‘Righteous Path Not About Scrimping On Health Care And Workers’

by Marya Salamat

MANILA – If the youth and students have planking as a new mode of protest, the health workers have “owling.”

“This is pop culture made progressive by health workers here,” said Sean Vilchez, deputy secretary-general of Health Alliance for Democracy (HEAD). Indeed, in the program his group and other members of the Coalition of Health Budget Increase held in front of the University of Sto. Tomas, and on the march toward Chino Roces Ave. (formerly Mendiola Bridge) this Thursday, some participants “owled” to hoots of delight from their fellow health workers and passersby.

But what they owled about are hardly delightful issues. The health workers have been battling against a yearly trend of cuts in health budget. Health practitioners from public hospitals and communities joined the march-protest cum owling to Malacañang in a bid to call for a P90-billion ($2.1b) health budget for next year.

The national budget is still being deliberated in Congress. Last Tuesday, its 2012 General Appropriations Act, amounting to P1.816T ($41.7b), was approved after final reading at the House of Representatives. The deliberations are now focused at the Senate.

The health workers’ groups brought their protests to Malacañang because, according to Jossel Ebesate, national president of the Alliance of Health Workers (AHW), “the real forces behind the ongoing deliberation of the national budget are President Benigno Simeon Aquino III and the Department of Budget and Management.”

The health coalition composed of health practitioners from public hospitals, students of health courses and community health workers, are urging President Aquino to act on what they describe as “permanent disaster” happening in the country – the government’s neglect of health.

“The Department of Health has often been reduced to shame by just being in a position to report the rising number of victims of dengue, leptospirosis, tuberculosis and other illnesses,” said Ebesate, adding that, on the ground, or in public hospitals and health centers, the health department has been proven again and again as “inutile” at providing much needed health services.

‘Initial victory’

The progressive health group’s early efforts at calling for a higher ‘just for starters’ health budget— higher than even the amount proposed by the health department— have garnered “an initial victory.” The House of Representatives approved on its final reading last Tuesday (Oct 11) a P200-million ($4.6m) addition to the DOH budget and P400-million ($9.2m) for government-owned and controlled corporation (GOCC) hospitals.

“Our efforts to expose the ill effects of low health budget paid off. But while we recognize this initial victory as a result of the people’s efforts through the support of pro-health lawmakers, we see that we need to exert more efforts to effect a more substantial increase,” said Ebesate in a statement.

At the Dr. Jose Fabella Memorial Hospital in Manila, members of Gabriela-National Capital Region urged senators “to realign the approved budget of the Lower House and give priority to the basic services that poor Filipinos need.” Gabriela-NCR stressed that senators must scrutinize Aquino’s proposed budget well and allocate bigger subsidy to health services and education, as the battleground on the issue of budget cuts shifts from Congress to Senate.

Though the women’s group did not “owl” their protest, they did something unique, too, in staging their rally at the Fabella Hospital Thursday. To symbolize “the inaction and negligence of the Aquino administration over the welfare of women and children,” in a place known to be the only public lying-in hospital in the country, pregnant moms bared their bellies with written slogans, ‘No to budget cut on health services!’

So far, the increase in health budget brings it to P42.893-billion. Sources from the House of Representatives said that of the P200-million increase in health budget, P100-million ($2.3m) will go to the East Avenue Medical Center, P50-million ($1.2m) to Jose Fabella Memorial Hospital and P50-million ($1.2m) to the Research Institute for Tropical Medicine.

Another P100-million ($2.3m) is reportedly added to the budget of the UP-PGH, plus another P60-million ($1.4m) for CT scan and other services. The supposed “hospital of last resort” has also clinched what they call as “initial victory” when they succeeded a month ago to “suspend indefinitely” the new order of its director to start billing indigent patients.

The GOCC hospitals including Philippine Heart Center, Lung Center of the Philippines, National Kidney and Transplant Institute and Philippine Children’s Medical Center, will get additional P100-million ($2.3m) each.

For the Coalition for Health Budget Increase, the initial increases “proved once again that organized action is necessary to push for our rights,” as Ebesate said during their rally at the Mendiola Bridge. The group also repeatedly thanked the support of lawmakers such as Bayan Muna Rep. Teddy Casiño, Gabriela Women’s Partylist Reps Emmi de Jesus, ACT Partylist Rep Antonio Tinio, Anakpawis Partylist Rep. Rafael Mariano and other pro-health legislators.

The group also chided Health Sec. Enrique Ona who they say had vehemently defended the department’s low asking budget during the hearing last September in Congress. At the hearing, the DOH officials’ position had been to make do with limited budget and to promote instead public-private partnerships and Philhealth as sources of funds for health services. This DOH stand, said Ebesate, was clearly enunciated in its proposal and defence of it during the budget hearings.

Yet, when news came out that the lower chamber of Congress approved a total of P0.6-billion ($13.8m) additional health budget, the health department crowed like it had angled for it all along, said some dismayed health workers during their rally.

They now challenge the health department and President Aquino himself to go beyond this initial increase to have something truly worthy of crowing about, for a start. They pressed Aquino to push for a P90-billion ($2.1b) health budget.

What P90-b health budget means for public health

These times of typhoons and floods have brought to fore the effects of years of neglecting people’s health and welfare, said Robert Mendoza, secretary-general of AHW. The health alliance observed that every year, “lives and properties are unnecessarily lost to typhoons and floods, evacuees are helped out by fellow citizens, civic, private and non-government groups, as government’s token relief services fail to cover up for its inadequacy and unpreparedness for disasters.”

The health group said the ill effects of the government’s privatization and fees for services schemes are revealed again and again in the dismal state of people’s health.

“Seven out of ten Filipinos still die without the timely and relevant health services and care, sometimes due even to illnesses that should have been easily prevented,” said Vilchez at the rally.

The increasing deaths and cases of dengue and leptospirosis, with patients shouldering most if not the full cost of hospitalization or asking good-hearted donors to pay for the bill, and the continuing prevalence of diseases of poverty like tuberculosis, pneumonia and diarrhea, and rising cost of health services in public hospitals, are depressing real-life tragedies of government neglect, the health coalition said in a statement.

For 2012, the Coalition for Health Budget Increase calls for “at least P90-billion ($2.1b), more than twice the government’s proposed P42.693-billion ($981m).” The amount is still admittedly not enough, the health groups say, but at last it would give for a start a somewhat comprehensive health care covering preventive, curative and rehabilitative aspects of it, including disaster preparedness.

It would also indicate that the Aquino government is trying to prioritize the people’s health, Ebesate said.

Unfortunately, the health coalition laments that the Aquino administration has been “turning a deaf ear” to calls for prioritizing health. “It is no different from the Arroyo administration,” they said, pointing to how this government has slashed the health budget for 2011, gave zero increase to hospital’s operational budget for 2012, and put up public hospitals for privatization or public-private partnership.

By 2012, some public hospitals that have been the last hope of poor patients, for example, the San Lazaro Hospital, Philippine Orthopaedic Center and National Center for Mental Health, and perhaps even the Philippine Heart Center, are in danger of being auctioned off or relocated to far-off unknown location, union leaders from these hospitals separately disclosed during the rally at the Mendiola Bridge.

Fees and neglect continue to haunt patients as public hospitals are forced by lack of budget to exact fees for its services, while its overworked health personnel struggle to attend to bigger number of patients.

The number of the country’s health workers remains pegged at some 70,000, or the same since twenty years ago, despite an increase of 40 million to Filipino population. The health personnel to patient ratio has worsened to the extent that in some public hospitals, health personnel are detailed for more than 16 hours per duty, said Ebesate.

Despite their longer and more intense work hours, the public health workers are steadily forced to cope with eroded wages and benefits.

“Due to the DBM impounding unspent budget as a result of unfilled positions, the benefits of savings will no longer be given to us,” said Ebesate. He told the Aquino government that the “real righteous path is not about scrimping on the budget for health and health workers, but giving health services and taking care of those who provide health care.”

Instead of taking on its responsibility of improving public health services, the government plans to remove subsidies to the maintenance and other operating expenses of public hospitals by year 2014, and personal services (health workers’ salaries) by year 2020, said Robert Mendoza of AHW.

Although Sec. Ona himself has admitted that the cost of health services will likely increase with privatization, the government, said Mendoza, is “passing the burden of health financing to us people through health insurance (mainly Philhealth).

Much of the increase in the original DOH-proposed budget goes to Philhealth, which works by collecting premiums, a form of specialized tax, from the people. These premiums are used to improve public hospitals that use the improvements, in turn, to gain more revenues for its operations.

Philhealth and privatization are the “backbone of President Aquino’s Health Agenda,” said the Coalition for Health Budget Increase in a statement. Following a World Health Organization-World Bank-International Monetary Fund prescription, the Health Agenda “aim to cut expenditures and generate revenues for foreign debt payment, policies like privatization, user-fee schemes, contractualization, wage freeze and eradicating unions.” The moves, said the health coalition, are meant not exactly for better health outcomes nor health care services, but more for increased business and profits for private and foreign corporations, “at the expense of the people’s welfare and violations of health workers’ rights.”

The health groups vowed to “continue serving the Filipino people with or without disasters.” They appealed to the public to strive with them for people’s health and rights, starting with working for a higher health budget, and pushing for free, accessible and affordable health services. (Bulatlat.com)

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