Stop privatizing public health services, facilities!

In the nine years (ending in 2010) that I served as legislator in the House of Representatives, I devoted considerable time and efforts to three advocacies: 1) human rights and peace; 2) national independence and sovereignty; and 3) public health services and health workers’ rights and welfare.

I pursued these advocacies in the halls of Congress, in public forums, and in the parliament of the streets. It was gratifying to have worked with like-minded colleagues, activists and allies. We won some battles, lost some. We must continue waging the big ones.

Through this column, I continue to pursue such advocacies. I have written pieces urging redress for human rights violations and for peace talks; against restored US military presence and expanded interventionism in varied ways.

Now I’ll dwell on the issue of public health, specifically the fight against the diminishing ratio of funds for public health in proportion to the overall national budget, and the continuing government policy to privatize public hospitals and health services. 

Last Thursday I had the opportunity to interface again with the indefatigable public health workers and advocates, and got updated on their various campaigns. Let’s focus on privatization.

The P-Noy administration’s approach to this policy is through its centerpiece Public-Private Partnership or PPP program, which includes the privatization of two key state responsibilities: education and public health services. The latter is backstopped by Universal Health Care via PhilHealth.

Plans entail eliminating the budget for maintenance and other operating expenses (MOOE) of public hospitals by 2014 and their allocation for personal services by 2020, as these hospitals are privatized, according to the Network Opposed to Privatization of Public Hospitals and Health Services (Network), formed last March 13.

Among the specific PPP projects are 1) to transform the Philippine Orthopedic Hospital into a Center for Bone Diseases and Trauma, and the San Lazaro Hospital into a Center for Infectious Diseases; and 2) to establish multi-specialty centers in Northern Luzon, Visayas, and Mindanao.

The implications of these moves, the Network points out, are as follows:

1) The public hospital budget cuts would further weaken the public health care system; even now public hospitals, both in the cities and provinces, lack vital facilities and personnel to serve ever-increasing numbers of patients; 

2) While the upgraded services of the privatized-cum-transformed Orthopedic and San Lazaro hospitals, and the regional multi-specialty centers would attract high-paying patients especially foreigners, their services would become unaffordable, thus inaccessible to the vast number of poor Filipinos;

3) The combined impact of budget cuts and privatization would reduce overall access by the poor to health services, increase the number of the seriously-ill people unable to get treatment, and result in more deaths from diseases;

4) Public health workers fear that these programs would further reduce regular hospital personnel, depress their pay and remove benefits. Their gains under the 1992 Magna Carta of Health Workers, now hardly enjoyed, would be rendered useless.

As regards the Universal Health Care through PhilHealth, the Network doubts that the scheme can enable the ordinary citizen to access quality but affordable health care services.

PhilHealth , which has 22 million members (population: 90 million plus), assumes only 30% of hospitalization costs, and only for those who have paid the P100 monthly due for nine months. Moreover, the fee is set to be doubled this year.

Now here’s some background:      The legal basis for the privatization policy — an IMF-World Bank lending imposition — was laid down during the Marcos dictatorship through Presidential Decrees 2029 and 2080. These were followed by the Cory Aquino administration’s creation of the Committee on Privatization and the Asset Privatization Trust, plus the enactment of the Build-Operate-and-Transfer Law.

The Ramos administration gave the policy a boost by pushing the globalization programs for liberalization, deregulation and privatization. Initially privatized were Petron, the Manila Hotel, Philippine National Bank, and MWSS.

In 1993 the World Bank issued a report, titled Investing in Health. It urged governments to 1) reduce public spending on tertiary hospitals and on various modes of health intervention; 2) promote private investments in essential clinical services, user-fee health services and privately managed health insurance; and 3) encourage private suppliers to compete in providing clinical and public health services.

That year the Ramos government devolved to local government units a big part of managing the health care delivery system, including the salaries of 44,000 of the health department’s 78,000 personnel.

In 1996 the government initiated the privatization of four government-owned-and-controlled hospitals (PHC, PCMC, LCP and NKTI). However, strong popular objections and militant protest actions led by government health workers stalled the plan.

During the Macapagal-Arroyo administration, plans were made to relocate the National Center for Mental Health outside Metro Manila and to sell the Welfareville land for private commercial development. Also planned was to integrate the four GOCC hospitals plus the East Avenue Medical Center into a Philippine Center for Specialized Health Care, and the corporatization of 68 government hospitals then under DoH supervision.

Again, the series of mass protest actions, lobbying and other modes of public campaigns delayed the implementation of these projects.

The fight continues, and must be won.

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