Tracking Sin Tax Revenues for Universal Health Coverage

Organization(s)

Action for Economic Reform (AER)

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Basic Project Information

AER worked closely with government officials to study the allocation of excise taxes on tobacco and alcohol to universal healthcare coverage.

Sector

Project Summary

Objectives

Improve public spending and service delivery in the health sector by ensuring the effectiveness, feasibility, and desirability of the expanded program for universal healthcare

  • Strengthen capacity of civil society organizations and beneficiaries to monitor and provide feedback on health services
  • Facilitate cooperation among beneficiaries, LGUs, and PhilHealth representatives in order to improve the services and benefits of PhilHealth’s Sponsored Program

Summary

AER monitored the utilization of incremental revenues generated from the Sin Tax Law and assessed the effectiveness of the expanded program for universal healthcare in addressing the healthcare needs of Filipino families. The project included three major research and advocacy initiatives:

  • Public Expenditure Tracking Surveys (PETS)
  • Citizens Report Cards (CRC)
  • Social Audits

Through the PETS, AER utilized health facility and beneficiary questionnaires to track funds generated from excise taxes on tobacco and alcohol products that were appropriated for PhilHealth’s “Sponsored Program” (SP), providing free health care to the poorest 20 percent of the Filipino population. The team sought to identify any problems or bottlenecks in the funding flow from the national-level down to local-level health facilities and beneficiaries. AER then conducted CRCs to assess citizens’ access and utilization of SP services, as well as service quality and beneficiary satisfaction. The study revealed low levels of beneficiary knowledge, awareness, access, and usage of designated health services and benefits. AER utilized the CRC survey instrument to develop a monitoring toolkit for automated application, thus encouraging continued monitoring of Philhealth services and benefits beyond the end of the project. Finally, AER led a social audit, which included focus group discussions with SP beneficiaries and dialogues between beneficiaries, local government officials, and PhilHealth representatives. Through these dialogues, citizens, local leaders, and service providers discussed beneficiary feedback and produced recommendations for improving services. AER documented the findings from all three tools and presented them at the national level to public officials with recommendations for how to improve the funding and delivery of the SP. The team leveraged their formal and informal partnerships with government agencies, NGO health groups and coaltiions, and local government units to advocate for health sector improvements, and participated in legistlative hearings and government budgeting process in order to promote project findings.

Use of Information Communication Technology

None

Scale

PETS: 217 survey respondents across 4 local areas

CRC: 527 survey respondents across 5 municipalities 

Social Audit: 4 municipalities

Target Population

Beneficiaries of the expanded program for universal health care, with particular focus on families belonging to the poorest 20 percent of the population
Results

Results Methodology

Self-reported results

Indicators Used

Not applicable

Reported Results

  • Bill approved extending coverage of PhilHealth’s Sponsored Program (SP) to all senior citizens
  • Research findings used to develop the Implementing Rules and Regulations (IRR) of the Sin Tax law
  • Partnerships established and strengthened with government agencies, local government units, budget watchers, NGO health groups and coalitions, and other organizations for monitoring the SP
  • Increased recognition of AER as lead CSO representative in monitoring sin tax revenues
  • Increase in benefits claimed by SP members
  • Increased public awareness and involvement in Philhealth services
  • Increased budget allocation for SP with revenues derived from sin taxes
  • Increased allocation for primary care benefits provided by Philhealth in the form of capitation funds for local government units
  • Replication and popularization of monitoring toolkit amongst CSOs and government agencies
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