THE PHILIPPINES NATIONAL-HEALTH INSURANCE ACT - A GERMAN PERSPECTIVE

Through the recent National Health Insurance Act (NHIA), the Philippin es have committed themselves to introducing a social health insurance with universal coverage within 15 years. Germany was the first country to introduce a social health insurance system more than 100 years ago . Its system is based on the principles of corporatism, federalism and a mandate for equity. Based on long-term German experience with equit y, quality, cost and efficiency issues, the Philippines' NHIA is analy sed concerning the entitlement to benefits and the benefit package, th e organization of the health insurance programme, health insurance fin ancing, and provider payment mechanisms. It is suggested that the Phil ippines could profit from including preventive and promotive services as well as pharmaceuticals in the benefits package. The organization o f the health insurance system could be decentralized using the 13 regi ons as its principal units. To achieve financial equity between region s and health funds, a contribution compensation scheme is proposed. To prevent over-utilization in over-served areas and to promote utilizat ion in under-served areas, a relative value scale for fee-for-service payments seem advisable. ((C) 1997 by John Wiley & Sons, Ltd.).