I may neither approve of nor rationalize many of President Duterte’s pronouncements, but one thing I admire is his political will to get vital reforms and legislation implemented no matter what it takes.

Recent examples of Duterte’s act of political will is his decision to close down Boracay to restore its pristine beauty; the order to clean up Manila Bay and make it safe enough for swimming; and declaring the universal health care (UHC) law and amended excise tax on tobacco and alcohol products as urgent.

I think the move to declare the amended sin tax bill as urgent, and significantly increasing the excise taxes from what was proposed by Congress, was a masterstroke. It’s raising the tobacco excise tax rates to P60. Under the Tax Reform for Acceleration and Inclusion Law, the tobacco excise tax, which is currently P35, will be raised to P40 by Jan. 1, 2022, and by 4 percent annually.

Not big enough

The original proposed increase is still not big enough to discourage smokers from licking their habit, to reduce disabilities and deaths directly attributable to smoking. Smoking rate in the Philippines is currently at 21.6 percent, which is still not acceptable. Significantly increasing the excise tax on tobacco hopefully could achieve the target of 15.7 percent.

Package 2 of the Comprehensive Tax Reform Program will also raise excise tax rates for alcohol. An excess intake of alcohol is likewise implicated in diseases of the liver, heart, brain, and in vehicular accidents and violence, too.

The revenue from the current sin taxes is also not sufficient to fund the UHC law, which aims to provide adequate healthcare for all Filipinos, especially the marginalized sectors.

According to Sen. JV Ejercito, the UHC has an initial P257-billion budget for the first year of implementation, but this won’t go far in sustaining it in the long haul. It would be unfortunate if UHC will be good only for a few years and lose steam subsequently.

With the increased sin taxes, the government should be able to raise the much-needed funds annually to make sure that the UHC law will not have the same fate of many laws which are great on paper but remain unimplemented or under-implemented after three to four years due to lack of funds.

Final proposal

I’ve heard from health advocate Dr. Tony Leachon that Sen. Sonny Angara and his ways and means committee are now busy conducting hearings and threshing out details to finalize the final proposal for the amended sin tax law.

The public should try to reach out to all senators and make them realize what this law would mean for the masses. The UHC’s fate is at stake, and that fate is now in the hands of our senators. May they follow more the dictates of their conscience, not what political expediency dictates.

The UHC automatically enrolls all Filipinos in the proposed National Health Insurance Program through the Philippine Health Insurance Corp. or PhilHealth.

Key role

The UHC remains a utopian dream of providing everyone access to the full spectrum of benefits of health care, including preventive, promotive, curative, rehabilitative and palliative care for all medical needs. Dental, mental or psychological, and emergency health services are also included.

Primary health care (PHC) providers will play a key role here, and all citizens will be registered with a PHC provider of their choice.

This provider will handle the outpatient care, supply of medicines, and requests for laboratory tests.

PhilHealth has already drafted a primary care benefits package, which should be upgraded from time to time, depending on the availability of funds.

This UHC scenario in the country used to be just a pipe dream. I remember having some exchanges with then Health Secretary Ike Ona on the issue. Despite the odds, he was bullish that this would be fulfilled in his lifetime.

I’ll give him a call one of these days and congratulate him for the groundwork he and the Department of Health have laid out, and the persevering hard work of everyone who came after him, including the present team of Secretary Francisco Duque, to make the UHC dream a reality.

Let it never be said anymore that Filipinos died without the benefit of adequate access to health care in the country.