ALVIN B. CABALLES, MD, MDE, MPP CURRICULUM VITAE PERSONAL DATA Name: Caballes, Alvin Bernardo Position: Associate Professor, College of Medicine, University of the Philippines Cell No.: 09217148829 Office: Social Medicine Unit, U.P. College of Medicine, P. Gil St., Manila (4006658); Rm. 519 Medical Arts Building, St. Luke’s Medical Center (7231021) Email: abchealth@ymail.com, abcmd@alumni.princeton.edu ACADEMIC/TRAINING RECORD College: University of the Philippines, Diliman (B.S. Biology, 1981, cum laude) Medical School: College of Medicine, University of the Philippines (graduated 1985, 11th in class; Class President, 1985; Class Award in Leadership, 1985) Post-Graduate Training: Internship: Philippine General Hospital (1986-87; Medical Student Council Representative; Outstanding Intern in Pediatrics) Residency: Pediatric Surgery, Department of Surgery, Philippine General Hospital (1987-92; Chief Resident, Department of Surgery, 1991) Masteral: Development Economics (University of the Philippines, 2002) Public Policy, with Certificate in Health Policy (Princeton University, 2008) Fellowship/Others: Transplantation, University of Miami; 1995; GB Ong Fellow, University of Hong Kong, 2003 CERTIFICATION Physician’s Licensure Examination - passed, 1986 U.S. Medical Licensure Examinations I & II - passed, 1994 Diplomate Examinations, Philippine Society of Pediatric Surgeons - passed, 1993 OTHER PROFESSIONAL CITATIONS Fellow, Philippine Society of Pediatric Surgeons, 1996 Fellow, Philippine College of Surgeons, 1997 Eusebio Paulino Professorial Chair, UPCM, 2007 OTHER POSITIONS Chief, Social Medicine Unit, UP College of Medicine, 2004 – present Program Administrator, Joint UPM-UPD Bioethics Graduate Program, 2004 – present Faculty, Department of Surgery, Philippine General Hospital, 1994 – present Head, Division of Surgery, Philippine Children’s Medical Center, 2005 – 2007 Head, Endoscopy Unit, Philippine Children’s Medical Center, 2004 – 2007 Board Member, Philippine Board of Pediatric Surgery, 1999 – 2002 Chair, Nutrition Support Team, Philippine General Hospital, 2000 – 2003 Editor in Chief, PCS Newsletter, 2005 – 2006 Associate Editor, Philippine Journal of Surgical Specialties, 2005 – 2007

1. Medical History Management Medical Economics Bioethics Medical Jurisprudence Rights Medical Anthropology

2. Risks of Surgical Conditions: Occurrence and Cost

3. Introducing Medical Students to Health Financing

4. Risks of Surgical Conditions: Occurrence and Cost

5. Average Family Hospitalization Expenses*** P 5,874 Poverty Threshold**** P 4,835 Percentage of Families Below Threshold**** 27.5 % *** FIES, 2000 **** NSCB, 2000

6. NDHS, 2008

8. Concepts & Contexts ALVIN B. CABALLES, MD

10. Sourcing Strategies Scenarios Synergies ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010

11. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 So why not just pay out-of-pocket? REMEMBER? Health services (and supplies) can be expensive (relative or absolute terms) Services needs to be paid, or else these will be under-provided Catastrophic health expenditures can lead to (further) financial ruin (& even worse health) Sourcing Strategies Scenarios Synergies

12. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 More on “Catastrophic Health Expenditures” Sourcing Strategies Scenarios Synergies

13. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 More on “Catastrophic Health Expenditures” Sourcing Strategies Scenarios Synergies

14. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 More on “Catastrophic Health Expenditures” Sourcing Strategies Scenarios Synergies

15. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Pooling Risks: Health & Financial Sourcing Strategies Scenarios Synergies

19. Once Again… ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies Pooling Options Private/Indemnity SHI Premiums Reflects Risk/Expected Loss Based on Ability to Pay Risk Spreading Group or Community Population/ ?Generations Insurer Commercial firms Public firms Government Subsidy May be indirect (tax incentive) Often highly subsidized

20. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies Insurance Concerns Information Assymetry Moral Hazard Adverse Selection

22. Philippine Trends: Total ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

23. Philippine Trends: Main Sources ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

24. Philippine Trends: Health Insurance ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies NDHS, 2008

25. Philippine Trends: PHIC ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

26. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010

27. Demographic Transition: Double Burden ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies Preston, 1975

28. Demographic Transition: Financing Effects ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

29. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

30. Economic Growth & Health Financing Sustainability ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 Sourcing Strategies Scenarios Synergies

31. ALVIN B. CABALLES, MD HEALTH FINANCING SUMMIT UP Diliman 14 April 2010 TAKE HOME MESSAGES: Adequate financing is necessary not only to remedy poor health, but also to safeguard against (further) impoverishment Efficient pooling mechanisms are necessary to ensure the accessibility of essential health services especially for the poor, as well as to prevent financial ruin Adequate financing is necessary for the provision of health services, but this alone is not sufficient for ensuring the adequacy and efficiency of provision Health is not a stand alone concern

32. Thank you for being a captive-ating audience