| Photo by Hush Naidoo Jade on Unsplash
Universal healthcare is aspirational. The Philippines is attempting it. To justify the shortcomings, let us consider our Republic as truly born on July 4, 1946, instead of 1898. Our nation was then a mere 76 years old in 2022. We are also fortunate that we have a young population. Nearly half of Filipinos are around 25 years old. This means we have enough time before this generation grows old and requires more healthcare.
Universal healthcare is mainly embodied in PhilHealth. The fragmentation of funding is immediately apparent. Healthcare financial assistance is still anchored on patronage. The savvy know to seek help from a motley combination of assistance from the DSWD, PAGCOR, Kalinga centers, the Red Cross, the Mayor, the Congressman, charities, senior discount, media appeals, relatives, and friends.
In rural areas, a fatalist conversation ensues where the sick resign themselves to lack of access, finances, and facilities which dictate the inevitable terminal outcomes.
PhilHealth is still in its infancy – most diagnoses are only covered up to a 20% discount. Its best coverage is likely for 144 dialysis sessions for those with kidney failure.
This is one of my favorite stories to tell when talking about healthcare. To illustrate, one of the best hospitals in the world, New York Presbyterian Hospital, a non-profit private hospital in Manhattan, does not discriminate between Middle East royalty and the poorest patients on Medicaid (healthcare coverage for no income to low-income patients) by law. This system, while expensive, is worth every investment made. It simultaneously provides healthcare and social justice. Not to say the American system is perfect because it has its share of flaws and problems; it is, after all, the most expensive healthcare system in the world.
The Philippines has had credible successes in infrastructure using public-private partnerships. The Philippines can also produce the best nurses in the world. Medical practitioners use textbooks mainly of the best authors, American or otherwise. We boast of specialized institutions like the kidney, heart, and lung centers. We have the ingredients – we lack coherence and resolve. Sadly, our society has so much contempt for the poor that we shudder at sharing our best and most expensive medical facilities with them; this is the only Catholic country in Asia.
While Filipinos acknowledge that the easy becomes impossible in a country so blessed due to one factor only – systemic corruption, not only in government but in our daily lives – how we transact business. We have no lack of economic saboteurs who will boast of being so cunning and clever for cornering any market – today onions, tomorrow sugar, rice, even masks, and vaccines. Never mind the dead. There’s profit to be made off of caskets too. But this, too, can be solved. This is a piece on healthcare, after all.
“The Philippines has had credible successes in infrastructure using public-private partnerships. The Philippines can also produce the best nurses in the world. Medical practitioners use textbooks mainly of the best authors, American or otherwise. We boast of specialized institutions like the kidney, heart, and lung centers.”
Most of Europe socialized health care. It is still a capitalist model in the US. There is a happy hybrid in between. First, all funding must be pooled into a single fund, creating a single payor with the leverage to negotiate prices on all aspects of healthcare, including outpatient care, emergency care, hospitalization, prescription, vision, hearing, and dental benefits. All healthcare must be privatized. An entity formed by a consortium of government regulators, hospitals, outpatient clinics, pharmacies, healthcare providers, bioethicists, pharmaceutical companies, dental, vision, and hearing service providers, etc., must be created to determine pricing and standards of care. The government must continue to provide funding, as should private employers. Adverse selection should never be tolerated to protect the self-employed and micro, small, and medium enterprises by enrolling them in the local government health plans where they reside or do business.
Medical science in therapeutics, vaccines, and devices, including design, engineering, and manufacturing, should be promoted domestically.
Oversight and disciplinary boards should be created to ensure continuing education, avoid malpractice, develop best practices and sustain the quality of care.
Unless health outcomes are separated from economic status, it will be sooner rather than later that tears in the social fabric become gaping rips in social stability. Marry inequities in healthcare with income inequality, food insecurity, and hopelessness, and ultimately history shall judge what we have failed to do.
Preventive care must be the bulwark of all healthcare. Health must be considered a right. Fail in that, and your wise pennies will quickly turn into pounds of foolishness and many fold more costly.
The Philippine Daily Mirror welcomes CRISPIN FERNANDEZ. MD as a regular columnist. Dr. Fernandez advocates for overseas Filipinos, public health, transformative political change, and patriotic economics. He is also a community organizer and leader, and freelance writer. His column, The Thinker’s Thinking, appears every Thursday.
