EDITORIAL - Health resource crisis

Salary scales in the bureaucracy cannot be skewed, officials said in explaining President Aquino’s rejection of a significant increase in the pay of government nurses. The proposed increase, officials said, would make nurses earn more than doctors and other government employees within the same civil service grade.

The explanation is valid, but it does not erase the fact that low compensation is the biggest disincentive for health professionals to join the government. This in turn has led to a continuing deterioration in public healthcare services, according to an independent director of the Philippine Health Insurance Corp.

PhilHealth’s Anthony Leachon said that despite an increase in the annual appropriation for health from P30 billion when President Aquino assumed power in 2010 to P205 billion last year, compensation for public health professionals remained way below competitive rates.

Leachon, who also heads the Philippine College of Physicians’ Foundation Inc., said the low compensation has led to a sustained exodus of doctors and nurses for better paying jobs overseas. The low pay has persisted even with the use of so-called sin taxes for public healthcare.

While the country is the biggest exporter of nurses worldwide and second largest source of migrant doctors after India, Leachon said the Philippines itself has such an acute lack of health professionals that it faces a “human health resource crisis.”

Those who bear the brunt of the crisis are the poor, particularly in the Visayas and Mindanao, who cannot afford premium health care in well-equipped hospitals. Even in these hospitals, however, the lack of health professionals is a problem.

Despite expanded PhilHealth coverage, Leachon estimates that up to 66 percent of Filipinos die without ever seeing a healthcare worker – a doctor, nurse, dentist or even a midwife. Healthcare expenses of up to 57 percent of the total bill, which are outside PhilHealth coverage and must be shouldered by beneficiaries, makes utilization of the health insurance program a low 33 percent among the poor. Among the higher-income beneficiaries, on the other hand, the utilization rate is 88 percent.

The ideal, Leachon said, is to have one doctor per barangay, or at least 25 healthcare workers for every 10,000 population. The current ratio is five per 10,000.

Almost all government workers are underpaid, so it makes sense to avoid disrupting pay scales to favor one profession. Still, the incoming administration must find a way to improve compensation for doctors and nurses if it wants to ease the crisis in public healthcare.