IS IT POSSIBLE TO STANDARDIZE PROFESSIONAL DOCTOR’S FEES IN THE PHILIPPINES?

 IS IT POSSIBLE TO STANDARDIZE PROFESSIONAL DOCTOR’S FEES IN THE PHILIPPINES?

The debate over whether professional doctor’s fees (PFs) should be standardized is no longer theoretical. With the push toward universal health care, the Philippines is now asking a difficult but necessary question: can predictable pricing make healthcare more accessible—especially for the poor—without discouraging doctors from practicing locally?

Many countries have already experimented with some form of standardized or negotiated medical fees. In Japan, the government maintains one of the world’s strictest national fee schedules, setting a uniform price for virtually every medical service nationwide. In France and Germany, physician fees are negotiated between medical associations and national insurance systems, creating predictable price ranges for most patients. Meanwhile, Australia and Canada use reimbursement-based systems in which the government establishes a standard fee, although some flexibility exists depending on insurance arrangements.

These international examples show that standardization is technically feasible, but they also reveal the trade-offs.

Possible Advantages

First, standardized fees promote affordability and transparency. Patients would know in advance how much a consultation or procedure costs, reducing the “bill shock” that often discourages people from seeking early medical care. This is particularly important for low-income families who delay treatment because they fear unpredictable expenses.

Second, standardization strengthens national insurance programs. If fees fall within predictable ranges, agencies such as PhilHealth can reimburse services more accurately, helping achieve the long-term objective of universal health coverage.

Third, fee ranges could reduce extreme variations in charges between hospitals, specialties, and regions, making healthcare planning easier for both government and patients.

Possible Disadvantages

On the other hand, many physicians argue that strict price controls may not fully reflect the years of training, specialization, malpractice risk, and operational costs associated with medical practice. If fees are set too low, some doctors may move abroad or shift to specialties where compensation remains higher, worsening the country’s existing physician shortage.

Another concern is that rigid pricing could unintentionally encourage “volume-based” consultations, where doctors see more patients in less time just to maintain income levels. This might affect the quality of patient interaction if not carefully managed.

Finally, private practitioners—many of whom operate as independent contractors—may view mandatory caps as interference in professional autonomy.

A Middle-Ground Approach

Rather than immediate nationwide implementation, pilot studies could be conducted in selected government hospitals or specific cities. These pilot programs could test tiered fee schedules based on specialization, experience, and regional cost of living. Agencies such as the Department of Health, working with the Philippine Medical Association, could jointly evaluate the impact on patient affordability, physician income stability, and service quality.

If the results are positive, gradual expansion could follow, possibly beginning with publicly funded facilities where standardization already partially exists through case-rate reimbursements.

The Bottom Line

Standardizing professional doctor’s fees is not a simple “yes-or-no” reform; it is a balancing act between fairness to patients and fairness to physicians. The central objective should remain clear: a system that protects the poor, ensures sustainability for healthcare professionals, and advances universal health care. Carefully designed pilot programs, transparent negotiations, and periodic fee adjustments may offer a practical path forward—one that improves access without undermining the medical workforce.

RAMON IKE V. SENERES

www.facebook.com/ike.seneres iseneres@yahoo.com senseneres.blogspot.com 09088877282/04-14-2027

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