The Sona and the true test of universal health care

President Marcos’ fifth State of the Nation Address (Sona) devoted considerable attention to health. He highlighted expanded PhilHealth benefit packages, the Yakap preventive care program, zero balance billing, the medical assistance program, VAT exemptions on essential medicines, additional medical scholarships, hospital modernization, and the proposed Virology and Vaccine Institute of the Philippines.

These are welcome developments. They demonstrate that health remains high on the national agenda. Yet as I listened to the President’s speech, one question kept coming to mind. Will these initiatives actually make Filipinos healthier? That, ultimately, is the true test of universal health care (UHC).

Government naturally reports what it delivers. It counts hospitals upgraded, benefit packages expanded, medicines made more affordable, and patients who received assistance. These are important measures of government effort. But they are not necessarily measures of better health.

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For most Filipinos, success is much simpler. Parents want their children to grow up healthy. Older adults hope to live longer without disability. Families want to see a doctor before an illness becomes life threatening, not after. No one should have to choose between buying medicines and putting food on the table.

UHC was never intended to become a checklist of government programs. It was envisioned as a promise that every Filipino, regardless of income or place of residence, can live a longer and healthier life without being driven into poverty by illness.

By that standard, our work remains unfinished. Today, the average Filipino lives only about 70 years, several years shorter than many of our neighbors in Southeast Asia. Nearly one in three Filipino children under five remains stunted because of chronic malnutrition. The Philippines continues to carry one of the world’s highest tuberculosis burdens, while human immunodeficiency virus infections continue to rise. Noncommunicable diseases, including heart disease, stroke, diabetes, and cancer, account for most deaths in the country.

These numbers tell us something important. They remind us that improving health is far more difficult than launching new programs.

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The Philippines has never lacked good health policies. Successive administrations have increased investments in health, expanded PhilHealth benefits, strengthened public hospitals, and enacted the UHC Act. This year’s Sona adds another set of promising commitments.

The bigger challenge has always been making these investments work where they matter most. A larger budget does not automatically translate into healthier communities. A new benefit package does not improve health if people cannot access services. A modern hospital cannot compensate for weak primary care that fails to prevent illness in the first place.

Every peso invested in health should eventually be reflected in fewer mothers dying during childbirth, fewer children becoming malnourished, fewer Filipinos developing advanced tuberculosis, better control of hypertension and diabetes, and more people reaching old age healthy and productive. That is the scorecard that matters.

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This is also the challenge facing the country’s next health secretary. The Department of Health does not necessarily need more programs. It needs stronger implementation. It needs to ensure that the reforms already in place are consistently delivered across every province, city, and municipality. It means investing in primary health care, supporting local governments, strengthening the health workforce, improving health information systems, and using data not merely for reporting but for better decisions.

Most importantly, it means shifting our definition of success. Instead of asking how many programs were launched this year, perhaps we should begin asking different questions. Did fewer mothers die? Were fewer children stunted? Did tuberculosis cases decline? Are more Filipinos controlling their blood pressure and diabetes? Are people living longer in good health instead of spending their later years battling preventable illness? Those are the numbers that ordinary Filipinos understand because those are the numbers that change lives.

The President’s health agenda offers reason for optimism. It lays out important reforms that deserve support. But the true measure of UHC will never be the number of announcements made or the size of the health budget. It will be whether those promises are translated into measurable improvements in the lives of ordinary Filipinos.

When the next Sona is delivered, I hope we hear not only about new programs or larger budgets. I hope we hear that fewer Filipino children are malnourished, fewer families are devastated by medical expenses, more patients survive preventable diseases, and more Filipinos are living longer, healthier, and more productive lives.

Only then can we truly say that UHC has fulfilled its promise.

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Dr. Anthony Rosendo “Tonyboy” Faraon is chair of the board of trustees of the Philippine Society of Public Health Physicians.