3 weeks ago
5
February 24, 2025 | 12:00am
Do the poor get sick more often than the rich? Do the poor require hospital care more often than the rich? Malnourished and living in packed neighborhoods with pretty bad sanitary conditions, the poor are more likely to need more health care to keep them going.
The petition before the Supreme Court questioning the transfer of PhilHealth funds to the Treasury to fund pork barrel projects of legislators cited a significant disparity between the utilization of hospital benefits by the poorest quintile of Filipinos (1.5 percent or 346.800 Filipinos) and the wealthiest quintile (2.4 percent or 554,880 Filipinos) despite the poor having a larger population.
Given that the rich are not more likely to become sick than the poor, the petition noted, a possible explanation for this gap includes what we call pagtitiis, or “enduring the illness” and forgoing medical care due to a lack of financial resources, or seeking medical care but lacking the financial resources to be treated for their illnesses.
The poor and their basic health needs are not important for our presidents, senators and congressmen. When the health care gap couldn’t be ignored, the Universal Health Care Act was passed, targets were made to roll it out to benefit as many Filipinos as quickly as possible.
But as the SC petition pointed out, “for the first three years of the law’s implementation, the funding for UHCA was way below the target budget of the first year of the implementation, making it undeniably underfunded…The UHCA provides for a ten-year timeline to implement the law. At present, we are in the fifth year of the UHCA’s implementation and still have not met the law’s objectives. Nor has the law met even its slightest promises which should have been achieved in the early years of the law’s implementation…”
The law says “Within two years from the effectivity of this Act, PhilHealth shall implement a comprehensive outpatient benefit, including outpatient drug benefit and emergency medical services…”
We are far behind our target. We are far from fulfilling the universal health care we need.
Funding was always cited as a problem until it wasn’t. Succeeding laws provided sources of new funds such as the Sin Tax Law.
Pagcor and the Philippine Charity Sweepstakes were also mandated by law to contribute to PhilHealth “to improve its benefit packages.”
The problem was implementation. The PhilHealth bureaucracy, tainted by corruption, didn’t have the competence to make the objectives of universal health care tangible to our people. How it managed to have so called excess funds that Secretary Ralph Recto sequestered was obviously because of bureaucratic failure to implement the UHC program properly.
The Filipino people got screwed thrice: first, through denial of health services they are entitled to by law. Second, the failure to implement created “excess” funds. Third, DOF called those funds “idle” and reallocated them to fund congressional pork barrel. According to an economist with the health industry, the P89.9 billion PhilHealth diversion just about matches the congressional pork programs: AKAP - P26.16 billion; AICS – P44.74 billion; TUPAD – P18.2 billion for a total of P89.1 billion.
Yet, the tourism department has launched a medical tourism program to, in the words of the tourism secretary, convey the seriousness of the Marcos administration in prioritizing health tourism as a marketable product.
We can understand the business objectives of medical tourism but the optics are bad. Can the Marcos administration prioritize health care for the people instead?
We don’t even have enough hospital beds, expensive as these are, and now we have to compete with medical tourists. The hospitals with medical tourism programs have been built on the back of the highly profitable pay-as-you-go health care system. This is precisely why the national health insurance plan we know as PhilHealth is very relevant, if only we can get competent people to run it.
Talk about medical tourism in one e-group elicited a comment from an American who has apparently been here for a while and familiar with our ways.
“While this is an intriguing proposal, I think there are some glaring issues to be addressed… Many of the best Filipino doctors and nurses already go abroad…
“Personally, I would rather the Philippine government focus on providing better medical services to Filipinos…It seems to me that the Philippine ‘house’ needs to be put in order first before pursuing what amounts to catering to patients with more means, including foreign ones.
“I was in the Philippines when the COVID Delta Wave finally hit around summer 2021. What I saw was terrible. Despite months (almost a year actually) of watching Europe and the US suffer, there was a sense of denial by both Filipinos and the former administration…people just accepting death – which by the way the government had completely underreported numbers.
“Hospitals with long queues of ambulances and private cars, people strewn out beside motorcycles sucking on shared oxygen tanks. Patients were not triaged at all according to need, but according to ability to bribe hospital administrators. After my ex’s father was refused at one hospital, I was finally able to bribe the staff at another. Well, her father died shortly anyway. On the death certificate it said, “pneumonia with history of tobacco smoking,” despite clear COVID symptoms and her father never smoked cigarettes in his life…
“Granted it can be argued that medical tourism can be a private initiative, but to what end? The privatization of most critical functions already exists in the Philippines and is a great contributor to the social divide of what I observed as the ‘two Philippines.’ The haves can afford what they need, and what they want. The rest have to make do or otherwise accept lack. I’m not against private industry, including medical, but clearly there has to be more government focus on at least a baseline that protects Filipinos’ health and welfare.”
Boo Chanco’s email address is [email protected]. Follow him on X @boochanco
