Guimaras Health Insurance Project
Guimaras, a newly created province in Western Visayas is one of the poorest provinces in the country with 75% of its 130,000 population living below the poverty line. Its residents suffered from high costs of healthcare and inadequate health facilities. To address the health problems, the province implemented a comprehensive health care program composed of the preventive/promotive health (primary health care), curative and rehabilitative health. Part of the curative component is the health insurance project which aims to provide adequate, affordable and accessible medical care services to the low income residents consisting of a comprehensive coverage (hospitalization, medicine, routine laboratory examination and professional fees), health information and education. All the five municipalities in the province forged an agreement with the provincial government to pay its share of P15 out of P100 annual premium and to subsidize the premium of 5 indigents per municipality. The province paid P25 and the remaining P60 by the beneficiaries. This partial subsidy is temporary until the indigents and the poor families are able to pay the full premium.
To support its health insurance program, the province renovated and expanded the provincial hospital. The whole provincial hospital complex was thoroughly cleaned making it the cleanest public hospital in the Western Visayas region. Hospital laboratory services and additional medical equipment and medical beds were acquired. In addition, the province secured land and water ambulances and communication equipment linking the remotest barangays with the hospital to immediately respond to any medical emergencies. To further make quality healthcare accessible, an extension of the provincial hospital was established in Buena Vista, another municipality.
After four years of implementation, the program enrolled 15,155 members with an average of four dependents per member representing around 85 percent of the potential beneficiaries, The members included small farmers, marginalized fishers and other self-employed workers. Around P2 million premium fees had been collected vis-à-vis a P1 million benefit claim. The program had served 4.17% of its members who would otherwise not had been provided with hospital care. The program assured the poorest access to hospital care.
This program is recognized as one of the Ten Outstanding Programs in the 1997 Galing Pook Awards.