When we talk about health transparency, we refer not only to all those government agencies and offices of course, but also to the various stakeholders and players in the health sector -- the corporations (pharma manufacturers, wholesalers, drugstores, hospitals, HMOs, etc.), academe and civil society organizations. But unlike corporate entities that are subject to competition among themselves and regulation by the government, the public or government sector is the largest, the most extensive, the most bureaucratic and the most politicized, naturally. So the big challenge in health transparency is how to make the various government agencies be more transparent, be more accountable, and if only possible, be shrinkable if they do not perform their mandate and the various public expectations of them.
I am posting below three recent articles by a friend who also writes a weekly newspaper column, Reiner Gloor of the Pharmaceutical and Healthcare Association of the Philippines (PHAP). Reiner writes in BusinessWorld, a big business newspaper here in the country. His three articles here are on:
1. Governance in Health, August 23, 2012,
2. Health in the Reform Agenda, August 30, 2012, and
3. To corporatize or not to corporatize, September 06, 2012.
All of these topics were tackled under the (DOH) "Secretary's Cup" discussion series in various places and dates.
The first article is about the role of local government units (LGUs) in healthcare delivery; the second is about the linkage and the need for collaboration between healthcare providers including the government, and patients or the public. And the third is about the need for public-private partnership (PPP) in currently government-owned and controlled hospitals that lack resources and managerial skills to make them more financially stable and less dependent on politics and politicians.
Of course I do not believe that public health can be depoliticized. When government implements various healthcare service provision from the barangay up to the national level, involvement and intrusion by politicians and administrators is inevitable.So the move towards corporatizing -- not privatizing as commonly misunderstood -- of certain government hospitals is a move to lessen the politics of healthcare.
Below are the three papers by Reiner. Enjoy.
(1) Governance in health
Medicine Cabinet -- Reiner W. Gloor
(First of a series)
In 1991, the Local Government Code drastically altered the bureaucratic landscape by transferring the management of public health program and government hospitals at the municipal and provincial levels, from the Department of Health (DoH) to local government units (LGUs). Not long after, the advantages and disadvantages of this new, decentralized system began to emerge.
While it enabled LGUs to deal with their own particular health needs, it also opened the possibility for LGUs to neglect health care delivery.
In a Universal Health Care scheme, the DoH would have to build strategic partnerships with local governments. While it is clear that there has to be a centralized body to coordinate macro-level functions, such as health information gathering, policy formation, and the operation and management of tertiary hospitals, there are also strengths in empowered local governments.
It must also encourage the strengthening and expansion of Interlocal Health Zones -- adjacent towns and cities that cooperate on health at the district level. These Zones have already demonstrated better health outcomes where they were successfully implemented. Dr. Alberto Romualdez, who spearheaded the Health Sector Reform Agenda in 1998 as DoH secretary, has advanced the notion that the district health system ought to be the level of devolution, and that a referral system must be in place to weave things together: from the smallest rural health unit to the district hospital.
PhilHealth can act as leverage to optimize local-national partnerships, by providing incentives to local governments that perform well, and as well as setting standards in the accreditation of LGU hospitals, ensuring quality and safety, and providing additional capital with which enough human resources and quality health services can be guaranteed.
Finally, by building a constituency on health sector reform, which is what the Secretary’s Cup aims to achieve, political capital on health is built, creating incentives for local and national politicians to work together towards better health outcomes.
(2) Health in the reform agenda
Medicine Cabinet -- Reiner Gloorhttp://www.bworldonline.com/weekender/content.php?id=57654
(3) To corporatize or not to corporatize
Medicine Cabinet -- Reiner Gloorhttp://www.bworldonline.com/weekender/content.php?id=58025
Health Transparency 5: Forum on Good Governance in Health, March 08, 2012
Health Transparency 6: Physician Protectionism, May 19, 2012
Health Transparency 7: DOH Advisory Council, CHAT, June 04, 2012
Health Transparency 8: Advisory Council on RA 9502, June 11, 2012
Health Transparency 9: Physician Misdiagnosis, Dispensing Medicines, July 20, 2012