depending on your location, as well as the amount you are willing to spend. While some of the hospitals in the bigger cities boast the best doctors, equipment and technology, medical facilities in the smaller towns as well as the rural areas lack the most basic infrastructure. Moreover, Filipinos generally feel that healthcare in their country is expensive, but outsiders from Western nations in particular find it very cheap in comparison.

However, before making the decision to move to this Asian archipelagic nation, it is important that you know how good or bad the local system really is. Below is a brief guide on the healthcare services and facilities for expats in the Philippines.

Overview of the system

The healthcare system in the Philippines can be best described as varied. On the one hand, Filipinos living in the rural areas don’t have access to basic medical facilities; but on the other, people from around the world travel to this country to make use of its high standard services at fairly low costs.

By law, it is mandatory for the healthcare authorities to extend their national services to all the 94 million citizens, free at the point of use. However, this practice exists in theory only, though the officials are making an attempt to improve healthcare services for the poor. While there are claims of the signs being encouraging, funds remain limited. At the moment, authorities spend as little as US $7 per person per annum on healthcare. To make matters worse, government subsidies are undergoing further cuts.

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According to data from the World Bank, even though Phil Health is supposed to be a universal system with solid state backing, the government funds no more than 35% of all the expenditure on healthcare across the country. That is even lower than the US, which is about 48%. Moreover, the actual proportion of the funds spent on health as a proportion of the GDP is also low, at just 3.8%. This figure is less than half the average of the UK’s 9.8%.

There are approximately 1,700 hospitals all across the country. About 60% of them are privately owned and the rest are run by the state.

Like in many other countries, you can choose between public and private healthcare. It is important to know how both work, in order to make the choice that is best for you.

Public Healthcare

In 1995, the government set up an organization called the Philippines Health Insurance Corporation, more popularly known as Phil Health. This scheme is funded by local and national subsidies, as well as contributions that are made by employers and employees. It is controlled by the federal government. All citizens of this country are entitled to free healthcare as part of the Phil Health scheme. About 85% of the population is enrolled.

Every citizen employed in the country has to join Phil Health, regardless of which organization they work for or what other insurance cover they have. For this, they are required to pay 2.5% of their income and the same amount is contributed by the employer.

Those who live below the poverty line get enrolled into the system without making any payments. It is the responsibility of the local government to define the “poor” in individual cases. Senior citizens who are retired also receive automatic enrolment for free; however, this is only applicable for those who have made contributions into the scheme for a minimum of 10 years. Anybody who does not fit into these categories has to pay for a subscription through an individual enrolment program.

The public healthcare system has been classified into 2 tiers. Primary care is usually offered through public health and primary healthcare centers that are linked to the peripheral Barangay Health Centers (BHC) or outposts.

Even though Filipinos are entitled to receive free healthcare under the state scheme, not all procedures are covered. For many types of treatments, the patients often end up paying considerable amounts from their own pockets. This has caused a huge amount of dissatisfaction with the system among citizens.

The majority of the population – more than 70% – relies on the public healthcare sector to fulfill their medical needs. The facilities are therefore heavily strained, in spite of lacking the infrastructure and technology found in private hospitals. Access to public healthcare has been a bone of contention for a while now, primarily in the rural areas.

Private Healthcare

In the Philippines, private healthcare is gaining a lot of popularity. The bigger cities, like Manila, are home to a number of privately-run hospitals with state-of-the-art amenities. The quality of private healthcare is excellent. Most of the expats living in this country rely on this sector for their medical needs.

By local standards, these facilities are extremely expensive. However, if you compare the fees and charges to hospitals in the UK, US and Canada, the Philippines is far cheaper. Be prepared to pay cash upfront for every visit, screening test and procedure. It is therefore best to sign up for a private insurance plan in this case.

If you are moving to the Philippines for professional purposes, it is best to speak with your employers about a private health insurance policy beforehand. Make sure that your compensation package includes fairly comprehensive cover (for yourself and your family members), so that the premium does not make a huge dent in your pocket.

The majority of the expats in the Philippines head to Manila for their checkups and treatments, as the standard of healthcare is highest in the capital. According to the global health insurance company Allianz, the top hospitals in the Philippines are as follows.

The Asian Hospital and Medical Center
Alabang Zapote Road, Cupang, Muntinlupa,
1771 Metro Manila
Talon Kuatro, Las Pinas
Philippines, 1747
Tel: +63 2 807 8189/ 775 0511/ 782 6696

The Makati Medical Center
2 Amorsolo Street,
Legazpi Village, Makati,
1229 Kalakhang Maynila,
Tel: +63 2 888 8999

The Medical City
Quezon City, Metro Manila,
Tel: +63 2 988 1000

St. Luke’s Medical Center
Quezon City, Metro Manila,
Tel: +63 2 723 0101

All the hospitals mentioned above are private facilities and you are therefore likely to pay premium prices for the higher quality of healthcare that you receive.

Reimbursement of Claims

The laws state that Phil Health has to refund any claims received within a period of 60 days. Unfortunately, this deadline was rarely met until a short while ago. A change was introduced recently, resulting in the claims being paid out without much delay. After a quick initial assessment 75% of the total claim is reimbursed; the remainder is given out later.

Statistics show that almost 90% of all the claims made are paid in full. These can be filed by an individual patient, or the service providers, like a public hospital.

Medical Practitioners

The Philippines is known to have some of the best surgeons, physicians, general practitioners, and specialists in the world. In fact, this nation is the biggest exporter of medical staff across the globe. A huge percentage of doctors and nurses worldwide are originally from this country and they take up long term assignments or contracts overseas. Many of the doctors have completed at least some part of their training in the US, the UK or Canada. Since almost everyone is quite fluent in English, it is quite easy to communicate with staff, even in the smaller towns.

On the downside, since a majority of the qualified and well-experienced healthcare professionals explore opportunities abroad, there is a constant shortage of doctors and nurses across the islands.

Emergency Medical Care

The higher end medical facilities in the Philippines boast excellent specialist medical and surgical care; however, don’t expect the same quality everywhere you go. Many hospitals in the public sector direct the more serious emergency cases to designated facilities and this may cause monetary and logistical issues for patients.

Fortunately, ICU services are on par with international standards in most of the private setups as well as in a few tertiary public facilities.

Anybody in the Philippines can call for emergency help, by dialing 112 or 117 from a landline. Since most Filipinos speak English, you should have no trouble communicating with the operators.

Pharmacies and Medicines

All medication sold in the Philippines has to be approved by the local health authority, the Bureau of Food and Drugs. Pharmacies have to be manned by professional pharmacists, who have received the required amount of training in this field.

You will find many drugstores in the bigger cities. Fortunately, the rural areas have their fair share of pharmacies too. It is very easy to locate these establishments, as the signs are almost always in English. Almost every street in the large cities will have a pharmacy that is open 24/7. Alternately, you can head to the nearest hospital, as it is bound to have a counter that sells medication. Many of the supermarket chains also keep a stock of the more basic over-the-counter medicines.

Drug control is quite strict across the Philippines, and the authorities have laid down stringent guidelines that have to be followed when buying or selling prescription medicines. It is therefore important that you get a written prescription from your doctor back home if you are undergoing any treatment, or are suffering from a pre-existing medical condition. Make sure that the prescription carries the generic name of the drug, not just the name of the local brand.

Health Risks

If you are planning to visit or move to the Philippines in the near future, it is best to take a few precautionary measures against a number of potential health risks. This could include getting immunized against certain diseases and consuming the right things during the course of your stay.

In the past, mosquito-borne dengue had become endemic throughout the nation. Another disease that poses a major threat to travelers is malaria. There is no vaccine for either ailment and it is therefore essential to follow anti-mosquito practices at all times. Carry a mosquito net and some topical repellants everywhere you go. It is also best to cover up as much as you can when going outside.

Water-borne diseases like cholera and typhoid have also been widespread in certain parts of the Philippines. Visitors are therefore advised to drink only boiled or bottled water. When outside, avoid adding ice to your drinks. Street food, especially uncooked items, can be very unsafe since the ingredients are not always washed properly. It is important that you seek immediate medical attention if you suffer from diarrhea.

To summarize, the standard of healthcare in the Philippines varies significantly depending on the sector you choose. Like most expats, you could rely on private healthcare to fulfill all your medical requirements. While private doctors and hospitals are expensive by local standards, their fees are a lot lower than what people pay in many other nations.

Have you lived in the Philippines? Share your experience in the comments below, or answer the questions here to be featured in an interview.

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