Build, Build, Build: Hospitals!

Several weeks ago, my sister in law “Jo” who has suffered from elevated blood pressure felt quite ill and asked to be brought to the hospital. Having our “family home” in UP Village, Diliman, the Beltrans have always felt blessed and at ease knowing that less than a kilometer away as the crow flies, we can always find a specialized government hospital. All within walking distance of each other, you can find the Philippine Heart Center, the National Kidney Transplant Institute, the Lung Center as well as the Philippine Children’s Medical Center, formerly known as the Lungsod Ng Kabataan.

It was at the NKTI that my mother was given emergency treatment for her first heart attack, and years after it was in the very same hospital that, last year, we spent the last 15 days of her life. It was at the Heart Center where I chose to have a life saving angiogram that revealed I had two serious arterial blocks that led to a double-angioplasty that I could actually afford. It was at the original Lung Center where I first learned about the serious damage that cigarette smoking does to my lungs. I am now an Anti-Tobacco advocate! Let’s not forget the Philippine Children’s Medical Center or PCMC where one of my many “apo-apohan,” the granddaughter of our caretaker in Lipa, was given the best medical care when she fell ill and was paralyzed due to an adverse effect related to dengue.

Times have changed unfortunately and going to our “neighborhood hospitals” is no longer a breeze as it used to be. In spite of her medical condition, “Jo” had the presence of mind to tell her husband Ricky that it was a Friday and going to the nearby hospitals, especially the NKTI, would be a bad idea because the hospital would surely be full of patients, particularly indigents and charity cases referred to the hospital by politicians and other government agencies (this we learned when we brought our mom to NKTI last year).  The couple eventually had to go to a private hospital that was several kilometers away and cost three to four times more. Thank God, Jo soon recovered and was back home.

I have long been writing about the need to build more specialized government hospitals in order to meet the serious shortage, but policymakers and politicians seem to be far more interested in infrastructure projects that are static instead of hospitals that have real physical and emotional value. I don’t think of past presidents who helped build, improve or expand EDSA, but from time to time I make mention of the value and contribution of the hospitals built through the efforts of Imelda Marcos. It has nothing to do with political color or loyalties but everything to do about healing, fixing and saving lives and loved ones. I have nothing good to say about the Martial Law years but I will not deny or discount the life giving or life saving significance of these hospitals.

The Duterte administration is currently promoting their “Build,  Build, Build” agenda. It is disturbing that the much needed “emotion generators” such as specialized hospitals and universities don’t seem to be in the program. The president has pushed for dedicated hospitals for the AFP and PNP, but no one has made mention of expanding and maybe duplicating the Philippine Heart Center, NKTI, Lung Center and the PCMC. The previous administrations have thought of simply privatizing said hospitals and being done with the “expense.” But as I pointed out, there is too much history and emotion tied to those hospitals and every attempt to privatize them has met with serious opposition.

After years of observing this conflict of ideas, it became obvious that the reason it could never be resolved is because the groups trying to find a solution were driven by absolutes or the “my way or no way” mentality. Perhaps they were also paranoid about rules and laws and lost sight of the possibility of “sharing” or what the private sector calls “real joint ventures,” not corporate takeovers or “management and maintenance” contracts where government simply steps back while an investor rakes in the profits. The government must be able to meet its social obligation, the public must be assured of affordable access to medical facilities, while the private sector is given a business model that turns a respectable profit for shareholders or owners.

The government has so much land available. Private sector has so much cash at their disposal. Government has a wealth of physicians and specialists; private sector has the marketing and management skills. Government can run hospital equipment; private sector can buy the equipment. Government has a never-ending stream of patients that contribute to maximization of resources while providing a wealth of cases worthy of research and scientific studies. Private sector has the network and skill set as well as technology to develop, market and promote these hospitals as centers of excellence, training and learning as well as profit centers. Why not build a two-in-one facility where one side is for government patients and a separate one for private patients with both sides having shared equipment and personnel and where no one is labeled as “Poor,”  “Indigent” or a “Charity” case.  This joint venture would maximize utilization and benefits and provide both sides a means to address their respective concerns and interests.

Privatization is not the answer because public health institutions are “owned” by the public and generations of patients that passed through their doors. It is one of the few things tied to their hearts and minds and they will not give that away. If the major corporations and visionaries of Philippine business simply re-invented the approach, not only would we harvest a lot of benefits locally, we could easily elevate Philippine medical facilities as a regional player just like when the PHC was once referred to as the “Asian Heart Center.”

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