[OPINION] Stop dividing the healthcare pie. Make it bigger.

When healthcare professionals call for more funding for PhilHealth, I agree. When they demand that money be redirected from the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) program, I also understand their reasoning. Healthcare should be a right, not a political favor.

Recently, more than 70 health organizations urged Congress to increase PhilHealth’s proposed 2027 allocation from approximately P74 billion to P244 billion, redirect MAIFIP funding, and release some P311 billion in withheld health-related earmarks. These are substantive proposals addressing genuine financing problems.

But while I agree with the advocates’ objectives, I question whether their proposed strategy adequately addresses Philippine political realities, the practical transition for patients, and the longer-term challenge of financing universal healthcare. The disagreement is not about where we want healthcare to go. It is about how we get there.

Political realities cannot be wished away

MAIFIP exists within a political system where elected officials are expected to provide immediate, visible assistance to constituents. For a legislator, helping a patient settle a P300,000 hospital bill may carry considerably more political value than supporting an increase in PhilHealth’s budget. We may condemn this as patronage, but political incentives do not disappear simply because a better institutional arrangement exists.

Nor can we ignore patients who currently depend on MAIFIP. Abruptly removing assistance without ensuring that PhilHealth can reliably cover the same needs risks leaving vulnerable Filipinos worse off. A credible transition would establish automatic eligibility, predictable benefits, transparent processing, and clear responsibility for patients whose costs remain uncovered. Political reform is about building an alternative that works well enough to replace the current system. (READ: Here’s PhilHealth timeline for expected benefit expansion until 2028)

What about the healthcare providers themselves?

There is another uncomfortable question for my fellow physicians. While we debate government allocations, have we sufficiently examined the financial responsibilities of healthcare providers? If medical associations are advocating more equitable public financing, could they also propose reducing or waiving professional fees for indigent patients receiving publicly funded treatment? Could specialists accept standardized fees for certain procedures?

Healthcare spending eventually becomes somebody’s revenue: hospitals, pharmaceutical companies, medical suppliers, laboratories, and physicians. If affordability is our objective, every participant in that economic chain deserves scrutiny. Reform should involve shared responsibility, ensuring that additional public financing translates into more affordable care rather than higher payments throughout the system.

Redistribution is necessary, but not sufficient

Passing ambitious legislation is not the same as delivering accessible and affordable healthcare. The Universal Health Care Act established an important framework, yet Filipinos continue to experience substantial out-of-pocket expenses, fragmented services, and uncertainty about what their insurance covers.

Recovering earmarked revenues is necessary, but how quickly can PhilHealth convert additional financing into dependable benefits? Even if the proposed funding gap were closed, would the institutional capacity exist to deliver all promised services effectively? More importantly, as the population ages and advanced treatments become more expensive, we cannot rely indefinitely on reallocating existing government resources. We need to expand the economic capacity that makes universal healthcare financially sustainable.

We are fighting over slices of a small pie

Consider the Philippine business process outsourcing industry. In 2025, the IT-BPM sector generated more than $40 billion in export revenues, compared with approximately $8 billion appropriated across the government’s health sector for 2026. One Philippine export industry generates more than five times the government’s annual healthcare allocation.

Now consider Pfizer’s acquisition of Seagen in 2023 for approximately $43 billion. A single biotechnology acquisition commanded a valuation greater than the Philippines’ entire annual BPO revenue at the time. This comparison demonstrates the extraordinary economic value that healthcare innovation can create. Why are we not equally ambitious about building this industry?

The Philippines already trains physicians, nurses, pharmacists, and scientists for healthcare systems around the world. Yet much of this talent is exported individually instead of being organized into domestic enterprises capable of developing intellectual property, technology, and internationally competitive products. We can begin with clinical trials, diagnostics, medical devices, pharmaceutical manufacturing, healthcare software, and specialized research services. Healthcare could become another pillar of economic growth.

Where is healthcare in Pax Silica?

In April 2026, the Philippines joined Pax Silica, a US-led initiative focused on strengthening supply chains for artificial intelligence, semiconductors, and advanced technology. The government is planning a major industrial hub in New Clark City, with medical-related industries identified among its potential activities.

Are our medical associations, universities, hospitals, and healthcare investors developing proposals to participate? Could we attract international medical device manufacturers, diagnostic technology companies, and healthcare AI developers? Healthcare leaders should engage early, working with economic agencies to ensure healthcare becomes a strategic national industry that creates the jobs, investment, exports, and tax revenues needed to sustain healthcare expenditure in the future.

Make the pie bigger

I respect the physicians and civil society organizations demanding stronger PhilHealth financing. Their concerns are justified. But achieving universal healthcare requires a politically feasible transition away from discretionary assistance, greater accountability from healthcare providers, stronger institutions, and an economy capable of sustaining rising costs.

If the BPO industry can generate more than $40 billion annually, why should we continue treating healthcare only as a fiscal burden? Reaching our destination requires political realism, institutional execution, and a much bigger economic vision. Let’s not just argue over the slices. Make the pie bigger. – Rappler.com

Dr. Jaemin Park is an adjunct professor at the University of the Philippines College of Public Health and works across Southeast Asia on healthcare financing, medical innovation, and public sector reform. The views expressed are his own.