Universal Health Care in a Low-touch Economy


by Elmer S. Soriano MD MPA

With the low-touch economy likely to to stay for the next 12 months or more, how can Universal Health Care be sustained and evolved? The disruptions in health systems because of the COVID19 pandemic release the system partially from old mindsets and institutional constraints, and the discourse on social distancing and health inequities allow for a reframing and leapfrogging toward more equitable health systems. The term emancipatory catastrophism by Beck (2015) proposes that there are good side effects of bad events.

Here are a few strategies building upon concepts at the interesection of Universal Health Care and leadership.

  1. Give the work back to the people by increasing health literacy. Harness the discourse and narratives around COVID19 to increase health literacy. Establish household-centric programs to emphasize the role of individuals and households as the first line producers of health care.
  2. Promote digital health. The use of telemedicine and self-care apps will reduce exposure of people to crowds as well as increase human capital for health. Telemedicine will reduce the need for physical face-to-face interactions while personal health care apps will improve feedback loops and health education as individuals take on new behaviors and increase their understanding of personal health.
  3. Integrate multiple service packages into fewer physical touchpoints. Patients and health care providers will be exposed less if they have fewer interactions. Client-centered bundling of services will allow clients to benefit optimally from each physical interaction. A cost-benefit and risk-benefit analysis of such bundling will have to thought through using scenarios of variable quarantine and prevalence settings. Murray (2000) provides a good nomenclature of health systems.
  4. Organize design sprints to reimagine service delivery systems.


  2. Reduce client travel by delivering services closer to home. Taking public transport to clinics and spending time in waiting rooms expose patients to crowded settings. Shorter travels reduce exposure of clients to
  3. tners Shorten physicr supply chains.

Methodologies to evolve low-touch health systems.

  1. Patient journey analysis will help identify the different touchpoints in the pre-COVID health system and allow health system designers to reconfigure processes
  2. touch points by adoptive Techniques

shorter supply chains

horizontal integration, unified touch points

task shifting

digital health

constant experimentation


Food Security Coupons amid COVID19 Disruptions



  1. Food supply chains have been disrupted by COVID19 quarantine affecting, supply, demand, and markets
  2. farmers and fisherfolk have difficulty selling their produce, urban poor communities lose their daily incomes, and government is spending resources to provide subsidies to support poor households
  3. the Woergl experiment demonstrated how municipal governments can create new mechanisms for exchanging value

Response: Provincial Food Security Coupons


  1. improve food security by re-establishing farm-to-fork supply chains enhanced by financial instruments
  2. engage stakeholders to co-create institutional arrangements that increase food security
  3. mobilize resources to support the incubation of new institutional arrangements for food security


  1. food producing Local Government Units (LGU) establish accounts in escrow to guarantee the coupons
  2. municipal governments purchase locally produced food products for redistribution within the  LGU or for sale to nearby LGUs
  3. purchasing LGUs send Letters of Credit to acquire food supplies from selling LGUs





Mindanao Futures Lab – Food Highway

Marikina Eco-savers Vouchers

Quezon Health Vouchers


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