Before and After the Sin Tax Law: Perceived Changes in Tertiary Government Hospitals by Inpatients and Healthcare Workers

  • Gideon D. Lasco
  • Jose Eduardo DL. Duya
  • Josephine H. Sanchez
  • Antonio L. Dans
Keywords: Health financing, patient perspectives, tobacco taxation, universal healthcare, Philippines


Background. The implementation of the “Sin Tax Law” (RA 10351) in 2013 has increased revenues for healthcare in the Philippines. What changes have taken place in government hospitals since the passage of the law? This qualitative study sought to answer this question by presenting perspectives from patients, doctors, and nurses.

Methods. Four focus group discussions (FGDs) and eight semi-structured interviews (SSIs) were conducted among patients, doctors, and nurses in two tertiary government hospitals in Metro Manila, Philippines.

Results. Significant changes noted by study participants over the past several years included increased financial assistance for patients as well as improvements in health services and continuity of care. However, their narratives underscored shortcomings in human resources and facilities, raising questions of ‘absorptive capacity’.

Conclusion. Given that the Sin Tax Law was the main policy intervention to which the changes reported by study participants can be attributed, the study provides a strong case for a continuation - if not expansion - of the Law, with the recommendation that increased health revenue should also translate to greater support for healthcare workers and enhanced health facilities. As these insights may be overlooked by traditional metrics, the study also recommends that policymakers consider qualitative studies in evaluating the efficacy of health care reforms.


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