With the debate on the shift to a federal form of government, many significant issues are at hand and those on health are among the most important. The Philippine health system has a devolved design, following the Local Government Code of 1991. Health service delivery, disease prevention and control, and public health programs are under the domain of local governments. Arguing on whether or not to push for federalism depends largely on the impact of devolution including the delivery of health services. Does the present setup respond to local needs? Is devolution sufficient in delivering responsive health care to people? Can a federal health care system that assigns health functions to subnational governments do the job better? This paper discusses the Philippine experience with devolution insofar as health is concerned. It also presents inter-regional health inputs. Experiences of some federal countries are surfaced to see if effective practices apply. This paper concludes by highlighting six basic ideas in view of reform, namely, the level of government to manage health service delivery, the system of financing, resolving inter-regional inequities, health insurance, cost-containment, and intergovernmental relations.>>read complete document
