Strengthening Peso In Relation to United States (U.S.) Dollar
The current market price for which one currency can be traded for another is called an exchange rate[1]. For example, if the U.S. Dollar exchange rate for the Philippine Peso of 44.38 means that 1 U.S. Dollar can be exchanged for 44.38 Philippine Peso. Though it is challenging to understand the changes in foreign exchange market rates, it stays as one of the most analysed and forecasted economic indicators as exchange rates play an important role in determining the level of competitiveness of a country.
According to TradingEconomics.com, the USD-PHP spot exchange rate has appreciated 0.6200 or 1.42 percent during the last 30 days. During the period from 1998 to 2013, this exchange rate averaged 47.2700 pesos to a dollar reaching an all-time high of 56.3400 in October 2004 and a record low of 37.8400 in May 1999. According to the BangkoSentral ng Pilipinas (BSP), the average monthly Peso per U.S. Dollar rate for 2013 is at 42.2954[2]
Earlier in October this year, the Philippine Peso was expected to significantly appreciate next year to 40-to-a-dollar and would be among the strongest in the region as forecasted by the investment bank Goldman Sachs due to increase in investments, continuous inflow of foreign exchange from Overseas Filipino Workers, and the strengthening of business process outsourcing (BPO).[3] Though the peso fell to its lowest since September last December 20,,2013 at 44.50:$1 due to the US Federal Reserve’s unexpected announcement of its intent to taper its monetary stimulus through quantitative easing (QE) on January 2014, the BSP remains untroubled and still expects the peso to gain its strength back as remittances from overseas workers continue to increase[4]. The following table shows a positive outlook by the Economist Intelligence Unit for the Philippine currency in the coming years:
Table 2. USD-PhP Exchange Rate
Year
|
USD-PHP Exchange Rate
|
2013
|
43.00
|
2014
|
42.50
|
2015
|
42.00
|
Stable Interest Rates
In 2012, the country’s key policy interest rate was at 3.5%.[5] In 2013, the said BSP’s rate for the overnight borrowing or reverse repurchase (RRP) facility was kept at 3.5% by the Monetary Board and 5.50 % for the overnight lending or repurchases (RP) facility[6]. The decision to maintain these rates stems from the BSP’s assessment that inflation stays non-threatening and domestic economic activity continues to show solid growth. Moreover, lending to the productive sectors of the economy has also been growing in strength, thus, contributing to the minimization of price pressures. Comparatively three years ago, rates for the RRP and RP facilities were at 6.00 and 4.00, respectively, which means that current rates are lower.
To further support this positive outlook, Table 3 shows a forecast for the next few years on this economic factor.
Table 3. Interest Rate Forecast 2013-2015[7]
Year
|
Interest Rate
|
2013
|
3.5
|
2014
|
3.5
|
2015
|
3.5
|
Lower and stable interest rates may mean an opportunity for the government and through it the hospitals, to improve its capability for the enhancement of its facilities through expansion projects and opens the option of financing these through long-term borrowings. Interest rates affect hospitals financially as it determines the level of costs the government incurs from its existing loans through interest expenses and repayments. With stable interest rates, the government will, in part, be able to efficiently control its financial health in terms of its current and future long-term borrowings for its capital investments. Additional hospital capital investments will consequently result to better delivery of health care services.
Low and Stable Inflation
With the strength of domestic economic activity and increasing capacity of domestic productivity, the BSP remains unruffled as it deems inflation as manageable over the next few years[8]. Forecasts support this stance as it shows that inflation will stay within the target range over policy horizon. In general, mean inflation is expected to decrease but still within-target for 2013 to 2015. For 2013 and 2014, forecast showed the decrease to 2.9% and 3.5%, respectively, and a stable 3.6% for the year 2015. With stable global commodity prices, price pressures in the country are expected to be unthreatening as well. Good demand indicators and manageable supply conditions are also anticipated to maintain the current robust domestic economic activity. The following fan chart demonstrates that risks to BSP’s positive outlook on inflation, through careful assessment of price trends and future inflation, appear to be positive as well. The fan chart illustrates the probability of different inflation outcomes and risks based on a central projection. The relatively larger bands above this central projection, the BSP’s baseline forecast, confirms that its position is indeed on the upside.
Relevance:
Inflation affects the hospital in terms of its costs of operation such as wages, repair and maintenance costs, supplies and equipment. Irregular fluctuations or fast increases in prices can cause the hospital’s inability to catch up in its adjustment of prices of services it offers or in its request for additional budget and may also therefore mean higher cost of operations and lesser profits. Low and stable inflation rates in the next few years shall present the hospital with more control in its costs of operations, prices of medical services it offers, and generation of revenues as well. Moreover, low and stable inflation also means more peso for people to spend and thus, increases their capability to pay for health services as well. This, therefore, presents an opportunity for the hospital.
Upward Trend of GDP Growth Rate
The domestic economy accelerated in the third quarter of 2013 by 7.5 percent from 7.3 percent recorded the previous year boosting the 2013 first nine months growth to 7.4 percent from 6.7 percent in 2012[9]. The third quarter growth is the fifth consecutive GDP growth of at least 7.0 percent under the Aquino Administration. This is the result of strong performance in the real estate, renting, and business activities, trade and financial intermediation. This growth is backed up by the Industry sector’s robust growth as well.
It even surpassed the World Banks’s expectation of 6.2% for 2013 and the forecast made by the Economy Watch that shows an expected GDP annual growth rate of 6.3-6.9 percent from 2012 to 2016 and will reach US$ 514 billion by the end of 2016[10].
According to World Bank, shall the country sustain a high GDP of at least 5%, around 2.2 million Filipinos can be provided with good jobs from 2013 to 2016[11]. The following table shows a positive viewpoint for the country’s annual GDP growth rate in the next few years.
Table 4. GDP Annual Growth Rate Forecast 2013-2015[12]
Year
|
GDP Annual Growth Rate
|
2013
|
4.50
|
2014
|
7.25
|
2015
|
7.17
|
Relevance:
An important component of GDP is consumption and government expenditure. The steady growth of economy may mean an increase in private and government expenditure on health. With private consumption as a basic driver of the country’s GDP growth, people could be spending more not only for non-medical items such as food but also for medical services offered in hospitals as well. Government spending for the provision of health services could also be increasing, and thus, may increase the number of Filipinos with health coverage. This has a positive effect on hospitals as continuous and increased spending on health care services would result to the hospital’s improved financial position and consequently improved quality of services.
Migration of Experienced Health Care Professionals
In the global labor market, the Philippines has become a source of a great number of professional workers especially for the first world countries; health workers are not left behind by this migration trend. Nurses comprise the largest number of health workers leaving the country followed by midwives and doctors. In 2010, the Philippine Overseas Employment Agency (POEA) reported a total number of 12,082 nurses and 266 midwives deployed to other countries[13]. Next to India, the Philippines is already the largest source of doctors in hospitals abroad. The country also supplies 25 percent of all overseas nurses worldwide[14] and 83 per cent of foreign nurses in the United States[15]. This loss of skilled manpower in the local health sector is attributed to the country’s deeper issues on employment opportunities and inadequate wages to sustain a decent living. Our professionals continue to leave our country to seek more opportunities for career development and higher living standards.
According to a report of POEA, Nurse Professionals ranked second among the top ten deployed land-based Overseas Filipino Workers by Occupational Categories. From 2008 to 2012, the number of nurse professionals deployed abroad shows an increasing trend. The year 2011 marked the highest number at 17,236 deployed nurses.
Table 5. Number of Deployed Land-based Overseas Filipino Workers by Top Ten
Occupational Categories, 2008-2012[16]
Relevance:
Because the migrating nurses are usually the ones with training, experience and skills, patients in hospitals and other health institutions in the Philippines can expect a higher incidence of cross-infections, adverse events after surgery, accidents, injuries and even increased violence against the staff.
Moreover, with the best among nursing students often leaving as soon as they graduate, the less skilled are taking the place of senior or relatively more experienced nurses who have also left for other shores. In a year or two, they too would be gone. The void would be filled once more by fresh graduates who would repeat the same cycle: get a few years’ experience in a local hospital, apply for work abroad and then leave. It is say many health professionals, a cycle that leaves local hospitals in a state of perpetual displacement—and patients in constant danger. With staff usually composed of trainees, quality of service may deteriorate. This would also contribute to higher costs of operation as hospitals continuously spend for the training of newly hired medical staff. This poses a threat to hospitals.
High Poverty Incidence Among Families
In 2012 full year official poverty statistics report made by the Philippine Statistical System in early December 2013, statistics show that extreme poverty remains at 1.6 million in the previous year[17]. This refers to the subsistence incidence or the proportion of Filipino families under extreme poverty. This is estimated at 7.5 per cent in 2012 with no significant increase since 2009.
Poverty incidence refers to the percentage of poor families to the total number of families in an area. The latest NSCB report shows that the poverty incidence in the country was at 19.7 per cent in 2012, a significant decrease since 1991. This means that about one (1) out of every five (5) Filipino families was poor in that year. Since 2006, with the continuing growing population of the country, no significant changes in poverty incidence were observed. Despite this fact, however, the number of poor families increased to 4.2 million in 2012 from 3.8 million in 2006.
Table 6. Annual Poverty Incidence in the Philippines[18]
Year
|
Poverty Incidence Among Families (%)
|
1991
|
29.7
|
2006
|
21.0
|
2009
|
20.5
|
2012
|
19.7
|
Table 7. Annual Magnitude of Poor Families in the Philippines[19]
Year
|
No. of Poor Families
|
1991
|
3,554,878
|
2006
|
3,809,283
|
2009
|
4,036,915
|
2012
|
4,214,921
|
Relevance:
With the basic needs as the priority of expenditure of families, persistence of poverty incidence in the country could mean lesser spending of people for health or medical services. The increasing number of poor families also means an increasing number of patients for government hospitals whose main thrust is to serve people who belong to poor families. More people will seek medical care from government hospitals that offers medical services subsidized by the National Government. This presents an opportunity for the QMMC to be able to serve more people.
Increasing Philhealth Coverage Through the Implementation of Case Rate System and No Balance Billing Policy
In September 2011, the Philippine Health Insurance Corporation implemented the New Case Rate System that standardized the cost of payment of medical services and surgical procedures. The case rate system assigns fixed rates that Philhealth reimburses for specific cases; thus, members will be able to know just how much Philhealth will be subsidizing for the medical services they have availed of. Moreover, this new system provides faster reimbursement of fees to health care providers such as government hospitals with significant reduction in the processing time of claim documents from 60 days to as fast as 10 days or less. The following table shows the rates for medical cases and surgical procedures in the new system.
Table 8.Medical Case and Surgical Procedures Case Rates[20]
Medical Cases
|
Case Rate in Pesos
|
Dengue I (Dengue fever, DHF grades I & II)
|
8,000
|
Dengue II (DHF grades III & IV)
|
16,000
|
Pneumonia I (moderate risk)
|
15,000
|
Pneumonia II (high risk)
|
32,000
|
Essential Hypertension
|
9,000
|
Cerebral Infarction (CVA-I)
|
28,000
|
Cerebral Hemorrhage (CVA-II)
|
38,000
|
Acute Gastroenteritis (AGE)
|
6,000
|
Asthma
|
9,000
|
Typhoid Fever
|
14,000
|
Newborn Care Package in Hospitals and Lying in Clinics
|
1,750
|
Surgical Procedures
| |
Radiotherapy
|
3,000
|
Hemodialysis
|
4,000
|
Maternity Care Package (MCP)
|
8,000
|
NSD Package in Level I Hospitals
|
8,000
|
NSD Package in Levels 2 to 4 Hospitals
|
6,500
|
Caesarean Section
|
19,000
|
Appendectomy
|
24,000
|
Cholecystectomy
|
31,000
|
Dilatation and Curettage
|
11,000
|
Thyroidectomy
|
31,000
|
Herniorrhaphy
|
21,000
|
Mastectomy
|
22,000
|
Hysterectomy
|
30,000
|
Cataract Surgery
|
16,000
|
The “No Balance Billing (NBB) Policy” is another benefit for sponsored members who are admitted in government hospitals. Philhealth’s insurance coverage includes expenditures as per the benefits schedule up to a limit. Shall a patient-member exceed the ceiling; he or she shall cover for the additional costs. Under the NBB policy, however, the patient-member will not be charged with any fees or expenses beyond the stated package rate thereby providing financial risk protection to Filipinos especially those from poor families.
NSCB Statistics also show that between 2000 and 2008, the number of Philhealth beneficiaries, comprising of members and their dependents, have significantly increased from 29,597 in 2000 to 68,869 in 2008. This increasing number of beneficiaries is reflected in the upward trend of NHIP coverage rate in the country from only 38.5% to 76.2% of the total Philippine Population in 2008.
Table 9. Number of active Philhealth Beneficiaries (Members & Dependents)[21]
Year
|
Total NHIP Beneficaries in Thousands
|
2000
|
29,597
|
2001
|
36,744
|
2002
|
43,565
|
2003
|
42,401
|
2004
|
69,506
|
2005
|
54,599
|
2006
|
68,403
|
2007
|
64,467
|
2008
|
68,669
|
2009
|
81,178
|
2010
|
69,984
|
2011
|
78,386
|
2012
|
77,669*
|
Relevance:
The upward trend of Philhealth coverage among Filipinos and Philhealth’s target of 100% will positively change the behavior of people towards seeking for medical services. As people get well-informed of the benefits they could get from being a Philhealth member, more Filipinos especially the poor will take advantage of its utilization. This is further enhanced by the implementation of the case rate system and the no balance billing policy that allows people to estimate the amount that Philhealth shall cover for the medical expenses provided to them, thereby protecting them from financial risks. More people seeking medical services and availing Philhealth benefits means more patients for government hospitals like the QMMC; thus, an opportunity for the hospital as well.
Increasing Gov’t Budget Appropriation for the Department of Health (DOH)
Annually, the DOH Budget is developed initially with the Department of Budget Management’s (DBM) issuance of the budget call during the first quarter of the year. The DBM sets budget ceilings based on the availability of funds in the treasury and its estimated income for the year. The DOH, then, together with all other line agencies formulates their budget for the year based on the issued ceilings. The line agencies’ proposals will then be consolidated into a National Expenditure Program (NEP) and converted into a General Appropriations Bill that will undergo a deliberation by both the House of Representatives and the Senate. The budget appropriated for DOH has significantly increased for the past five years from P18 billion in 2008 to P50 billion in 2013. This is even expected to increase as the proposed budget for 2014 is at P80 billion indicated in the 2014 NEP[22].
Table 10. Department of Health Annual Approriations[23]
Year
|
Annual Appropriation in Peso
|
2008
|
18,912,010,000
|
2009
|
23,666,655,000
|
2010
|
24,649,765,000
|
2011
|
31,828,616,000
|
2012
|
42,155,963,000
|
2013
|
50,442,299,000
|
2014
|
80,171,300,000*
|
Note: *Proposed DOH budget for 2014
The increasing trend of government budget for DOH means more resources for government hospitals. Greater resources will mean more and better health services to be offered for the people. Greater subsidy received from the government will allow for more capital spending on equipment and other facilities, and therefore, better quality of services. It is, thus, necessary that the DOH is able to maximize the spending of available resources provided for by the National Government.
Technological
Implementation of Health Facilities Enhancement Program (HFEP)
The Health Facilities Enhancement Program (HFEP) is one of the banner programs of the Aquino Administration. Its main goal is to improve basic and specialized health services providing trainings for health professionals and upgrading health facilities, thereby providing better quality health care[24]. Primary health care facilities will be strengthened to become more responsive to the needs of the communities in their respective areas and be able to provide Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency and Newborn Care (CEmONC) services.
In 2007, the program started to receive a separate line budget item with P10 million allotted for Capital Outlay (CO) with continual significant increases. The CO budget increased from P1.6 billion to P3.2 billion in 2010 and even reached P7 billion in 2011[25]. Moreover, its budget for DOH hospitals alone was at P6.6 billion for the year 2013[26].
Relevance:
The HFEP, with its thrust to upgrade health care facilities such as Barangay Health Stations (BHSs) and Regional Health Units (RHUs) including government hospitals nation-wide, will be able to enhance the country’s health facility network. Expansion of services could be achieved in tertiary hospitals enabling them to achieve higher quality level of service delivery. This program, therefore, presents an opportunity.
The Growing Trend of IT in Health Industry
Globally, the application of Information and Communications Technology in the operations of health institutions has been the norm in the more developed countries for more than 2 decades. Hospital operations are supported in terms of health record systems management, inventory management, and accounting and financial management and inter-operational communications. Over the years, this trend has made available useful technologies for the health industry such as electronic health record software (EHR), personal health gadgets, telemedicine, clinical and billing software, health information exchange, and cloud services[27].
IT innovations will also improve population health management through which chronic conditions in patients in a hospital may be determined and related readmissions may be reduced thereby leading to cost savings and improved services for both patients and health care providers.
Social/Cultural
Increasing Population
According to the projections made by the NSO, the population will continue to increase and will reach around 141 million by the year 2014 at growth rate of 0.92%. This projection shows that 65 million people would be added to the Philippine population from 2000 to 2040, on the account that there will be a significant decrease in the average annual growth rate to 1% in 2030 to 2040 from 2.34% in 1990 to 2000.
Table 11. Summary of Projected Philippine Population, by Five Year Interval: 2000-2040[30]
Year
|
Projected Philippine Population
| ||
2000
|
76,946,500
| ||
2005
|
85,261,000
| ||
2010
|
94,013,200
| ||
2015
|
102,965,300
| ||
2020
|
111,784,600
| ||
2025
|
| ||
2030
|
128,110,000
| ||
2035
|
135,301,100
| ||
2040
|
|
Relevance:
The increasing trend of Philippine population presents an opportunity for the hospital industry. The increasing population means more people will be needing medical or health services from health care providers such as government hospitals. Since the main thrust of government hospitals like the QMMC is to deliver medical services to the people, more Filipinos will be served and therefore utilization of such institutions is maximized.
Health Seeking Behavior of Adolescents in the Philippines
Of the total population of the Philippines, it is estimated that around 20% is comprised of adolescents[31]. In 2010, young people aged 10 to 24 years old accounts for an estimated 30.5% of the said total.
Table 12. Number and Percentage of Young People by Age and Sex, Philippines 2010
Year
|
Total Number
|
% of Total Population
|
10-14
|
10,168,219
|
11.0
|
15-19
|
9,676,359
|
10.5
|
20-24
|
8,370,398
|
10.0
|
Total
|
28,214,976
|
30.5
|
On the account of the total Philippine population, the number of young people in 2010 showed an increase since 2000. Its size, however, had slightly declined from 31.3% in the 2000 census[32]. This proportion to the total population is expected to further decrease by the year 2025 to 27% with a total of approximately 32 million[33].
On the health seeking behaviour of adolescents in the country, latest report of the World Health Organization about the Philippines indicate that adolescents and young people are likely to care less in seeking medical or health care. This is due to the fact that they have already surpassed childhood diseases and are not yet affected by the health problems that usually occur among the older population[34]. According to the 2008 National Demographic and Health Survey in the Philippines, young people who seek primary care visited RHUs and BHSs more than other types of health facilities due to illness and injury and medical check up, the top two reasons of visits at 67.6% and 28.1%, respectively[35]. The study also showed that those surveyed mentioned at least one problem in accessing health care with lack of money as the top reason at 56.8% among 15 to 19 year old women. This is further supported by a survey conducted on health living of Filipinos by a large independent life insurance group. Results of the survey show that among the Filipino adults who were surveyed, only 53% have had a medical check up in the past 12 months. Moreover, according to the same study, their decision to visit health care providers was mainly influenced by the price of health care services that are perceived to be expensive[36].
If this trend will continue to increase in the future, diseases among this age group may not be detected and treated early and therefore lead to increases in the incidence of such diseases in the latter years. The following restrictions to the use of health services were also identified: lack of financial resources to pay for medicines and medical fees, lack of information on availment process of health benefits offered by the government and perception of poor quality of health services in the country[37].
Environmental
Persistence of Climate Change causing Increased Incidence of Diseases
It is undeniable that the weather and climate affect our health as changes in weather/climate factors such as temperature, precipitation patterns and weather conditions could increase and spread diseases especially the climate-sensitive ones[38]. Higher temperature not only increases mortality rates but also leads to higher levels of air and water pollutants that are dangerous to human health. In a report made by an environmentally concerned organization, global temperature is expected to increase to 4.9 degrees Celsius by the year 2100 if no action (business as usual) is taken to reduce greenhouse gas emissions as shown in the graph below[39]. Moreover, climate change leads to the occurrence of frequent extreme weather conditions such as stronger typhoons that poses threats to people with flash floods, extremely high winds and landslides among others.
Factors of climate have an impact on human health because these are critical determinants of various diseases. Climate change could affect transmitters of diseases through food, water and even animals. Because bacteria grow more rapidly in higher air temperatures, this could lead to higher incidence of food-borne diseases such as salmonella and bacteria-related food poisoning. With frequent heavy rainfall or flooding, contamination of water bodies with bacteria can causes disease such as gastroenteritis and infections.The effects of climate change also increase the incidence of diseases such as Dengue, Malaria and even Leptospirosis transmitted by mosquitoes that thrive in stagnant waters and rats whose feces may contain pathogens.[40] Increasing incidence of diseases also means an increase in the number of patients in hospitals; thus, providing an opportunity for hospitals to serve greater number of patients.
A. Positive and Negative Aspects
Positive Aspects
1. Economic Growth – This means more people can afford healthcare, more taxes paid and more revenues for the government for its health programs, health infrastructure and staffing pattern increase. This also spells additional funds for medical research and development.
2. National Health Insurance Program (NHIP) – Philhealth is nearing its 100% coverage. That means the No Balance Billing for the greater percentage of Filipinos
3. Technology – The widening use of Electronic Medical Records (EMR), Telehealth and new generation equipment in hospitals and healthcare centers lead to efficient healthcare delivery and healthcare operations. Telemedicine offers wider dissemination of information and diagnosis and treatments for patients particularly in far-flung areas.
Negative Aspects
1. Climate Change – Climate Change leads to the increase of diseases that are not endemic in other areas before such as Dengue and other water-borne diseases.
2. Population Growth – The increase in population strains the healthcare infrastructure of the government in meeting the healthcare demand of the people. Also, population pressure leads to a higher population density wherein poor areas are the most vulnerable to diseases that are easily spread due to proximity. Also, these areas are the most prone to climate change related diseases.
[1]Philippine Peso.Trading Economics.http://www.tradingeconomics.com/philippines/currency. Accessed on December 22, 2013.
[2] Peso Per US Dollar Rate. BangkoSentral ng Pilipinas.http://www.bsp.gov.ph/statistics/spei_pub/Table%2024.pdf. Accessed on December 27, 2013.
[3]Montecillo, Paolo.Peso seen appreciating to 40 to $1 in 2014. The Philippine Inquirer.October 10,2013.
[4]Montecillo, Paolo.Peso seen to strengthen against US Dollar. Philippine Inquirer.December 22,2013
[5]Central Bank Rates.http://www.cbrates.com/ Accessed on December 27, 2013.
[6]Inflation Report Third Quarter: 2013.Bangko Central ng Pilipinas.www.bsp.gov.ph.
[7]Philippines Economic Forecast. 2013-2015 Outlook. Trading Economics.http://www.tradingeconomics.com/philippines/forecast. Accessed on December 27, 2013.
[8]Inflation Report Third Quarter: 2013.Bangko Central ng Pilipinas.www.bsp.gov.ph.
[9]Source: National Statistical Coordination Board. 2013: Philippine Economy Posts 7.0 % GDP Growth in Q3 2013. http://www.nscb.gov.ph/sna/. Accessed on December 28, 2013.
[10]Philippines Economic Forecast.http://www.economywatch.com/world_economy/philippines/economic-forecast.html. Accessed on December 28, 2013.
[11]The World Bank.Philippine Economic Update. May 2013
[12]Philippines Economic Forecast. 2013-2015 Outlook. Trading Economics.http://www.tradingeconomics.com/philippines/forecast. Accessed on December 27, 2013.
[13] POEA: OFW Deployment by Occupation, Country and Sex – New Hires Full Year 2010. http://www.poea.gov.ph/stats/2010%20Deployment%20by%20Occupation,%20Destination%20and%20Sex%202010%20-%20New%20hires.pdf
[14]Matsuno, Ayaka. Nurse Migration: the Asian Perspective. International Labor Organization.http://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/documents/publication/wcms_160629.pdf. Accessed on December 29, 2013.
[15]NCLEX in Manila open by mid-year.The Philippine STAR. 12 February 2007.
[16]Philippine Overseas Employment Administration.2008-2012 Overseas Employment Statistics.http://www.poea.gov.ph/stats/2012_stats.pdf. Accessed on December 29, 2013.
[17]National Statistical Coordination Board.Poverty Statistics-Press Relaease.http://www.nscb.gov.ph/pressreleases/2013/NSCB-PR-20131213_povertypress.asp. December 9, 2013. Accessed on December 31, 2013.
[18]National Statistical Coordination Board.Poverty Statistics. December 9, 2013. Accessed on December 31, 2013
[19]National Statistical Coordination Board.Poverty Statistics. December 9, 2013. Accessed on December 31, 2013
[20]Philippine Health Insurance Corporation. Special Benefit Packages:Case Rates. http://www.philhealth.gov.ph/members/special_package/case_rates.htm. Accessed on December 31, 2013.
[21]National Statistical Coordination Board.Philippine National Health Accounts.
[22]Department of Budget Management.National Expenditure Program 2014.
[23]Department of Budget Management.General Appropriations Act 2008-2013.
[24]DOH Department Order no. 2008-0162 entitled, “Guidelines and Procedures for the Implementation of the Government Hospital Upgrading Project under the CY2008 Health Facilities Enhancement Program Funds of the DOH” dated 7 July 2008.
[25]Improvement of the Implementation Procedures and Management Systems for Health Facilities Enhancement Grant of the DOH
[26]Health Facilities Enhancement Program.Department of Health.www.doh.gov.ph. Accessed on November 24, 2013.
[27]CIO.13 Healthcare and IT Trends and Predictions in 2013.http://www.cio.com/slideshow/detail/83055#slide13. Accessed on December 29, 2013.
[28]National Statistics Office.www.nso.gov.ph.
[29]World Population Review.The Philippine Population 2013.http://worldpopulationreview.com/countries/the-philippines-population/. Accessed on January 2, 2014.
[30]National Statistics Office.Population Projections.www.nso.gov.ph
[31]United Nations Statistics Division.Demographic Yearbook 2008.
[32]National Statistics Office.Philippine Census 2000 and 2010.
[33]Inter-Agency Working Group on Population Projections. Republic of the Philippines: National Statistics Office. www.bles.dole.gov.ph/2009%2520Publications/2009%2520YLS/statistical%2520tables/Chapter%252001/TAB1-3.PDF. Accessed on October 5, 2012.
[34]World Health Organization.Health of Adolescents in the Philippines.http://www.wpro.who.int/topics/adolescent_health/philippines_fs.pdf. Accessed on January 2, 2014.
[35]Philippines National Demographic and Health Survey 2008.
[36]Philam Life Insurance. AIA's Healthy Living Index Survey Uncovers: Filipinos Very Concerned About Modern Day Health Hazards Such as Pollution, Obesity and Food Safety. Media Release dated November 8, 2013.
[37]Cetrangolo, Oscar. Health Care In the Philippines: Challenges and Ways Forward. Friedrich Ebert Stiftung 2013.
[38] United States Environmental Protection Agency. Human Health.http://www.epa.gov/climatechange/impacts-adaptation/health.html. Accessed on January 2, 2014.
[39]Climate Interactive.Climate Scoreboard.http://climateinteractive.org/scoreboard. Accessed on January 2, 2014.
[40] United States Environmental Protection Agency. Human Health.http://www.epa.gov/climatechange/impacts-adaptation/health.html. Accessed on January 2, 2014.
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