2.2 Political Economy Evaluation Metrics for Health Financing
This methodological framework evaluates the political economy of health financing by operationalizing metrics that track how social health insurance structures interface with primary care networks. Because achieving universal coverage across mixed health systems constitutes a complex dynamic endeavor requiring institutional alignment among bureaucratic structures and grassroots delivery agencies (Universal Health (UHC) and Primary Health Care (PHC) – a complex dynamic endeavour, 2021), this study applies a multi-level documentary and policy evaluation design. The analytical model measures fiscal risk protection and provider purchasing dynamics to determine where entitlement mechanisms succeed or fail in shielding socioeconomically vulnerable populations from out-of-pocket medical expenses. In mixed healthcare markets where private provision operates alongside devolved public services, social insurance schemes often fail to lower out-of-pocket costs unless public facilities are utilized or strategic complementation with private mechanisms is established (Navigating Universal Health Coverage (UHC) and Complementation in Financing Inpatient Care in Low- and Middle-Income Countries (LMICs) with Mixed Health Systems: Lessons from the Philippines, 2026). Furthermore, the evaluation framework assesses structural inequities through the operational philosophy of primary health care, auditing whether benefit packages realistically facilitate clinical utilization for impoverished groups and address systemic disease burdens under statutory national health reforms (Equity in Health and the New Normal: The Philippine Universal Health Care Law, 2023). By synthesizing institutional governance assessments, public financing metrics, and mixed-system purchasing rules, the protocol provides an empirical basis for analyzing frontline access bottlenecks in national health systems.