The Philippine Health Care System
(This essay was in response to an invitation to write to TBR 6th ed.)
The Philippine healthcare system is a tricky machinery which no Philippine Government in its young history has ever mastered. At present, the entire system is suffering both from its inherent flaws and external threats. Perhaps the greatest challenge the Philippine healthcare system has ever faced is its mass exodus of medical professionals. Never before has the Filipino society ever encountered doctors leaving for abroad, nurses abandoning posts for greener pastures and even midwives leaving the rural and countryside for better opportunities in the urbanized society. The brain drain that is affecting the Philippines has, first of all, affected the very heart of its society: health. For what can a country do if it is loaded with sick people? A lot of these mentally sick people are cohorted in the government itself. The poor are being neglected and are deliberately made to remain poor so that they will be cheap enough to be bought during elections. Their health are sacrificed. Only the rich can afford to stay healthy, but for how long?
During the AMHOP convention, I was among those who are serving in public health and the most dominating demands from these government physicians are: better compensation, improved health care facilities and implementation of the Magna Carta. It is not an overstatement when I say government doctors are the least compensated of all professionals in government. Point in comparison: the salary difference between a municipal judge and a municipal health officer. Judges earn at most 80,000 pesos a month with a starting salary of maybe 25 to 30 thousand pesos. As his service lengthens, the salary increases. The poor MHO remains at salary grade 24, with even having a hard time claiming for his medicolegal services, and his hazard pay of 4,000 plus a month. Politicians only remember their MHOs when it is election time.
The devolution of the public health system has made it even worse. Now that the LGU has control over the health system in their respective localities, MHOs and CHOs are at the mercy of their LCEs. In most LGUs, the health budget receives only less than 10 percent of the total annual budget. Of the entire health budget, at least 60 percent goes to salaries and wages of health staff. The RHU/CHO/MHO has only at most 40% to be spent for projects, purchase of medical equipments and supplies, etc. There is a 20% development fund but touching the DF is a lot more difficult than passing camel through a needle's eye. It is a blessing to find a supportive LCE but sometimes, even if you have a sympathetic LCE, the cordon sanitaire makes it unpleasant.
For the private doctor who maybe earning at least 100,000 a month, especially if he is a specialist, the concern maybe less. But every one in the medical profession will be affected. A sneeze from the public health sector will reverberate throughout the entire medical profession. There was even a joke during the AMHOP convention. What happens when there are no more "moonlighting" doctors? Most likely the private physician will do 24 hours duty as well. There was one province which all of its MHOs are Registered Nurses and are now ready to leave for the states.
How does one therefore solve the problem? Well, the problem is obvious. The solution must therefore be obvious as well. To solve the problem though requires political will. Unfortunately, the Philippine government is mostly made up of politics rather than will.
Being a doctor to the barrio, I have felt the frustration brought about by the slow bureacracy. While the intentions are there, the pacing can be slow and sometimes the doctor is misunderstood.
I believe it is time for the government to call for a Health summit. Private and Public doctors sitting together discussing the problem and providing the recommendations to the President and Congress. A united medical community can be a strong lobby group. Let us lobby for 100% health insurance coverage which covers our patients and pays promptly their doctors. Let us lobby for the centralization of our health system. The devolution is not working and the health system is not a willing sacrificial lamb when political season is in the air. Let us lobby for a culture that protects its medical professions, giving importance to their contributions.
The Philippine healthcare system is a tricky machinery which no Philippine Government in its young history has ever mastered. At present, the entire system is suffering both from its inherent flaws and external threats. Perhaps the greatest challenge the Philippine healthcare system has ever faced is its mass exodus of medical professionals. Never before has the Filipino society ever encountered doctors leaving for abroad, nurses abandoning posts for greener pastures and even midwives leaving the rural and countryside for better opportunities in the urbanized society. The brain drain that is affecting the Philippines has, first of all, affected the very heart of its society: health. For what can a country do if it is loaded with sick people? A lot of these mentally sick people are cohorted in the government itself. The poor are being neglected and are deliberately made to remain poor so that they will be cheap enough to be bought during elections. Their health are sacrificed. Only the rich can afford to stay healthy, but for how long?
During the AMHOP convention, I was among those who are serving in public health and the most dominating demands from these government physicians are: better compensation, improved health care facilities and implementation of the Magna Carta. It is not an overstatement when I say government doctors are the least compensated of all professionals in government. Point in comparison: the salary difference between a municipal judge and a municipal health officer. Judges earn at most 80,000 pesos a month with a starting salary of maybe 25 to 30 thousand pesos. As his service lengthens, the salary increases. The poor MHO remains at salary grade 24, with even having a hard time claiming for his medicolegal services, and his hazard pay of 4,000 plus a month. Politicians only remember their MHOs when it is election time.
The devolution of the public health system has made it even worse. Now that the LGU has control over the health system in their respective localities, MHOs and CHOs are at the mercy of their LCEs. In most LGUs, the health budget receives only less than 10 percent of the total annual budget. Of the entire health budget, at least 60 percent goes to salaries and wages of health staff. The RHU/CHO/MHO has only at most 40% to be spent for projects, purchase of medical equipments and supplies, etc. There is a 20% development fund but touching the DF is a lot more difficult than passing camel through a needle's eye. It is a blessing to find a supportive LCE but sometimes, even if you have a sympathetic LCE, the cordon sanitaire makes it unpleasant.
For the private doctor who maybe earning at least 100,000 a month, especially if he is a specialist, the concern maybe less. But every one in the medical profession will be affected. A sneeze from the public health sector will reverberate throughout the entire medical profession. There was even a joke during the AMHOP convention. What happens when there are no more "moonlighting" doctors? Most likely the private physician will do 24 hours duty as well. There was one province which all of its MHOs are Registered Nurses and are now ready to leave for the states.
How does one therefore solve the problem? Well, the problem is obvious. The solution must therefore be obvious as well. To solve the problem though requires political will. Unfortunately, the Philippine government is mostly made up of politics rather than will.
Being a doctor to the barrio, I have felt the frustration brought about by the slow bureacracy. While the intentions are there, the pacing can be slow and sometimes the doctor is misunderstood.
I believe it is time for the government to call for a Health summit. Private and Public doctors sitting together discussing the problem and providing the recommendations to the President and Congress. A united medical community can be a strong lobby group. Let us lobby for 100% health insurance coverage which covers our patients and pays promptly their doctors. Let us lobby for the centralization of our health system. The devolution is not working and the health system is not a willing sacrificial lamb when political season is in the air. Let us lobby for a culture that protects its medical professions, giving importance to their contributions.
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Btw, it's TBR which stand for THE BLOG ROUNDS.
Thanks again. Will send you the link of my host post, sometime next week.
See you.