Health Earmarking in the Philippines
The Philippines started its path toward universal health coverage (UHC) in 1969 with the creation of an early Medicare health insurance scheme, where direct payments were made to accredited providers or to patients for reimbursement. After decades of implementation, more than half the population remained without health coverage, prompting the creation of the Philippines Health Insurance Corporation (PhilHealth) in 1995—a parastatal entity tasked with managing delivery of a costed benefits package to all citizens through a mix of premiums, user fees, and government subsidies for the poor. PhilHealth has progressively expanded to cover a greater number of services for larger segments of the population, with Sin Taxes providing an avenue to drive expansion in fiscal space for health.