National Health Insurance Act of 1995

The National Health Insurance Act of 1995 (Republic Act No. 7875) is legislation enacted in the Republic of the Philippines on Feb. 14, 1995. The act was created to design and provide an interconnected, all encompassing approach to health care reform in the interest of providing a “national health insurance program for all Filipinos and establishing the Philippine Health Insurance Corporation” to oversee the program.

The Program and Corporation

• The act created the National Health Insurance Program (the program) and the Philippine Health Insurance Corporation (the corporation) to oversee it. The corporation would be run by a board of directors comprised of Secretaries of Health, Labor and Employment, Interior and Local Government, Social Welfare and Development. Additionally the board would have a president and representatives for the labor sector, employers, self-employed sector and health care providers. The corporation issued health insurance ID cards to identify participants and their pertinent information.

National Health Insurance Fund

• The act also created the National Health Insurance Fund, consisting of contributions from program members, balances from the existing health care programs, new national and local government funds created by the act, donations and grants-in-aid. The act states that people who couldn't pay the contributions “shall be subsidized partially by the local government unit where the member resides.”

Benefits and Provisions

• The benefit package each resident is entitled to under the act includes inpatient hospital care, outpatient care, emergency and transfer services and “some other health care services that the corporation shall determine to be appropriate and cost-effective.” Provisions described in the act include health care “development which shall endeavor to make essential goods, health and other services available to all the people at affordable cost. Priority for the needs of the underprivileged, sick, elderly, disabled, women and children shall be recognized. Likewise, it shall be the policy of the State to provide free medical care to paupers.”

Principles

• Guiding principles described in the act include the allocation of national resources for health, responsiveness to changing health care needs in a person's life, effective financial responsibility. The program was founded with universality and equity in mind, providing at least a “basic minimum package of health insurance benefits” to all citizens. The program also mapped out guidelines for informed choice among health care providers, aided by a clear and straightforward explanation in each person's language. Impatient Education Packages, which inform a sick or injured person about their illness and options, were a brainchild of the act.

Related Legislation and Amendments

• The act follows the 1987 Constitution of the Republic of the Philippines, which declared the intentions to start such a program in Section 11, Article XIII of the document. The act was amended by House Bill No. 883 that increased the coverage provided for home care and rehabilitation support services.