"Sin Taxes" and Health Financing in the Philippines

This case traces the implementation of tobacco tax policy and health system reforms in the Philippines from 2009 to 2015, in the context of the global tobacco control movement, the economic and political influence of the Philippine tobacco industry, and the Philippine health system. After providing background on the prevalence and costs of smoking in the Philippines, the case follows the steps taken by a diverse group of actors to design, promote, and implement higher taxes on tobacco and alcohol products, the primary goals of which were to reduce smoking and raise funds to achieve universal health care. The case highlights the strategies used to counter opposition from the tobacco industry and allied politicians. It focuses on Health Secretary Enrique Ona’s efforts to support sin tax reform and how the country used the resulting revenues to try to improve health care and health insurance coverage. Subjects covered in this case include health insurance, health care financing, tobacco control, smoking, universal health care implementation, policy, cross sector collaboration, health system reform, political leadership, and management.

Learning Objectives: A productive class discussion will allow students to appreciate the complexity and trade-offs governments may face in stimulating their economy, regulating industry, and improving public health; the importance of data in driving and sustaining policy reform; the role of financing policies and funding as tools for health system strengthening and value creation when leveraged strategically; and the potential for health to unify different actors and sectors to generate new policy and restructure fiscal and financial systems.

The Global Health Delivery (GHD) Project, an interdisciplinary collaboration between Harvard Business School, Harvard Medical School, and Brigham and Women’s Hospital, investigates the management decisions behind disease treatment and prevention globally. The Global Health Delivery (GHD) Case Collection is a set of teaching case studies that are available for all at no cost online through Harvard Business Publishing, GHDonline, and The Case Centre.