Bawal magkasakit!” (It is forbidden to get sick!). This is the tagline of a commercial advertisement which highlighted the fact that medicines are prohibitively expensive in the Philippines; especially for indigent families. But, in Bindoy, Oriental Negros, indigent families are assured of an affordable health insurance program.
A 2006 survey showed that 73 percent of the 7,204 households in Bindoy are indigents with a per capita income of less than PhP11,480. To date, all of these indigent households are covered by the Bindoy Social Health Insurance Indigency Program. Before the program was put in place, most of those who got sick and hospitalized could not afford the necessary drugs and medicines and often could not pay their hospital bills because they were impoverished. Often, they would choose to endure their illness and would only go to the doctor when their health has deteriorated. That all changed in February 2002 when the BSHIIP started.
The BSHIIP aimed to provide affordable and quality health care especially to the poor. But, unlike in other areas, where the municipal government assumed sole responsibility for the local premium counterpart, Bindoy’s leadership ensured that the province, municipality, barangays, and the sponsored families contributed in sustaining the program. Even the congressional representative contributed in the initial phase of implementation by providing the basic equipment necessary for the provision of the Outpatient Benefit Package. The LGU also conducted an intensive information campaign about the program’s benefits and successfully encouraged the people to participate.
The annual premium required to provide PhilHealth coverage to an indigent family amounts to PhP1,200. The national government shoulders the bulk of the premium cost depending on the income classification of the LGU. For every beneficiary that the LGU enrols into the National Health Insurance Program, it earns a capitation fund of PhP300. As a result, Bindoy has been earning PhP1.5 million per year, which it re-channels for the purchase of hospital equipment and medicines that further improves health care delivery.
In the initial year of implementation, the households’ membership in the program was offered at no cost. But in the second year, a BSHIIP household member was required to pay a measly PhP120 as an annual premium counterpart. This was introduced and institutionalized by the LGU as the “Innovative Sharing Scheme of the Local Premium Counterpart.” When a household could not pay in cash, it was allowed to pay in kind or render service to the barangay. The rural health workers were tasked to collect the household contributions.
Records show that the program elicited strong community involvement as evidenced by the equity contributed by household counterparts which was relatively larger compared to the rest of the premium share contributions. In the past three years, the collection from households averaged 92 percent. The household counterpart contribution has also reached PhP1,350,878.70, which is even higher than the municipal budget allocation of PhP955,000. In 2006, 612 beneficiaries have availed of the hospitalization benefits and 4,406 had sought primary consultation. About 3,254 beneficiaries have also availed of the complimentary OPB services provided at no cost by the RHU diagnostic laboratory. The program has clearly made a mark in the health service delivery of the municipality.
The BSHIIP is now a model for those who seek to adopt Bindoy’s health insurance scheme for its poor constituents. The former Local Chief Executive, who originally started the program in Bindoy, has been invited as resource speaker to different areas and for various conferences in the country to share Bindoy’s experience in health care delivery. The much improved health facility and upgraded health service capabilities are now sites for study tours from different LGUs and NGOs all over the country.