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March 4, 2014

To The Philippine Government, From One Of Your Doctors

     According to the Philippine government, I am a tax evader, or at least my kind. I am a medical doctor and it wasn't easy becoming one. One can just imagine the sh*t - literally, at times - that I've been through just to get to where I am now. While my contemporaries are already well established in their careers by the time they were 28 years old, back then I was just about to start, after having just finished 4 years of medical school (not including 1 extra year of internship and 4 years of premed). I decided not to pursue any more specialization because I wanted to focus on public health and community medicine. But for many of my "masochistic" batchmates, they decided another 3 or 4 years of physical and mental torture wouldn't hurt them so they went on to get specialty training as residents. That meant another round of 24-hour duties every 2-3 days in a place which can be as unforgiving as our renowned government hospitals: dilapidated and undermanned facilities where supposedly a portion of our taxes would go to for their refurbishing.  Meanwhile, I went to work for the Department of Health under their doctors to the barrios program, deployed in a far flung area for 2 years, working 24/7, literally living inside my Rural Health Unit to cater to almost every kind of illness at any time of the day, any day of the week.

     By the time my friends were done with their specialty training, they had to go to Manila to get subspecialty training. Nowadays, a doctor must acquire more specialized skills in order to serve a specific section of the society. By the time they are done with their training, they would be biologically 35 years old but physically 50. On the other hand, I left the country as an OFW after this government failed to even protect my rights as a government physician, after the LGU I served failed to give me the Magna Carta benefits as mandated by law and worse, even decided to "kick me out" because well, they just wanted to. After all, the money they would no longer spend for the salary of a Municipal health officer would be savings for them, which they in turn would divide among themselves by the end of the year.

     Many of my friends who were then residents could have decided to quit and live a more relaxed life. I would have wanted to stay in the Philippines where family is closer and I enjoy my rights as a first-class citizen of my own country. But with the sh*tty economy that we had, we couldn't just quit and "relax". After all, believe it or not, many of us wanted to become a doctor not because we wanted to be rich. Of course, we wanted to earn. But to think that after passing the board exams and the specialty training a doctor automatically becomes rich is actually so not true.

     So, when the Bureau of Internal Revenue suddenly publishes a picture of a doctor riding on the back of a teacher insinuating that doctors are tax evaders and when they don't pay their taxes they are a strain on the backs of those who do, I felt like I wanted to smack one of my pay slips on the face of these commissioners.



     According to my government, many of the doctors "don't pay" their taxes simply because for example they don't issue receipts after giving their medical service, whether it is a simple outpatient consultation or a major surgery. If we assume for a moment that the government is right in this observation, the fault does not lie on the doctor and his or her failure to issue receipt but really it is in the flawed taxation system of our government. What this government failed to understand is that the service of a physician is not as simple as a tangible commodity, like one of those grocery items you can pick and place in your cart. We doctors don't charge for every "healing motion" we do with our patients. By insisting that we post the type of services we offer in our clinic with their corresponding fees only "commoditizes" (if there is such a word) health. I don't charge higher fees for example for a patient who has Multi-drug resistant Tuberculosis than a patient who only has mild pneumonia if both come to visit me in my clinic. The fees are the same, even if my risk of getting infected with a contagious and hard-to-treat illness is higher in the former than the latter.

     Don't get me wrong, those who don't pay their taxes should be prosecuted. No exceptions. This includes doctors, lawyers, accountants, politicians, etc. But to single out one profession over the others and make a sweeping generalization only proves how myopic, narrow-minded and apathetic these bureaucrats in government are. They failed to recognize that there are doctors working in government and being government employed they pay their taxes. They failed to recognize that there are doctors working in non-government organizations and they are also paying their taxes. They failed to recognize that there are community and rural physicians who don't get paid in monetary value but instead they get paid by their poor patients with goods. How do you tax that?

     I don't mind paying taxes. But every time I receive my pay slip and see how big the withholding tax is being deducted from my pay and then see the likes of Janet Napoles on the news, I can't help but vent my spleen.

     If BIR is really serious about increasing their tax collections, maligning the health professionals is sending the wrong signals. They are barking up on the wrong tree. Perhaps, this country has not fully appreciated the importance of the doctors and other health care workers particularly their contribution to nation building. Perhaps, this country has not really given what is due to its health workers, especially the doctors, many of whom sacrificed comfort and family time just to serve the needs of others first. I am not looking for entitlement here (nor even a tax exemption. Hindi po ako Boxing Champion). I do hope none of the commissioners nor any of their family members would need to see a doctor soon. I do hope they are in the fullest of their health.

     Meanwhile, there are certain people in our society who had to trek for hours just to bring their sick child to a health facility in the boondocks only to find out their town has no doctor or nurse or midwife and therefore they need to travel even further just to see one.

     I think BIR got the picture all wrong. I think they got the wrong person piggyback-riding on the teacher. I think it is more suited that a politician or a government bureaucrat should be portrayed as the ones sitting on our backs. After all, these government officials are the biggest "pabigat" to all of us, yup including the corrupt BIR tax collectors. Bakit? BIR lang ba ang may kakayahang mang-generalize? If BIR is in the mood for generalizing, then allow me to do that as well. 




     To the BIR, isip-isip din pag may time.


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