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The average Filipina doesn’t engage in much preventative care.  When they get sick they go to a doctor if they can afford it and usually at the last minute. The upper income class does engage in preventative care similar to what might happen in the west. Programs such as Phil Health are available but appear to mainly cover hospital visits inpatient stays and surgery.  There are plenty of good healthcare options for expats in the bigger cities, not so much in the province.  I have used the ER (Chong Hua) in Cebu City on several occasions and was very satisfied. I used a small hospital ER on one occasion in Argao  (province) for a minor issue and was satisfied.  There are several quality healthcare plans for expats above and beyond what Phil Health offers.  In the Philippines the quality of healthcare is directly related to what you can afford to pay 

I agree with what Morgacj said. Most Filipinos do not avail themselves of preventative healthcare, mostly for financial reasons, as incomes are predominantly low compared to the west. And it is not a priority in their culture, where the same money could be spent on a lechon for all to enjoy. In my experience they wait too long for both health care and dental care. My partner lost two brothers to cancer - it was discovered too late. And I have sent nieces and nephews to the dentist that had never had a checkup, at age 15. Needless to say there were plenty of cavities.

In their traditional agrarian culture this might not have been a problem, but the amount of sugar now being consumed by Filipinos is staggering, so it has become a problem. As has diabetes, which affects 25% of the population (diabetes or pre-diabetes) due to the poor diets among those living in the cities mostly. White rice, white bread, snacks, and lots of pre-packaged foods are very bad for health, yet it comprises a large part of the diet.

I pay as I go when in the Philippines and doctors are inexpensive for the most part, maybe $10-15 for an office visit, but you have to wait in line, as appointments are generally not taken. At Chong Hua or Cebu Doctors Hospital in Cebu that might well take most of a day. We have found the quality of doctors to be hit or miss - some are knowledgeable and honest, a couple we have encountered were not. Anything serious and I would fly back to the States for treatment, or go to Malaysia or Thailand where care is better.

Hospitals generally require payment up front, which is often difficult for locals. We once bought a downed Narra tree from a local guy in the province who needed money for his child's hospitalization. We gave him more than he was asking so he had enough, and had it made into a piece of furniture. And we sometimes help the feisty older lady living nearby pay for her medicine, but we know that she keeps an eye on our house when we're away. This is how things work in the Philippines.

I have read that private hospitals are the best. And you need good health insurance.

Tbloom12 said. . . . I have read that private hospitals are the best. And you need good health insurance.

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My wife was hospitalized three times at Saint Lukes. About $27K including surgery. Ouch out of pocket.

@pnwcyclist

At Chong Hua or Cebu Doctors Hospital in Cebu that might well take most of a day.

The 2 doctors I routinely visit at Chong Hua are listed on the "Now Serving" App and that is how I schedule my appointments. It does not take a day; usually I get seen within an hour of the Now Serving scheduled time. You can also try to call the doctor's secretary by phone or messenger for a time slot but good luck with that. Yes, that could take all day. I pay more like $17.00, not $10.00.

I have read that private hospitals are the best. And you need good health insurance. - @Tbloom12

True, virtually everywhere in the world, so...?

Agree Dan but we are self funded apart from PhilHealth and feel private health insurance like all insurance is mostly a waste of money. I recently saw my Neuro surgeon in our private hospital and her bill was P500 and a few days later the attending doctor while I was in hospital for a lengthy consultation and his bill was P550.

2 days and nights in a private room with a multitude of tests from CT scans to ultrasounds, bloods, all their medications etc. was P 40K.

Thing is it seems to be a great private hospital offering all services and only 25 minutes drive.

Yes we make a booking with the secretary a few days before and normally 1st cab off the rank but always get there half an hour early. I have no complaints with the system here and the surprising thing was the spare bed for my partner labeled as my carer in the room.

Just as happy here as I was in Australia,,,,,, perhaps more so here.

Cheers, Steve. 

@bigpearl

Agree Dan but we are self funded apart from PhilHealth and feel private health insurance like all insurance is mostly a waste of money.

Exactly the same here and we also think the private  insurance here is a waste of money. Many insurance clients apparently do not 1) consider their coverage limits vs premiums paid and 2) do not know that after a certain age (like 65) the insurance company only reimburses the patient, not the hospital, meaning you must pay in cash or use your credit card to be released. So we are self-funded as well. We also quit phil health because as SRRV expats, we were charged 15000 each per year but the one time we used it in 7 years, they only reimbursed about 10000 pesos out of a 150000 peso bill. That is far less than the 20% discount we thought phil health would typically pay. I believe phil health is largely subsidized by foreigners (informal economy) who pay 15000 ot 17000 annual premium and receive much less coverage than regular citizens here, for example, no Z benefits for foreigners. I am fully understanding of the poverty in the Philippines but I decided not to continue to help subsidizing the national health plan. If your phil health is based on a citizen's  plan (formal economy) then of course premiums are very cheap and the PH discount is probably worth it. Also, it is said that PH will get you into the hospital in an emergency if you don't have cash on hand. BS. That may only be true for government hospitals, most of which you would never decide to enter.  In my case, the private hospital never asked to see a PH card, they just wanted you to pay a deposit and a credit card will get you admitted. I doubt that a PH card by itself will get you admitted to Chong Hua in Cebu for example. So based on our experience, PH is useless but I am not surprized if others may have better experiences.

Sorry you had a bad experience with PH Dan and so far not my experience, the rebate on your hospital bill sounds ridiculously low and can't blame you for pulling out of that system but for me my 2 days and nights in hospital and heaps of tests, heart, liver, brain, ultrasounds and blood tests, very accommodating and caring nurses,,,,,, usually 3 to 4 of them every 4 hours and the crappy hospital food, a bed for the better half was all simply showing my PH. card and no deposits or credit cards. At the end the bill was around P60K and after PH. ended at P40K. My P17K was wisely spent and if I have to be re admitted then a bigger saving.

For the better half it's about P6K and we also pay our live in workers PH. another 6K........ chicken sh1t if you need help.

Private health insurance is a rip off and like all insurance companies are there for the profits for the share holders.

So far Dan My experience with PH. has been more than good and we will continue to contribute. The money is sitting there for major events, I and the better half can access the funds if needed instead of pissing the money into lame health insurance companies and earning 5% interest instead.

Choices.

Cheers, Steve.

The best preventive care is taking responsibility for your own health.  Nearly all chronic diseases are preventable and many if not most are reversible.  Take diabetes for example.  Eliminating carbs, processed foods and seed oils from the diet will reverse it.  This is a proven fact, but don't ask your doctor, their livelihood relies on the patient being sick.

One thing I noticed pretty quickly is the number of overweight Filipinos there are now compared to 20 years ago.  The contrast is staggering. (The same applies in the US by the way). It's all about the diet. Another thing I noticed is that it is nearly impossible to get lard or tallow in a store.  Lots and lots of seed oils in which everything is cooked but nothing healthy.  I ended up making my own tallow.

My advice on preventive car:

1. Do not eat highly processed food (anything with more than 3 ingredients).
2. Do not eat or cook with seed oils.
3. Do not eat any carbs if you have any chronic conditions and only sparingly if you are 100% healthy.
4. Stay away from the pharmaceutical/industrial complex.  One prescribed medicine inevitably leads to more.  Nearly all conditions can be treated with lifestyle changes.
5. Exercise, especially high impact stuff light weight lifting.  This is especially important as we get older.

@kjwilde

One thing I noticed pretty quickly is the number of overweight Filipinos there are now compared to 20 years ago.

Copy that KJ. I first arrived in the country in 2001. Most were like bean poles then. Given their short stature ( they are the shortest Asians of all ) this compounds the redistribution of fat in the body.

A ticking time bomb given that the Philippines has one of the youngest age demographics in Asia.

I am very happy with MaxiCare. Although it is not specifically preventive, your membership makes available enough tests so that you can see how you're doing. You can walk in anytime you want, as often as your hypochondria drives you there; you may have to wait to see a doctor if it's busy (as it often is)--but what else is new in the Phils....

At ~16,000 pesos a year, it is an incredible bargain IMHO--unlimited visits and testing (they list 880 diagnostics, including various ultrasound, blood, ECG, X-ray, etc.) that your doctor can specify for you if you ask. I got a comprehensive check-up upon joining--at least as good as in the US.  Specialists are available periodically (ENT, ophthalmologist, dermatologist, etc).

There are clinics all over the PI.

@bigpearl

So far Dan My experience with PH. has been more than good and we will continue to contribute. The money is sitting there for major events, I and the better half can access the funds if needed instead of pissing the money into lame health insurance companies and earning 5% interest instead.

I have heard similar sentiments from other people who usually say that PH gives approximately a 20-25% discount at private hospitals and in your case it was even more while mine was about 7.5%. In my case it could be that some of my treatment showed dates of greater than 24 hours of our helper making the claim. They apparently said that PH claims are forfeited if you inform them more than 24 hours after treatment. I am not sure about that. That is second-hand information. PH never informed us of such a rule. But if you or your partner registered with PH at the time of admission, that could explsin the disparity.. Still, even 30% or 45000 pesos payback is close to the premiums not being worth it in our case. Real "insurance" should cover a lot more. The principle of charging informal economy members 10x more in premiums with no catastrophic Z benefits while local members are covered for catastrophic care (Z benefits) is actually a bit offensive. I am convinced they get away with that because most expats just pay into the program and don't investigate and are not aware  how they are being screwed. But I do understand you are doing well with PH. Also, many expats who are married used to get spousal coverage under their citizen spouse, which is a fraction of expat premiums. I am not sure if cheap spousal coverage like that exists today..

Unmarried expats in the informal economy are paying 15K (SRRV) or 17K, subsidizing spousal expats married to citizens as well 😆. In my case I am married to a former citizen and we are here on SRRV and we paid 15K each.

As for the extra hospital bed. I had that too in Dumaguete. I think that is how they do it in the Phils. It is because you are expected to have a spouse/partner or other paid person or family membet with you to help you with basic needs, for example, going out and getting your prescriptions filled or even getting extra food, snacks, toiletries, maybe clean clothes and the like. Somebody may need to find a nurse for you at night while you are not being monitored. In the USA, nobody was ever even allowed to stay in your room past visiting hours but here you are expected to have someone with you and they always provide a small bed for that person. However, things in the USA may be changing. Last month, when I was using my USA plan, my hospital in NC also had a bed for one overnight stayer. It was a newer state of the art hospital and my wife stayed there. Very convenient.

And as mentioned, we don't bother with health insurance here, no offense to agents here who may make a living selling it.

@kjwilde

The best preventive care is taking responsibility for your own health.  Nearly all chronic diseases are preventable a. ....

Well, at least that seems to be the conventional wisdom. But then again, there are several heart problems due to calcification (not the same as plaque from LDL). You can "take responsibility" all you want but you are not going to stop many heat diseases such as aortic stenosis fron calcium build-up (very commonplace) by exercise and diet. When it happens you need a new heart valve or face a bad prognosis. The same goes for many types of cancer. I hate to say this but in terms of my own personal experience, I see little difference in lifetimes between those who became vegetarians and those who eat traditional western meals, between those who exercise and those who didn't. Richard Simmons, younger than me, died a few months ago as just one notable example.

Yes Dan around a 30% discount on the hospital bill for my first ever stay in a hospital here, yes my annual fee is P 17K while the better half and our worker here we pay P 6K each. To me it's very cheap insurance providing you are admitted and then the 20 or in our case 30% comes off the bill before you exit the hospital, no additional paperwork that I saw for PH, the hospital did all that and it was easy. Yes the spare bed for the "care giver" is very alien to western norms but maybe that was because we had a private room? Was nice to have the better half there to slap me as required. The TV sucks as the 15 or 16 channels are all Tagalog. As for nurses 3 to 4 of them would come into the room to check my vitals and give me pills to swallow but very attentive every 3 to 4 hours, as said no complaints but who want's to be in hospital,,,,,,, last choice but there when needed.

Private health insurance is a rip off, learnt that long ago in Australia. Definitely not treading that path here.

Just from my perspective Dan PH gets you into hospital instead of dying in a gutter, the care I received was equivalent to having private hospital cover in Oz.

Cheers, Steve.   

@bigpearl

I just wanted to comment on:

Just from my perspective Dan PH gets you into hospital instead of dying in a gutter,..

I have never tested that nor known any expat who has. However, I highly suspect that if I were to try that at any private hospital in Dumaguete, they would turn me back and send me to the government hospital  NOPH. I think there is no law mandating private hospitals to let you in on a PH card. Most likely, government hospitals must let you in and in some cases, even charge you only would PH will pay out (causing PH to be true insurance). Do you know where it's stated that any hospital must let you in -with your PH?

I am sure you will agree that being admitted to a government hospital here is a fate worse than one's ailment.

What I do know is that private hospitals here do let you in on the basis of your cash on hand or more likely, your foreign (higher limit) credit card with a deposit charged to it.

But FWW I too have heard it stated that the hospitals must let you in with your PH discount card. The question is, "which" hospitals are mandated to admit you on that basis?

Very true Dan and I've never tested that either so just an assumption. As for a deposit to be admitted that was never asked for but maybe because the better half's sister and niece are both nurses there and they booked me in, who knows.

Yes as for the "Z" coverage I was well aware of that and keep AU 50K in an investment account if the need arises. The better half and our worker at P 6K each is well worth it.

As for coverage and I did post on this some time ago. We lost Bens mother and almost father with C 19 a couple of years ago sadly, She and he are both senior citizens so get free PH. She was in Hospital for over 5 weeks and the last 2 weeks in ICU, he was there for over 2 weeks and eventually discharged.

The bill was over P 1.6M and after PH and rebates was around P 1M.

Ben forked out P 700K of his own money to help, there were some Barangay/Municipal and government grants and the balance of a bit over P 150K was paid by the family over a 2 year period to the hospital.

We won't get into why I never helped as that might stir up a hornets nest.

For me Dan I don't mind paying PH as a public system. In Australia the fees for Medicare again a public system are tax based and used to be 1.5% of your taxable income,,,,,, that used to add up to thousands of dollars annually for us as well as about AU 7K for private hospital cover........ almost 6 years living here and no Aussie medical insurance has saved us maybe AU 50K,,,,, no waste.

Anyway we all have choices and find what suits our needs.

Cheers, Steve.