Senior Health

In support of the RA 9257 (The Expanded Senior Citizens Act of 2003) and the RA 9994 (Expanded Senior Citizen Act of 2010), the Department of Health issued Administrative Orders for health implementors to undertake and promote the health and wellness of senior citizens as well as to alleviate the conditions of older persons who are encountering degenerative diseases.

With the goal of Health and Wellness Program for Senior Citizen of promoting quality of life among older persons and contribute to the nation building, the HWPSC intends to provide the following:

• focused service delivery packages and integrated continuum of quality care,
• patient-centered and environment standard to ensure safety and accessibility for senior citizens,
• equitable health financing,
• capacitated health providers in the implementation of health programs for senior citizens,
• data base management, and
• strengthened coordination and collaboration with other stakeholders involved in the implementation of programs for senior citizens.

In the current Philippine Health Agenda (2017 - 2022), guarantees that centralize health services for care in all life stages, service delivery networks, and financial risk protection, geriatric health is mentioned as an area of concern. All senior citizens are mandatory covered by the Philippine Health Insurance Corporation by virtue of Republic Act No. 10642 “An act granting mandatory national health insurance program of PhilHealth for all senior citizens”.

Licenced Health facilities in Makati City.

Financing elderly health care.

In December 2015 the World Bank reported that the East Asia and Pacific (EAP) region—home to some 211 million elderly or one-third of the world’s population aged 65 years and above—is aging faster than any other region in the world today.

Such rapid aging is unprecedented. It took France 115 years to transition from a “young” to an “old” society—a point where seniors comprised at least 14 percent of the population. The United States took 69 years; the Russian Federation, 50; and the United Kingdom, 45.

In contrast, the World Bank estimates this transition will only take 15 years in Vietnam; 20 in Lao PDR, Malaysia and Indonesia; and 25 in Timor Leste, Mongolia, Myanmar and Cambodia. Only the Philippines (30 years) and Papua New Guinea (40 years)—with their comparatively younger populations—appear to be taking slightly longer.

Societal aging at this fast rate poses significant risks to an economy’s public finances and health-care system, especially when aging is associated with increased morbidity and risks for noncommunicable diseases (NCDs), like dementia and diabetes.

A recent report by the Asia, Pacific Risk Center (APRC) estimated that 14 Asia-Pacific economies—Japan, Hong Kong, Australia, New Zealand, Singapore, South Korea, Taiwan, China, Thailand, Vietnam, Malaysia, India, Indonesia and the Philippines—will incur a cumulative $20 trillion in elderly health-care expenditures between 2015 and 2030.

That amount is equivalent to the combined 2015 GDP of the 14 economies and represents half of the group’s projected health-care expenditures for the said period. It points to a gargantuan challenge, especially when the APRC projected that annual elderly health-care costs will grow five times as much as they were last year in just 15 years—from $500 billion in 2015 to $2.5 trillion in 2030.

These spiraling costs will test the capacity of governments to fund and implement their elderly health-care and social-pension programs. They also demand that enough investments are poured into building the necessary infrastructure, like hospitals and nursing homes; and training the needed human capital, like caregivers, doctors and gerontologists.

If governments are unable to collect adequate taxes, roll out cost-effective programs and manage the changes brought by an aging population, they run the risk of falling into fiscal crises and social instability. Efforts to sustain any long-term economic growth and development would be severely hampered.

To be sure, the burden of the spiraling health-care costs will not be carried equally by the 14 economies the APRC studied. In fact, the Philippines—in the midst of reaping a demographic dividend—will experience the full cost of an aging population much later than its counterparts in the study.

This does not mean, however, the country can dilly-dally. A 2015 University of the Philippines Population Institute study projected the country’s senior-citizen population would balloon from 6.2 million, or 6.8 percent, of the population in 2010 to 12 million, or 10 percent, of the population in 2025. This aging boom may coincide with an equally significant spike in health-care expenditures.

Urgent action is, indeed, needed, considering that the Coalition of Services for the Elderly recently estimated that more than half of Filipino senior citizens receive no pension at all. Or that, in a 2015 Global Aging Institute and Pru Life UK survey, 9 out of 10 Filipino workers interviewed said they were anxious about being poor in their retirement, as they struggle with little savings and almost no government support.

The first week of October marks Elderly Filipino Week—an annual nationwide celebration that emphasizes the important role the elderly play in Philippine society. A more long-lasting tribute would be to start discussing and acting on our national policies on aging. And we must do so urgently, given the prohibitive costs we may incur.

Situation of older people.

The number of older people is growing

In the Philippines, the number of older people is increasing rapidly, faster than growth in the total population. In 2000, there were 4.6 million senior citizens (60 years or older), representing about 6% of the total population. In one decade, this grew to 6.5 million older people or about 6.9% of the total population. The National Statistics Office projects that by 2030, older people will make up around 11.5 % of the total population.

Older people need care and support

An ageing population increases the demand for health services. Older people suffer from both degenerative and communicable diseases due to the ageing of the body’s immune system. The leading causes of morbidity are infections, while visual impairment, difficulty in walking, chewing, hearing, osteoporosis, arthritis and incontinence are other common health-related problems.

Older people struggle with poverty

According to the Department of Social Welfare and Development (DSWD), a nearly a third (31.4%) of older people were living in poverty in 2000. Currently, this number is estimated to be 1.3 million older people.

More than half of all older people (57.1%) were employed in 2000. More males were employed (63.6%) than women (37.4%). The majority of those employed (41%) were involved in primary economic activities such as farming, forestry work and fishing.

Key facts

Below are the key statistics on the Philippine’s population of older people:

National policy on older people Government policies related to older people

The Philippine Government has enacted laws that cater to the needs and provides privileges and benefits to older persons.

Republic Act No. 344 or the Accessibility Law of 1982 provides for the minimum requirements and standards to make buildings, facilities, and utilities for public use accessible to persons with disability, including older persons who are confined to wheelchairs and those who have difficulty in walking or climbing stairs, among others.

Republic Act No. 7876 entitled “An Act Establishing a Senior Citizens Center in all Cities and Municipalities of the Philippines, and Appropriating Funds Therefore” provides for the establishment of Senior Citizens Centers to cater to older persons’ socialisation and interaction needs as well as to serve as a venue for the conduct of other meaningful activities. The DSWD in coordination with other government agencies, NGOs and people’s organisations shall provide the necessary technical assistance in the form of social and recreational services, health and personal care services, spiritual services, livelihood services and volunteer resource services.

Republic Act No. 8425 provides for the institutionalisation and enhancement of the social reform agenda by creating the National Anti-Poverty Commission (NAPC). Through its multi-dimensional and cross-sectoral approach, NAPC provides a mechanism for older persons to participate in policy formulation and decision-making on matters concerning poverty alleviation.

Republic Act No. 10155, known as “The General Appropriations Act of 2012”, under Section 28 mandates that all government agencies and instrumentalities should allocate one percent of their total agency budget to programs and projects for older persons and persons with disabilities.

Republic Act No. 9994, known as “Expanded Seniors Citizen Act of 2010″, an act granting additional benefits and privileges to senior citizens, further amending Republic Act No. 7432 and otherwise known as “an act to maximise the contribution of senior citizens to nation building, grant benefits and special privileges and for other purposes”.

Presidential Proclamations and Executive Orders
Presidential Proclamation No. 470, Series of 1994, declaring the first week of October of every year as “Elderly Filipino Week.”

Presidential Proclamation No. 1048, Series of 1999, declaring a “Nationwide Observance in the Philippines of the International Year of Older Persons”.

Executive Order No. 105, Series of 2003, approved and directed the implementation of the program providing for group homes and foster homes for neglected, abandoned, abused, detached, and poor older persons and persons with disabilities.

The Philippine Plan of Action for Senior Citizens (2011-2016) This plan aims to ensure giving priority to community-based approaches which are gender-responsive, with effective leadership and meaningful participation of senior citizens in decision-making processes, both in the context of family and community. This plan of action aims to ensure active aging for senior citizens where preventive and promotive aspects of health are emphasised in communities and where health services are accessible, affordable and available at all times. Envisioning a population of senior citizens who are self-sufficient and self-reliant, this plan aims to promote financial security and financial independence of senior citizens by developing community-based local delivery systems to address their needs.

Health and care

The Department of Social Welfare Development (DSWD) has issued Administrative Order No. 4 series of 2010, “Guidelines on the Home Care Support Services for Senior Citizens”, establishing community based health care services for older persons.

The RA 9994 provides health care services for poor older persons such as free medical services on government hospitals, discounted services on private hospitals and clinics, free vaccines, discounted medicines, and mandatory PhilHealth coverage.

Older people’s associations

The Philippine Constitution supports the formation of community based organisations. The DSWD have facilitated the formation of older people’s associations in every city and municipality. They are also tasked to provide technical assistance to support and strengthen OPAs.

Social pension

Under the RA 9994, the Philippine Government provides a social pension of 12USD (Php500) per month to poor older persons aged 77 and over who are not yet receiving any government or private pension. The Department of Social Welfare and Development is the lead agency tasked with identifying and reviewing social pension beneficiaries.

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