IPC 43rd Anniversary
Conference on “ Culture and
Technical Sphere”
“Exploring Damayan and Tulungan as Core
Values on Community Health Care
Financing ”
Dennis B. Batangan, M.D., M.Sc.(CHDC)
Institute of Philippine Culture
Ateneo de Manila University
Outline of Presentation
I.
II.
Context of Community Health Care Financing
A.
Health Care System Infrastructure
B.
Individual Health Care Context
C.
Community Health Care Financing Model
Core Values in Community Health Care Financing
A.
‘Damayan’ and ‘Tulungan’ in Practice
B.
‘Kapwa’ as the broader framework for
solidarity and shared responsibility
C.
Exploring health belief models in
community health care financing
Philippine Health System Infrastructure ( Sanchez et.al, 1993,Adopted from
WHO,1987)
MANAGEMENT
1 Health Planning
2. Administration
3. Regulation
RESOURCE
PRODUCTION
1. HHR
2. Health Care Facilities
3. Commodities
4. Science and Technology
ORGANIZATIONL STRUCTURE
1. Hierarchy of Health Services
2. Integration of Public Health and Medical
Care
3. Roles of Different Sectors
4. Indigenous Medicine
ECONOMIC SUPPORT
1. Public Health Activities
2. Medical Care Services
3. HHR Production
4. Research
DELIVERY OF SERVICES
1. Health in the Hands of the People
2. Community Health Workers
3. Professional and Paraprofessional
Health Personnel
4. People Oriented Programs
Juan or Maria and Health Care Financing
Govern ment
Appropriations
Public Health
Programs
Health Care Services
Taxes
Subsidies
Contributions
Premiums
Juan
or
Premiums
Maria
Community
Organizations
User Fees
Health Care Services
Insurance Companies
Personal Health Care
Providers
Premiums
3rd party payer
User Fees
Operation of a Social Health Insurance (Adopted
from the DAR-
Agraryong Pangkalsusugan Training Manual, 2001)
insurer
Donations
Government
Phil Health
Foreign assistance
Health Fund
insured
Health Care Provider
Risk sharing and resource pooling for
Social Health Insurance
Risks
------------Resources
‘Damayan’
 Damayan –
– Mutual or common empathy with another’s
suffering (Gerali, 2000., Asperas, 2001)
– Resources shared or contributed are outward
manifestations of this empathy and feeling
of unity
– The case of the Senior Citizens ‘Damayan
Assistance Program (Racimo, 2001)
‘Tulungan’
 Contributing one’s resources and/or
capacities towards a common good
 Acceptance of one’s responsibility and
contribution to achieve a desired goal
(Batangan, 2002)
 Shared responsibility, solidarity and
shared humanity (Batangan, 2001)
“ Kapwa” (Enriquez & Santiago,
1976)
“Ibang Tao” or Outsider Category
Levels:
Pakikitungo
Pakikisalamuha
Pakikilahok
Pakikibagay
Pakikisama
“Kapwa”
“ Hindi Ibang Tao” or One of Us Category
Levels:
Pakikipagpalagayang-loob
Pakikisangkot
Pakikiisa
References:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Fulop and Roemer, Reviewing Health Manpower Development: Geneva: WHO, 1987
Gorra, M. National Social Health Insurance Conference,January 9-10, 2003. Institute of Philippine Culture,
Ateneo De Manila University.
People-Managed Health Services and Multi-Purpose Cooperative. Designing Operational Management
Systems on Community-Based Social Health Insurance Schemes:Training Manual for the Department of
Agrarian Reform Agraryong Pangkalusugan Project. Quezon City. December 2001.
Gerali, Pedro. Saving for Health: Towards Developing a Model for Health Savings in WHSMP-PC Areas.
DOH-WHSMP-PC, Manila, 2000.
Asperas, G. and Morales, J.The concept of Social Solidarity: A Study of the Expereinces of Two
Barangays in the Municipality of Guimba in Indigenous Mutual Support Mechanisms. CSWCD, U.P.
Diliman, Quezon City, 2001.
Racimo, J. Case Study Presented during the Pursuing Partnerships in People-Centered Health Conference,
March 1-2, 2001. Institute of Philippine Culture, Ateneo De Manila University.
Batangan, D. Enhancing Capacities of Program Stakeholders to Implement Community-Based Social
Health Insurance Schemes. Project Report for Catholic Relief Services. Manila, 2002.
Batangan, D. Solidarity and Shared Responsibility. Contact, No. 174, July-Sept2001, New Delhi, India.
Enriquez, V. Kapwa : A Core Concept in Filipino Social Psychology. Sikolohiyang Pilipino: Isyu, Pananaw
at Kaalaman. Aganon, David (eds). National Bookstore, Inc. Quezon City, 1985.
Virtual Conference
Cut the Cost Cut the Pain
Network
Virtual Conferences on Safe and Affordable Drugs
September 24-26, 2003
(www.ipc-ateno.org.ph)
“Ang Game ng Gamot sa Pilipinas - II: Presyo at Patent ng Gamot
Sino ang Pumapasan?” A National Virtual Conference
“The Social Cost of Drug Pricing and Patents in Developing
Countries” A Parallel International Virtual Conference