A healthy people, a healthy nation

Houston, Texas – After the US elections, my next stop was to visit the beautiful museums in downtown Houston (Natural Science Museum, Children’s Museum, Fine Arts Museum and the Health Museum). Of course before you reach the area you will have to go around the loop of the Texas Medical Center. Houston has the largest medical center in the world, home to thousands of Filipino nurses and medical assistants.

There are almost a hundred hospitals in this city like the Methodist Hospital, St. Luke’s Episcopal Hospital, M.D. Andersen Cancer Center, Memorial Hermann Healthcare System, Texas Children’s Hospital, etc.; 50 medicine-related institutions; and two excellent medical schools Baylor College of Medicine and the University of Texas Medical School.

The Medical Center performs most of the heart surgeries in the world. As a matter of fact, an uncle of my husband who has worked for the cardio-vascular operating room as circulating nurse at St. Luke’s for more than 20 years told me that there are around 12 heart surgeries in his hospital a day.

By the way, the Texas Medical Center receives over 200,000 visitors daily. So the traffic in the city is pretty heavy but the city police do a good job of controlling it ensuring a smooth flow of daily commute. This just goes to show how the city officials take their job seriously in public service.

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During the US elections, many Americans talked about the current US healthcare program Republican’s tagged as Obamacare. Today, it is still an issue as the Republicans in Congress want to repeal it but majority of Americans oppose this move. In the Philippines, our healthcare program is as the German’s say “kaput” – finished, destroyed, out of commission.

When P-Noy became President, there was a great disparity in the delivery of health care between the rich and the poor. According to Dr. Leizl Lagrada, then OIC of Health Policy at the Department of Health, enrollment coverage in Philhealth favored the rich due to a weak policy of targeting poverty. Two thirds of reimbursements made by Philhealth were for private hospitals that cater to the rich. Health facilities that were accessible to the poor were often not accredited.

Poor Filipinos die from curable diseases because they cannot afford to buy medicine. A recently-conducted Family Health survey showed that maternal deaths have increased from 160 in 2006 to 221 last year. Although cheaper generic drugs have been produced in the Philippines for 20 years now, those who can afford to buy medication, still tend to prefer brand names. Health resources were (still are) unevenly distributed. Healthcare financing was inadequate.

Last month, a roundtable discussion on health financing was held at the Traders’ Hotel, Manila as part of the ongoing Secretary’s Cup, the series of talks, debates, and meetings that aim to raise awareness and build a constituency for Universal Health Care or Kalusugan Pangkalahatan.

Dr. Eduardo Banzon, current Philhealth director talked about Universal Health Care for every Filipino. He noted that the Philippines, a middle income country has 60% of the population die unattended by a doctor. He also mentioned that out-of-pocket payments’ share of total health spending is still high with 54% of the total health expenditure. Dr. Ramon Paterno from the Institute of Health Policy and Development Studies, UP Manila – National Institute of Health said, “People should not go bankrupt just because they are sick.”

The country aims to attain universal health care by year 2016. By this time, some 100 million Filipinos shall have been enrolled with the Philhealth, according to Dr. Eduardo Banzon. But the question is, how much will the country spend for universal health care? The government needs P682 billion for universal health care from today till 2016. Of the amount, the government shall be providing P224.8 billion, while the other amount would come from local government units and other agencies.

Of the amount, the government will be using P92.7 billion to finance the 100% subsidy for the health insurance premiums of the 5.2 million poorest families. The government also needs an additional P55.3 billion to be able to provide 50% subsidy for the next 5.6 million poorest families. And for 2012 alone, it will need P50.3 billion to fund its financing requirement for universal health care.

Just where will the government get all these money? This is why the Department of Finance has been pushing for the passage of House Bill 5727, the measure that seeks to reform the current excise tax regimen of alcohol and cigarettes. It is said that the passage of the bill will not only prevent if not stop illnesses caused by these vices but will also yield additional revenues of P60 billion a year from alcohol and cigarettes.

Dr. Banzon also said that if we have to attain universal health care by 2016, the premium for Philhealth members will have to be increased from P1,200 per year to P2,400. We must understand that the benefits we are getting from Philhealth are based on the premiums being collected. The Philippines is said to be offering one of the cheapest health insurance premiums among all countries in Southeast Asia. The premium is only P7 per day.

The recent expanded benefits for in-patients including what is called “catastrophic benefits” to patients suffering from cancer and leukemia and for prostate operation and organ transplants is commendable. It is also such a relief to know that Philhealth now has a program for overseas Filipino workers and their dependents. I just hope that all these can be sustained even long after P-Noy has stepped down from office.

The challenges in achieving universal health care are many. There is the delay in updating the civil registry data; the discrepancy between the data from the National Household Targeting System vs. Community-based monitoring system; the IT and network infrastructure; Physical and Financial access to health care that includes facilities with limited supplies and empty health care facilities; unregulated prices of services; irrational drug prescription; generic drugs still perceived to be ‘substandard’; consumer behavior – an overemphasized power of choice and unregulated access to specialists and hospitals and the concept of paying for security that is still not understood. Then there is this issue on high level hospitals being mostly concentrated in urban areas like the NCR. Majority of hospitals in the country are private regardless of level of care.

No matter what happens, in whatever way it can be achieved, now is the time for the government to look into the health care of the citizens, young and old, rich and poor alike. There should be no discrepancies and no differences in the services to be delivered. After all, we are of the same race. We have the right to equal health benefits and services. Remember, healthy citizens bring about a healthy nation. This is what we should aim for!