‘Who’s going to pay for it?’

A nurse in New York revealed the tragic last words of a dying man as he was about to be placed on a ventilator: “Who’s going to pay for it?” the coronavirus patient asked the nurse in between labored breaths.

“(This patient) was in severe respiratory distress, had difficulty speaking, and yet still his main concern was who could pay for a procedure that would extend his life… I was very sad and honestly, a little horrified that we have a profound failure when one has to worry about their finances when they’re dealing with much bigger issues that have to do with life or death,” the nurse told CNN.

The coronavirus will severely test the health systems of nations. Canada and the Scandinavian countries seem to be doing fine, so far. The US is proving to be a catastrophe. In our case, we don’t really have anything much anyway as many Filipinos still live and die without seeing a doctor.

The late Sen. Sonny Alvarez, who died of the coronavirus disease 2019 or COVID-19 was reported to have left a hospital bill of P7 million. But that includes P2 million for his wife Cecille who was also hospitalized for COVID, but survived.

Luckily for the late senator’s family, PhilHealth will take care of the bill because the Alvarez couple were hospitalized before the cut-off date of PhilHealth.

PhilHealth announced that it would cover the full hospital costs of all COVID-19 patients admitted to health facilities before April 14. After the cut-off date, PhilHealth will only pay based on a schedule which gives less than a million pesos for the most severe case.

Sen. Sonny Angara said his COVID-19 hospital bill amounted to P400,000.

“My bill wasn’t as big because I was fortunate not be taken into the Intensive Care Unit (ICU),” Angara said in a virtual press conference. “The stories of these huge million-peso bills were of patients that had to be intubated and had to be in the ICU. I was lucky that wasn’t my case,” he said.

But the senator did not say if PhilHealth shouldered his bill as guaranteed under the Bayanihan to Heal as One Act. 

Based on patient records, the cost of COVID-19 treatment ranges from P5,000 to as much as P3.8 million in rare cases, PhilHealth president and CEO Ricardo Morales said. Treatment for the patient with a P3.8 million bill, incurred after a month in the ICU, will be paid until April 14.

Even before COVID-19, the thought of having a catastrophic illness is a cause of financial insecurity for almost all Filipinos. We do not have a health care system like Canada’s that takes that worry away.

I listened with amazement as a friend of mine related how he had a heart attack while jogging in Vancouver’s Stanley Park. Within minutes an ambulance picked him up. He had a heart bypass operation and when he left the hospital, he paid a bill of $7 for administrative expenses. That was all.

Here, we are covered for our health care needs for as long as we are working with a large enough company that can afford to provide it. But once you retire, you lose that benefit.

That’s the irony of it. I don’t recall using my health benefit that much when I was working because I was young and didn’t get sick much. The HR folks had to force me to take the annual executive check-up.

But after retirement, that’s when I started seeing doctors a lot more often and having regular blood and other tests. Too bad, no more company health card. It is all out-of-pocket from savings now.

The only large local company I know that took care of their retirees is Meralco during the time of the late Eugenio Lopez Sr. He even built a hospital in the compound to take care of employees and retirees.

After martial law, Meralco still took care of retirees, but only to the extent of giving them free medical consultation and medicines. The company could no longer afford to cover hospitalizations and still keep electricity rates low.

The PhilHealth concept of universal health care excited me when then Sen. Freddie Webb introduced it in the Senate. I was covering the Senate at that time and felt it was a fantastic idea. But even then, I didn’t think we would have the resources to sustain it.

Decades after, not only does PhilHealth not have enough resources to take our health cost worries away, some of its bureaucrats apparently looted its coffers regularly. Scandal after scandal are reported. PhilHealth is covering a very small part of our hospital bills.

There has to be a better way of taking care of health needs, specially of seniors and not necessarily one involving government. We could possibly contribute to a fund while we are healthy that will kick in to pay our major health bills once we retire.

Maybe that could be managed by SSS as an extra service to members willing to make extra contributions. My hesitation with a private fund is the ghost of educational plans that took our money and was mismanaged to bankruptcy.

But if some private and reputable company like PhilAm Life or Insular Life can devise such a retirement health fund, that should help a lot of middle class people. Too late for my generation. But lessons could be learned from our problems today.

This COVID-19 pandemic has heightened insecurities of a lot of people with regard to the costs of hospitalization in case a catastrophic illness hits you. When we reset to the new normal after this emergency is over, let us fix our faulty health care system.

Make public hospitals as top rated as PGH and the specialized hospitals for heart, kidneys and lungs. No reason why we must depend on for profit private hospitals with a pay-as-you-go system. We can afford the cost of good public health care if we have a good health plan and spend our taxes right.

Boo Chanco’s e-mail address is [email protected]. Follow him on Twitter @boochanco