Revisit devolution and universal health myth

In general, when government or the legislature passes a law or rolls out a program, there is a prescribed or set period after which a review or evaluation is done in terms of the success or effectivity of the law or the program. From the time of president Noynoy Aquino, president Rodrigo Duterte until the second year of the Marcos Jr. presidency or approximately 14 years, there have been a lot of programs or laws in place but not much in terms of reviews or evaluation.

The Local Government Code, which caused the major devolution of services and funds from the national government down to provincial and local government units, was passed into law in 1991 or 32 years ago. The law that established PhilHealth was passed in 1995 or 28 years ago. The Universal Healthcare Act was signed into law in 2019 and was supposed to be implemented in 2020 but was totally disrupted by the global pandemic COVID.

When does Malacañang or Congress and the Senate plan to do the full review of these laws and programs?

In the meantime, the Local Government Code, PhilHealth and the Universal Healthcare Act have been the target or focus of complaints for what critics call infirmities or defects of the law or the related program. A number of former Cabinet secretaries and undersecretaries representing the Department of Health, Department of Agriculture and the DepEd have pointed out that these laws and programs have created serious gaps, misinterpretation of roles and authority and serious failure to deliver services.

Two former secretaries of the DOH – namely Francisco Duque and Janette Garin – have told me that the government and Congress should act to “renationalize” health care under the DOH. The fragmented reality of health care under the current system of devolution has jeopardized health care needed by Filipinos because LGUs and political leaders are all short-term officials (three years) and are generally “professional politicians,” not necessarily career management executives, certainly not trained health care administrators.

The reality is that there is also politics in the appointment of senior officials of regional hospitals and local hospitals. Rumor has it that the confirmation of Secretary Ted Herbosa got hamstrung because one congressman wants an official of a regional hospital related or closely associated with a governor replaced by an acceptable candidate. In other regional hospitals, things are so bad and impoverished because the governor or congressman has never set foot inside the dilapidated and poorly funded regional hospital.

I remember a time when several provincial governors made a beeline to borrow something like P1 billion each from the PNB or Philippine National Bank to put up their respective provincial or city hospital. Twenty years later, those hospitals have been run to the ground, hospital equipment busted and patients having to provide their own materials before and after surgery! Essentially all that’s left is the building and the personnel.

I can only hope that while Congresswoman Janette Garin is in Congress, she can muster enough support for the re-nationalization of health care and while she’s at it, review the PhilHealth program which gives zero balance billing to indigent patients who don’t pay contributions while contributing members end up shouldering most of the cost of a medical emergency or procedure. During a recent event among health care stakeholders and organizations, a high-ranking officer was very vocal about how she had to pay so much for the medical emergency of her father. Other people quickly joined in and shared how they too felt left out or betrayed by the “No balance billing” slogan of PhilHealth. One participant asked, “Do you always have to be as poor as a rat in order to get relief from the government?”

*      *      *

I got an email from one of our readers that was so informative I had to copy-paste it today:

Reacting to your column today, Nov. 24, “Teach a man how.”

I was extremely gladdened by your putting emphasis on the backyard industry as a vital cog in the livestock and poultry setting. The backyard industry still remains as the main source of meat supply for the large rural areas outside the cities, in spite of the constantly/oft repeating backyard animal population dips and rises brought about by the repeating outbreaks of endemic animal diseases, like NCD in poultry, hog cholera in swine, hemorrhagic septicemia in cattle, among others. And now, adding to the stew, the more pathogenic, more destructive ASF and avian flu.

Backyard livestock production is really the descriptive phrase of the word “resilience.” Pre-1987, the Bureau of Animal Industry (BAI) was a constant field partner for the backyard industry, having a technician in nearly all the towns, providing ready technical support, breeding stations and regular free vaccination activities.

The BAI was then producing its own vaccines for NCD, hog cholera and hemorrhagic septicemia, among others, at its Vaccine Production Laboratory in then Alabang Stock Farm. The continuous vaccination activity greatly tempered the effects of repeating outbreaks.

Devolution effectively decimated the ranks of livestock technicians, breeding stations and backyard livestock support services. LGU agriculture technicians are now basically “gift givers,” not technology providers.

The BAI then was wise in leaving the commercial livestock sector alone, concentrating available resources on the backyard sector, with commercial sector support limited to removing the barriers to allow unimpeded growth of the then emerging industry (which, essentially, laid the groundwork for the phenomenal growth of the commercial livestock and poultry sector in the last three decades).

Thank you bringing forth the issue to the public arena, and to the new secretary of agriculture, Kudos also to the work you and San Miguel are doing for backyard industry.

Sincerely, Joel F. Mangalindan, DVM, animal clin. nutrition practitioner

*      *      *

E-mail: [email protected]