Preventive medicine

Diseases aren’t destiny. There are many ways to stay healthy and save ourselves from the grief and costs of getting sick. My late father was a public health specialist, and one of the subjects he taught at medical school was preventive medicine. This is how I learned early on what should be done to keep the doctor away.

Preventive medicine is about taking measures to prevent the onset of diseases. In other words, keeping healthy means eating the right kind of food, maintaining personal cleanliness habits and avoiding vices like smoking and alcohol. There are things that the government should make available, like vaccines and staffed health centers that will regularly check on the health of kids and adults alike.

A Harvard Business Review article states, “Prevention is key to achieving health improvements. We find that 70 percent of the economic benefits could be achieved with cleaner and safer environments, supporting the adoption of healthier behaviors, and more access to vaccines and preventive medicine. The remainder would come from treating diseases and acute conditions with proven therapies, including medication and surgery.

“Making the shift to prevention is no small challenge. It would require not only shifting incentives in health systems from disease treatment to health promotion, but also making better health a social and economic priority. A focus on addressing chronic conditions such as diabetes, high blood pressure, obesity and mental health – all massive contributors to premature deaths and a lower quality of life – would be key.

“What’s more, the shift to prevention can be realized at a relatively low cost. We found that focusing on known health improvements such as vaccines and preventive medications for heart conditions could deliver an incremental economic benefit of $2 to $4 for each $1 invested. In higher-income countries, implementation costs could be more than offset by productivity gains in health care delivery. However, low-income countries would need to build out health infrastructure.”

Yes, low-income countries like ours have rather inadequate health infrastructure. We have failed to invest in improving it, and there are no signs that our current government has plans to do so.

Our country, being a Third World nation with bad governance, means that more, if not most, of our people are not as healthy as they should be. We don’t have enough medical workers. The doctors and nurses we graduate are often eager to get out of this country so they can earn what their skills deserve in the international market.

Because our population has grown tremendously, there are fewer doctors now to care for more Filipinos. An article in The Lancet, a peer-reviewed medical journal, says six of 10 Filipinos die without seeing a doctor.

According to Statista, in 2022, there were about 34,500 doctors employed at health care facilities across the Philippines. The Philippine Medical Association lists about 100,000 doctors, but most likely only half of them are actively practicing medicine to serve the 120 million Filipinos. Of those, half are in NCR. Even then, the shortage of doctors can be felt by patients in NCR, who wait hours to see a doctor. The waiting lines in doctors’ offices are always long.

Even in NCR, the inadequacy is glaring. A doctor friend shared the story of his relative “who needed to be transferred to the Philippine Heart Center from one of the top hospitals for an emergency procedure – because despite being a level 3 and teaching/training hospital, it did not have the specialists to operate since most were attending a conference abroad (perhaps on a junket trip?). It is absurd that the medical staff only realized that shortcoming when the case presented itself – they were caught with their pants down.”

Here is another story: “An indigent patient in Batangas, who collapsed due to vertigo, hit her head on the floor, prompting a doctor to recommend a CT scan of the brain. She went around begging to a politician (no budget yet for this year), DSWD, a government hospital, etc., to no avail. I suggested seeking PhilHealth’s Konsulta services. I’m waiting for the result.”

Still another: “A patient went to a government facility in NCR and was diagnosed with dengue fever. Was it a surprise to know that there were no beds available? A common refrain all over the country.”

So, disabuse your mind that being in NCR where the medical facilities and resources are at their best, can save your life.

Still, half of the tertiary hospitals with facilities and resources to care for more serious medical cases are in the NCR. If you have a heart attack or a stroke anywhere other than NCR, Metro Cebu, Iloilo City and Davao, your chances for survival decrease significantly. Health is a basic human right. Yet we keep electing officials who don’t give universal health care the kind of attention it deserves.

Our health care workers are overworked and, outside of NCR’s top specialists, are also underpaid. BBM’s first SONA promised more major hospitals and specialty hospitals in the regions so heart and kidney patients don’t have to go to the Heart and Kidney Centers in Manila for adequate care. But as of now, there is no hint that BBM intends to deliver on this promise. BBM, given his current resources, should be ashamed that we are still using his mother’s legacy projects 50 years after.

What can be done? We can stop cutting PhilHealth’s funds. We can insist that the DOH stop wasting billions of tax money by letting vaccines and drugs expire. We can have a Health Secretary with managerial abilities and a vision of what our health system should deliver.

We can invest in and leapfrog development by using technology, automation and AI in our health care system. We saw how telemedicine proved useful during the COVID-19 emergency. The other thing we should have learned from COVID-19 is the importance of making health a priority to improve resilience, reduce health inequity and promote greater individual, social and economic well-being.

Are pork funds more important than our health?

Boo Chanco’s email address is [email protected]. Follow him on X @boochanco