Abstract for: Modeling the Philippines’ social health insurance program for financial stability
The role of health care providers in any health system is crucial. Both financial sustainability and profitability are essential for providers to deliver quality health care services consistently. In the Philippines, it has chosen to rely on the Philippine Health Insurance (PhilHealth) to support both inpatient and primary health care providers and as the route to achieving universal health coverage. PhilHealth has been recognized both locally and internationally for its achievements in providing social health insurance to Filipinos. However, there have been ongoing concerns about its financial stability and ability to provide universal health coverage, and debates on the sustainability and fairness of its premium contributions system. This research paper proposes a systems thinking approach to gain a deeper understanding of the Philippines' social health insurance program and its implications for financial strategies. By examining the program's various components and stakeholders, we aim to identify the interdependencies and feedback loops that shape the program's performance and financial stability.