The importance of being unimportant: health care funding

Written by Danielle Uayan

In our economics class, we were taught the ‘Law of Supply and Demand’ and how each factor influences the price market. It was something that was simple and easy to understand: in principle, the availability of a good and the willingness or desire to have that good affects its price in the market. One example would be the price of rice. When there is a great demand and a scarcity of it, the price will increase.

But as with any law that describe interactions, there are certain subtleties to it, and one of the concepts that struck me the most was that of ‘the importance of being unimportant’. It is based on cases such that a difference—particularly an increase—in the prices of goods that were deemed not to consume a significant amount of a household’s budget would often go by unnoticed. To illustrate this, think of a medical student who buys a pack of gum from the convenience store every day to stay awake during lectures. One pack that used to cost Php 18.00 (GBP 0.25) the year previous has become Php 25.00 (GBP 0.35), yet the medical student continues to purchase the gum despite the 38.8% increase in price.

It seemed something so obvious and mundane, but it made me think of all the trivial things in my daily life, things that I might have overlooked but are actually quite important. If I add them up, they would contribute significantly to who I am, how I interact with people, how I deal with certain situations—and how much I spend or save up. It is true that it all starts with the little things. For example, we have a stall selling coffee in our School’s cafeteria that deducts Php 5.00 (GBP 0.07) if you use your tumbler whenever you buy coffee. I drink around four to six cups of coffee per day, and so it means I save up to Php 20 to Php 30 (GBP 0.38 -0.42) daily. I used to not pay attention to how much that simple habit of bringing my tumbler every day had allowed me to save so much if I total my expenses weekly, but now, it made me wonder what other seemingly inessential things had I largely ignored.

Ultimately, it made me think of health care. Since I do not get sick so easily, I have not portioned my monthly allowance for it, and am not a health card holder. But at the instance I do get sick, without asking from my family and relatives, how would I pay for treatment and medication?

I took that question with me to Northern Samar and tried to wiggle variants of it in the conversations I had with the people from a coastal town. Who pays whenever you get sick? Where do you get your medicine? Are you a member of PhilHealth? Do you and your family save up for health care?


PhilHealth’s signage for tuberculosis management in a municipal health office

The responses varied on the first question. The locals say they usually get medicine from the health centers, the district hospital, or at the nearby pharmacy. Most are members of PhilHealth and the collective answer was ‘no’, they did not save up for health care.

Huwag na lang magkasakit, no, para wala nang gasto’s [Then maybe we should not get sick so we don’t have to spend (for health care)], one of them told me with a grin. ‘Pag di sakitin, wala namang aalalahanin’ [If (you’re) not sickly, then (you) have not nothing to worry about]. ‘Unahin ko muna edukasyon ng mga anak ko. Mga bata pa yun’ [I’d focus first on putting my children through school. They’re all very young], a father replied. ‘Sa tamang panahon naman, makakahanap ka ng pera para doo’ [At the right time, you would find money for (health care)], one of them said. ‘Huwag na lang talaga magkasakit. Eh hindi naman kami sakitin. Ubo, sipon lang paminsan. So ayun, okay naman’ [So we really shouldn’t get sick. And we don’t. Just the occasional cough and cold. So it’s fine].

One would think of it as a curious phenomenon, when obviously health care is important and integral to ensure our well-being, but I personally think the principle of “the Iimportance of being unimportant’ explains it quite well. You would not pay attention to health care financing, because most of the time, it does not take a huge sum out of your daily budget—until you get sick, that is. Almost nobody saves up for health care. In a country with a health financing landscape of mostly out-of-pocket expenditure, and especially in an area with a significant number of families living below the national poverty threshold, it is a huge problem that we cannot, in any circumstance, consider as unimportant.

I asked a lot of people about health care financing at this public market

It is certainly great (and a relief) that a lot of brilliant people have thought of this already, and through their collective efforts, there has been an increase in indigent membership in PhilHealth in recent years. But there still remains the proper allocation of health funds, the appropriate selection of beneficiaries for health care packages, and the effective implementation of policies. The fact that half of out-of-pocket expenditure is spent on pharmaceutical products and supplements also needs to be addressed. Attaining universal health care coverage would mean overcoming such systemic problems that has plagued the nation for decades.

I for one cannot think of a proper recommendation yet for our current situation in health care, but I do hope I can convince people the importance of the deemed unimportant. Especially for the poor—for those who cannot help but keep health spending at the back of their minds—I do hope that we can all band together to make health care equitable, affordable and accessible to all.