While the West invests in longevity, Southeast Asia still pays cash for the basics

The concept of longevity is gaining traction, particularly in the United States, where individuals spend up to $2,499 for a full-body MRI and pay hundreds of dollars monthly for peptide protocols, often at their own expense. Contrastingly, in the Philippines, a very different scenario unfolds. Many households delay routine check-ups and screenings until symptoms become severe.

Public hospital beds become full, and a private hospital bill can consume a significant portion of a household's income. The underlying issue lies in who bears the financial burden of health care and how it impacts decisions. Longevity often builds upon essential healthcare services. While full-body scans and injectable peptides have witnessed rapid growth, the evidence supporting many of these services remains preliminary.

Medical organizations typically endorse routine full-body scans solely for high-risk individuals. These services operate under the premise that the buyer's basic healthcare needs are already covered. The model of payor significantly influences access. In Japan, Australia, and New Zealand, households allocate 12 to 16 percent of their health expenses out of pocket.

However, in the Philippines, this figure stands at 44.4 percent, the highest in the region, followed by India and Vietnam. When households serve as the payor, every test competes with daily necessities such as food, rent, and school fees. Prevention tends to be compromised because its immediate costs overshadow its long-term benefits.

Factors beyond income also play a role. Thai households, although classified as upper-middle-income, maintain out-of-pocket spending below 10 percent. The manner in which care is financed holds considerable significance. While universal coverage is a goal, high individual bills remain a challenge. Every Filipino is automatically enrolled in PhilHealth, a national health insurance program.

Nevertheless, households spend approximately $9.8 billion out-of-pocket on healthcare annually, a 11.8 percent increase from the previous year. PhilHealth typically covers around 56 percent of hospital bills on average, and less than 45 percent in private and tertiary hospitals. Three out of five Filipinos remain uninsured, with insurance coverage comprising only 1.78 percent of the GDP.

The delay in seeking medical attention exacerbates the situation. Only about 1 percent of Filipino women undergo screening for breast and cervical cancer, compared to roughly 20 percent in Malaysia and Thailand. Up to 65 percent of breast cancer cases are identified at an advanced stage, resulting in significantly higher treatment costs.

Assistance exists in the form of PhilHealth's YAKAP program, which covers a mammogram at approximately $42 and a breast ultrasound at around $22. However, a benefit only benefits those who are aware of it and can access it. The challenge lies in ensuring accessibility. In households where individuals pay for healthcare, services must be conveniently located, have transparent pricing, and be easily bookable nearby.

A marketplace model could address these issues more effectively than a chain of clinics. Instead of constructing new facilities, such a model would connect patients to existing laboratories, screening centers, and clinics, enabling individuals to compare options and prices before making a decision. The effectiveness of this approach hinges on partner coverage beyond major cities and maintaining transparent pricing.

For the 700 million people residing in Southeast Asia, the most substantial improvements in healthy lifespan would stem from timely screenings, vaccinations, and early diagnosis. Achieving this requires building systems that cater to the household payor, investing in distribution alongside new treatments, and ensuring that public benefits are easily accessible and usable.