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An Urgent Appeal to Call Attention to the Deteriorating Public Health Care System
by Rep. Satur C. Ocampo
Friday, Sep. 10, 2004 at 4:26 PM
Privilege Speech, 7 September 2004
Mr. Speaker,
I rise on an issue of collective and personal privilege to call the attention of this august body to the rapid deterioration of our public health care system. With us now in the House, sitting in the gallery, are our public health workers who ask us to particularly look into how the provision of health services in government hospitals has reached the critical level.
The rising incidences of communicable and non-communicable diseases, coupled with the continuing commercialization of health care, clearly point to a seriously ill – and flawed – health care system, both at the national and local levels.
Our largely poor population used to rely on the public health system. With the declining health budget, government hospitals are crippled by the lack of funds. A survey done by the health alliance, Kilosbayan Para sa Kalusugan, in 13 public hospitals from August 29 to September 2, 2004 showed that 89% of the patient respondents had to wait from three days to one month before they were admitted to the hospital. Most of the respondents, or at least 61%, said they had no money to pay for admission fee; another 17.3% said there were no beds available. Some even had to wait for one to two years to be admitted. Poor patients cannot get treatment even for emergency cases in public hospitals if they cannot shell out P500 to P2,000 for admission fee.
A short trip to several public hospitals and health institutions would reveal how ill- equipped, understaffed, and crowded these hospitals have become.
- The Vicente Sotto Memorial Medical Center in Cebu, for example, operates on a budget for 400 patients. However, the hospital admits up to 600 patients daily.
- The Amang Rodriguez Medical Center in Marikina City has a budget for 150-bed capacity but maintains 250 beds, almost always occupied by indigent patients. In January 2004, the Department of Health cut the hospital’s budget of P22 million by P18 million, or 82%.
- At the Jose Fabella Memorial Hospital in Manila, two patients often share the same bed.
- At the Philippine General Hospital in Manila and at the East Avenue Medical Center in Quezon City, patients lying along the corridor of charity wards is a familiar daily sight.
These are common occurrences nowadays. They have become the norm – a tragic manifestation of how inaccessible and unreliable much needed health services have become to the poor and less privileged Filipinos, the large section of our people represented by Bayan Muna in this chamber.
The budget cuts on health care virtually institutionalize the commercialization of health care even in government hospitals. Under the guise of fiscal autonomy, government hospitals are now required to come up with their own income-generating projects. Simply put, what this means is that, if before medical service was freely available for indigents, today, every medical service and even medical supplies have corresponding fees.
At the Lung Center of the Philippines, for instance, patients at the outpatient department have to pay P30 for electricity, water and other miscellaneous fees. They are also required to buy masks, costing P8 each.
As it is, our current health care system is no longer responsive to the people’s needs. The commercialization of health care further worsens this condition. The collection of fees is a virtual death sentence for indigent patients. Where will charity patients get the money to pay the prohibitive cost of health services in government hospitals?
Consider, Mr. Speaker, the following cases documented by the Alliance of Health Workers which were brought to the attention of this representation:
- At the Philippine General Hospital, there have been reports that charity patients at the gynecology department have been bumped off to give way to pay patients, who are prioritized for admission and services, and even for medicines and supplies at the pharmacy.
- At the National Kidney and Transplant Institute, one patient who was too poor to pay for the dialysis suffered complications. Gasping for breath, she and her family pleaded with the staff to give her oxygen, but this was ignored. Needless to say, the patient died. The kidney institute gives priority to paying patients and charity patients are deemed “chance patients” only.
- At the Philippine Children’s Medical Center, an 8-year old child of a security guard was admitted for bacterial meningitis and the family spent more than P30,000. The parents had to literally beg from politicians and charitable agencies to be able to pay for the hospital fees.
- At the Lung Center of the Philippines, Loreto Espiritu, a tenant-farmer was admitted for bronchitis. He spent P98,953 for his treatment, which included hospital laboratory procedures totaling P68,953 and medicines costing P30,000 bought outside because these were not available at the hospital pharmacy. Selling all of his farm produce was not enough to pay his hospital expenses. He still had to borrow from relatives and friends.
- On July 31, 2004, the Philippine Daily Inquirer published the letter of a concerned citizen, Vyana Figueroa, 26, who works at the Bureau of Broadcasts. She witnessed how the staff in a government hospital took out the life support system attached to a 19-year old mother from Bauang, La Union, because her family could no longer pay the bill. She had delivered a baby and lost a lot of blood. The family of the girl pleaded with the staff, but to no avail. They were even asked to pay for the bed sheet and linens soiled with the girl’s blood.
The chronic lack of budget in government hospitals is obviously depriving countless poor Filipinos of much-needed health services. The Department of Health itself admitted that the average hospital bill is three times the minimum wage. More complicated operations, like transplants, are options no longer readily available to indigent patients.
- At the Philippine Heart Center, an open heart surgery costs about P400,000. Charity patients have to wait for six months to three years before they can undergo the required operation – assuming that they live long enough. Dr. Ludgerio Torres, PHC director, told a forum of the Philippine College of Surgeons in 2002 that PHC had a backlog of 4,000 charity patients already screened and approved for open heart surgery and that 40% may die before they could be operated on. The PHC budget is only P150 million.
- At the Philippine General Hospital, pediatric heart surgery on charity patients is done only once a week, resulting in a big backlog.
- At the National Kidney and Transplant Institute, charity patients have to shell out P360,479.12 for a kidney transplant. They are also required to pay a deposit amounting to P50,000 to P80,000 upon admission.
Mr. Speaker, the state of our government hospitals is such that poor patients and their families have been practically reduced to begging just so they could come up with the money for their treatment and medication. A health worker told me the story about the mother of a kidney patient who would board public buses, asking the passengers for donations for her child’s dialysis. Every day, on national television, we see many more of our poor, weeping openly and hoping that viewers would take pity on their children and help fund their medical treatment
A recent survey of the Kilosbayan Para sa Kalusugan on the state of our government hospitals revealed that 72% of patients were able to settle their bills either by borrowing, soliciting, or begging for contributions from relatives, friends, politicians and charitable institutions.
This deplorable situation, Mr. Speaker, has to be taken into consideration as we in Congress begin to tackle the General Appropriations Act. The right of the people to health care is enshrined in the Constitution. Therefore, we, who hold the power of the purse, have the duty to ensure that the proper amount for health care be given to address the problem. For the past eight years, the health budget has declined by about 40 percent. In 1996, per capita spending on health amounted to P230, but the current spending is now only P114 – or 37 centavos a day. This amount is not even enough to buy a tablet of Biogesic, or its generic version, which costs P1.
For this reason, we in Bayan Muna are filing a resolution asking the House, particularly the Committees on Health and Appropriations, to conduct a joint inquiry into the deplorable condition of government hospitals and the consequences of this on our largely poor constituents because of the minuscule budget allotted to health.
We also urge the House Committee on Appropriations to ensure that the heath appropriations in the 2005 national budget meet the World Health Organization’s prescription that 5% of the gross national product be spent for health.
Mr. Speaker and distinguished colleagues, we ask for your full support for this resolution. Let us work together with our public health workers to resuscitate our ailing public health care system so as to ensure affordable health services for the poor.
Thank you, Mr. Speaker.
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