Make health care free and universal through a single-payer system
THE numbers are hard to ignore. In the 2025 CEOWorld Magazine Health Care Index, the Philippines ranked 87th out of 110 countries, behind not only Singapore but also Indonesia and Thailand.
As data scientist Dr. Alicor Panao has argued, the country’s health-care crisis is not just about limited capacity. It is about unequal access. For those with money, or those who live near Metro Manila, treatment is easier to get. For poor families and people in remote provinces, care remains delayed, uncertain, and often out of reach.
• Nearly half of all deaths still occur outside health facilities.
• Medicine availability scored only 53.81.
• Government readiness was just 57.45.
That is why piecemeal reform has fallen short. The Universal Health Care Act was an important step, but its implementation has been uneven. In Panao’s view, the deeper problem is governance: resources exist, but coordination is weak, accountability is thin, and performance remains far below what the public needs.
If the aim is universal and equitable care, the Philippines has to move beyond minor fixes. It needs a more ambitious reform: free health care through a single-payer system, private hospitals integrated into a unified public network, and centralized procurement of medicines and supplies.
What a Single-Payer System Could Look Like
1. A single national payer for health services. The government would become the sole purchaser of health care, covering all Filipinos through a national health card funded by progressive taxation and larger contributions from corporations and the wealthy, rather than from ordinary workers. Hospitals would bill one public fund, replacing the fragmented mix of health maintenance organization claims and Philippine Health Insurance Corp. (PhilHealth) bureaucracy.
2. Integration of private hospitals into one public system. Private hospitals would be folded into a unified national network, with fair compensation to owners. Facilities, equipment, and personnel would operate within a common public framework, narrowing the divide between underfunded charity wards and premium private services. Care would be based on medical need, not ability to pay.
3. Centralized medicine and supply procurement. The government would purchase medicines and supplies in bulk for the entire population. At that scale, national procurement could reduce prices, limit dependence on middlemen, and help prevent recurring shortages and inflated tenders.
Addressing Common Concerns. The usual objections come quickly: long queues, weak administration, bureaucratic inefficiency. Those concerns are real, but they are not arguments against universal care itself. Many of the countries that lead global health rankings, including Taiwan, South Korea, Canada, and Sweden, rely on universal systems that are single-payer or close to it. Their success rests on a simple idea: health care is essential public infrastructure, and it should be funded and managed that way.
None of those systems was built overnight. Each began with a political decision to treat health care not as a commodity, but as a right. The Philippines is not too poor to make the same choice. Taiwan in the 1980s had a broadly comparable gross domestic product per capita. The difference was not wealth. It was political will.
Funding the Reform. The real question is not whether the country can afford universal care. It is whether it is willing to make it a priority. Funding could come from reallocating wasteful spending, cutting nonessential expenditures, and imposing modest taxes on extreme wealth. PhilHealth already collects billions each year, yet out-of-pocket costs still weigh heavily on ordinary families. A single-payer structure would not solve every problem, but it would reduce duplication, cut administrative waste, and direct more money toward actual care.
Panao is right to call for renewed attention to basic public services, especially health care. But attention alone is not enough. The country needs structural reform.
A free, unified, single-payer health-care system is not a fantasy. It is a working model in many countries. For the Philippines, it offers the clearest path to ending a system that still delivers very different outcomes depending on income and geography.
MANNY ILAO,
manny.ilao@yahoo.com
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