Health, social security and pensions in the Philippines

1. access to the healthcare system

Who has access?

• Since the Universal Health Care Act (2019), health insurance has officially been compulsory for all. According to government figures, the state health insurance scheme PhilHealth covers around 92 % of the population, including formal employees, informal workers, indigenous people, senior citizens and their dependents^1.
• Urban population and middle/upper class benefit from better-equipped hospitals and can afford private supplementary insurance or treatment.
• Employees in the formal sector are usually automatically insured and have access to better benefits.

Who is often excluded or forgotten?

• Rural populationAccording to the Ministry of Health, 79 % of the provinces lack sufficient primary care centers. Many people have to travel long distances and incur high costs to receive medical help^2.
• Poor and informal workersDespite compulsory insurance, many are in fact underserved because they cannot afford co-payments, medication (often 3x more expensive than internationally) or transportation. Over 50 % of healthcare expenditure is paid privately, which places a particular burden on poor families[^2][^4].
• Indigenous groups and internally displaced personsLanguage, cultural and geographical barriers make access difficult. They are often dependent on poorly equipped health stations.
• Children, the elderly and people with disabilities in remote regions often do not receive adequate care, especially for chronic or complex illnesses.
• Migrants and informal settlersThey often fall through the cracks because they have no fixed place of residence or formal employment.

2. social security

Who has access?

• Social security systems (SSS for the private sector, GSIS for government employees) cover formal employees. Since 2025, the self-employed, informal workers and gig workers have also been better covered, including flexible contributions and digital services^5^7.
• Remittances from migrant workers ensure the survival of many families, but are no substitute for state protection.
• Social aid programs such as the conditional cash transfers (4Ps) are aimed at the poorest households.

Who is excluded or forgotten?

• Informal employees (around 60 % of the workforce) and day laborers are often not or only irregularly insured despite reforms, as contributions are difficult to make or registration is bureaucratic^5.
• Unemployed, small farmers, fishermen and day laborers usually receive no or only minimal benefits.
• Internally displaced persons and people without identity papers are often excluded from social benefits.
• Women, especially single parentsoften do not receive sufficient support, as many programs are tailored to the male breadwinner.

3. retirement benefits

Who has access?

• Formal employees receive a state pension via SSS (private sector) or GSIS (public sector). In 2025, pensions were increased and voluntary supplementary programs were introduced^5^8.
• Indigent seniors (without their own pension or family support) receive a small social pension (approx. 500-1,000 PHP/month) if they are recognized as needy^9.

Who is excluded or forgotten?

• Many older people in the informal sector or without contribution periods receive no or only very low pensions. The social pension for those in need is low, access is bureaucratic and the budget is limited^9.
• Women are more frequently affected, as they were less likely to have been in continuous employment subject to social insurance contributions.
• Indigenous, rural and poor senior citizens are often not recorded or have difficulties proving that they meet the requirements.
• People with disabilities and the chronically ill in old age rarely receive targeted support.

4. overview: who benefits, who is left behind?

Conclusion

Access to health, social security and pensions in the Philippines is heavily dependent on income, employment status and place of residence. Despite reforms, rural, indigenous, informally employed and migrant population groups in particular are often overlooked or receive only minimal benefits. Social security remains fragmented and is not sufficient for many to prevent poverty and insecurity in the event of illness or old age^2^4^9^7^8.

[^4]: https://www.gdn.int/sites/default/files/Philippines-Philippines Towards Expanding Access to Healthcare Services - A Policy Simulation Report.pdf

Supplementary assessment from a Gradido perspective

Access to health, social security and pensions in the Philippines is still profoundly characterized by social inequalities. Once again, it is the most vulnerable - poor, rural, indigenous and informally employed people - who suffer from gaps in care and exclusion.

Additional thoughts from a Gradido perspective:

• Health: The official health insurance obligation conceals the fact that real access depends on financial means, place of residence and social status. Those who are rich or live in the city have sufficient treatment options; those who are poor, rural, indigenous or migrant are left out - or have to make do with inadequate, hard-to-reach and expensive services. The elderly, children, people with disabilities and internally displaced persons are particularly affected.
• Social security: Despite developed systems, informal workers, women, day laborers, small farmers and internal migrants in particular often remain dependent on themselves, their families or unsecured remittances. Bureaucratic hurdles and inflexible programs lead to disadvantages.
• Retirement provision: Those who work all their lives in the informal sector enjoy little pension security in old age - especially women, who are hardly recognized for care and family work, are affected. The social pension for those in need is often just a drop in the ocean.

Gradido as a beacon of hope: Gradido could bring these "forgotten groups" into the spotlight:

• A universal basic income would give everyone access to basic health, security and dignity - regardless of employment status, place of residence or identity documents.
• Care and neighborhood work, often carried out by women and older people, would be visible and valued for the first time.
• Community-financed health projects and local solidarity communities, supported by the spirit of Bayanihan, could create structures that no longer exclude anyone.

Therein lies the great opportunity: to truly enable social participation and social security for all people - full of love, gratitude and respect for all generations.