The health of our nation


March 17, 2015


A RELATIVE of mine had a stroke last week. She is still in the hospital since then and had to spend several days in the intensive care unit. Recovery was fairly quick but staying in the hospital for a length of time gave me a peek into our health care system at work in close proximity.

There are only so many public tertiary hospitals in the country and most of them are in Metro Manila Area. East Avenue Medical Center, for example, is perennially full and one would feel guilty occupying the emergency room when more critical cases come in every so often. The same is true for the Heart Center, the Philippine General Hospital and other public hospitals in the area.

Of course, stroke is a time-critical event and one must bring the patient immediately to the emergency room. The earlier you bring the patient for medical care, the better his or her chance to recover. Upon consultation with my cousin who is our doctor, she asked our relative to be placed under her care in a private hospital in Manila. Fortunately, traffic was light and we reached the emergency room in just a few minutes.

The first contact is with the preliminary interviews at the triage which we got to skip since we were admitted direct to the room. After several tests, it was diagnosed that our patient had a stroke and had to be placed in intensive care for observation.

We were fortunate to have a cousin working at the hospital but how easy (or difficult) it must be for an ordinary family to access health services in the country. Even for us, the cost is not trivial and would have placed us in financial stress had we not prepared for it. The medicines are expensive, the expense for many kinds of equipment is expensive, and every bottle and cotton ball has a price and the cost accumulates every day.

With the impending privatization of public hospitals, this situation will be more of the norm. According to the Health Alliance for Democracy (HEAD), the privatization of health services under this administration is being done through the public private partnership (PPP) schemes of the government and through corporatization. This will push our health providers toward profit making instead of giving genuine service.

HEAD notes that seventy two (72) government hospitals such as the Philippine Orthopedic Center (POC) are targets for PPP. Their fear is that privatization will make health services even harder to reach for the ordinary person and would put the job security of health workers in jeopardy.

One may argue that there is the Philhealth to help to reduce the burden to patients. Yet it is only a palliative since the underlying costs are still going to be high. For public hospitals, the PhilHealth can only do so much if they remain ill-equipped and understaffed. The Coalition for Health Budget Increase (CHBI) in 2012 pointed out that the lack of equipment and staff limits the benefits from PhilHealth since members would still spend from their own pockets for their medical needs.

The inner geek in me also found another problem in the case of the use of specialized medical equipment for testing. There must be a cheaper way to do the CT scans, the ECGs, oxygen monitoring, blood tests and the battery of tests that doctors would base their medical diagnosis and treatment on. I understand the need for finding the underlying causes but we have to have a program of developing these instruments so that our hospitals can provide these services at a much lower costs. Most of the equipment are imported, hard to maintain and would need specialized personnel to operate— all of these contribute to the costs of treatment.

I remember Dr. Darby Santiago of the HEAD talking to me about making a low cost laser that will help him provide ophthalmology services to poorer communities. The typical equipment costs several tens of thousands and would be difficult to bring to communities. Maybe it would be time to look back at doing that since we have a strong optics community here in the Philippines.

Health services, just like other social services and basic utilities, are important services that should have a strong public character since they impact the lives of many people. According to HEAD, the budget for health services is a far cry from the World Health Organization’s (WHO) recommendation of 5% of gross national product (GNP).

Taking care of the people’s health should be top priority for the government but it is clearly not being done. We should not be surprised because privatization is the current government’s answer to the transport problem (such as the MRT), water, power and many other public services. On top of the mismanagement and blunders of Mamasapano, we wonder whether the “daang matuwid” was ever straight in the first place?

Dr. Giovanni Tapang
Dr. Tapang is Agham's National Chairperson.