The luxury of health care

Because of the dengue scare, a young woman was rushed recently to a hospital in southern Metro Manila after she started running a high fever, throwing up and suffering from acute abdominal pain.

At the hospital, barely known and barely surviving, where you have to bring your own bottled water to drink your medicine, she was examined at the emergency room and told that she would have to be confined for observation.

So she lay on a bed next to the women’s toilet with a busted light. At least the ER was clean and air-conditioned. A blood sample was taken and sent to the laboratory. She was fed intravenously and given oral rehydration salts and medicine to bring down her fever.

The next day the results of the lab test were not yet available. So she spent another night there, with a new IV pack and still with a slight fever. On the third day the results were known: she had urinary tract infection. The tests were negative for dengue or influenza. She was sent home.

Her hospital bill for two nights plus the money for the antibiotic needed for the UTI amounted to about P7,000.

And this was only for UTI, in a little known hospital. Okay, and also for fears that the woman might have potentially fatal dengue or contagious flu. That was the price not for diagnosing and treating UTI but for an ounce of prevention.

The young woman at least did not have to scrounge for money to settle her hospital bill and buy her medicine. For a growing number of Filipinos, an ounce of prevention is becoming a luxury they can no longer afford. In fact decent health care has become a luxury for millions of Filipinos.

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Start with the cost of medicine. With the revised value-added tax, the price of my favorite antihistamine has jumped by about 25 percent. And I thought the revised VAT would add only 10 percent, max, to the prices of consumer goods.

I would try generics, but I don’t think that common antihistamine has a generic equivalent available locally.

Generics would make medicine more affordable to millions of Filipinos. But the nation’s program to promote generic drugs has sputtered along for years, held back by the powerful, well-oiled lobby of the giant pharmaceutical multinationals. The government’s efforts to reassure the public about the efficacy of generic drugs have proved to be no match for the argument of the pharmaceutical giants that with branded medicine, product quality is guaranteed, and that you risk your health with unknown companies.

Several times I have been told by physicians that they could prescribe generic drugs to me but were worried that the medicine might not work like the branded versions.

There are also many Filipinos who do not trust the government to enforce stringent quality control on the manufacture of local generic medicine.

Such perceptions can still be overcome if the government launches an effective information campaign and people see generic drugs working on their neighbors or relatives. Given the wide price discrepancies between branded medicine and generic counterparts, it won’t be impossible to persuade many Filipinos to make the switch, starting with medication for basic ailments such as diarrhea.

The government should also start looking at incentives to develop our own pharmaceutical industry. This is a vast market that countries such as India have learned to tap.

Tax breaks, support for research and development especially for products using indigenous materials, as well as assistance in marketing locally and even overseas can be invaluable in developing our own pharmaceutical industry.

As it is, poverty prevents many Filipinos from buying even a daily dose of aspirin to prevent blood clots. Maintenance drugs for illnesses such as diabetes, high cholesterol, high blood pressure and cardiac problems are luxuries millions of Filipinos cannot afford.

For many Filipinos, even the cost of treating flu is prohibitive.

And for Filipinos who can’t afford to have symptoms monitored for two nights in a hospital, even dengue can be a death sentence.

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Given the state of the country’s public health care, even a visit to a hospital is no guarantee of proper treatment.

The nation’s hospitals illustrate the widening gap between rich and poor. The exodus of health professionals is taking its toll on public health care. Private hospitals across the country have been forced to shut down while government health centers suffer from an acute lack of nurses, doctors and other vital personnel. You feel the lack of health professionals even in the top hospitals in Metro Manila.

At the free wards of government hospitals, there are long lines for admission. There are long lines even at the pay wards. New mothers share not just rooms but beds at the Jose Fabella Memorial Medical Center in Manila.

The demand for health care can be overwhelming. Health officials are investigating whether filthy surroundings caused the neonatal sepsis or infection that killed seven babies at the Rizal Medical Center in Pasig shortly after typhoon "Milenyo" struck. Of 28 babies born there on Oct. 4, 12 developed neonatal sepsis.

Hospital administrators explained that the power and water cutoff during Milenyo led to the failure to keep the hospital clean. They have apologized for the deaths but will have to do more than say sorry.

Those were just normal baby deliveries. For many Filipinos, life-saving operations such as carotid and coronary bypass surgeries are out of the question. Even dialysis to save a kidney is beyond their reach. An average wage earner might survive a stroke, but he might not survive the cost of his hospital bill. One day in the intensive care unit of a reputable hospital can cost P50,000.

Cancer? The attitude of those who can’t afford chemotherapy and maintenance drugs is that ignorance is bliss. What they don’t know will kill them, but everyone has to die anyway.

A dose of fatalism rather than medicine helps millions of Filipinos get on with the day-to-day task of survival.

We often say that health is wealth. In this country, you need to be wealthy to stay healthy.