Nenita Bautista, 62, lives in a barangay in Nueva Ecija with her husband and two grandchildren. For most of her adult life, healthcare decisions were governed by a simple calculation: can we afford it? When her husband was diagnosed with Type 2 diabetes four years ago, the family spent nearly a quarter of their monthly income on medication.
Since the Universal Health Care Act began full implementation last year, that calculation has changed — partially. Nenita's husband now receives his insulin and metformin through the National Formulary at no direct cost. Their PhilHealth coverage has expanded automatically. The nearest rural health unit has been upgraded with better diagnostic equipment.
"It's better," she says carefully. "But we still have to go to the provincial hospital for anything complicated. And there, the waiting is very long."
Her assessment captures the broader picture of the UHC program at the one-year mark: genuinely significant progress in some areas, persistent gaps in others, and a healthcare system that is moving in the right direction but still very far from the promise its name implies.
The achievements are real. PhilHealth coverage has expanded to include nearly all Filipinos, with automatic enrollment for those in the lowest socioeconomic categories. The outpatient benefit package, which previously covered only inpatient care, now covers primary care consultations, annual health assessments, and preventive services. Medicines for hypertension, diabetes, and mental health conditions are available at zero cost through accredited facilities.
But structural problems persist. The Philippines has one of the lowest doctor-to-patient ratios in Southeast Asia. Rural health centers, even those recently renovated, often lack the diagnostic equipment and specialist referral networks that meaningful healthcare requires. PhilHealth reimbursement rates remain below actual service costs in many categories, deterring private providers from accepting PhilHealth patients.
The road to genuine universal healthcare is long. But Nenita Bautista's husband is getting his insulin. That is something.
