Philippines healthcare unaffordable
DEMAND AND SUPPLY - Boo Chanco (The Philippine Star) - July 5, 2019 - 12:00am

A study has just confirmed what we already know is true: many Filipinos cannot afford to pay their hospital bills.

Nearly half of Filipinos are unsure if they can pay for their hospitalization if they get sick, according to the 2nd Philippine Wellness Index released last week. Initiated by PhilCare, the study found out that 40 percent of 1,350 respondents from various parts of the country expressed uncertainty on their capability of paying medical bills.

The study revealed that 37 percent of respondents had to use their savings while 25 percent sought the help of their relatives to pay their medical bills.

As reported by The Star, the study also showed that 30 percent of the respondents were not sure if they can afford the cost of regular medical checkups.

Philippine Wellness Index chief researcher Fernando Paragas said Filipinos lack the confidence to address their medical needs. “We are at our weakest when it comes to medical and financial needs.” 

A retired medical practitioner confirmed to me the existence of a serious problem. “Yes, Juan de la Cruz inherited a flawed ‘pay-as-you-go’ system. It is flawed in a first world economic setting. In a third world country, it is/can be a disaster due to lack of first world ‘filters’. Let me be clear - all classes are affected.”

And things will not get any better in the foreseeable future. Government through the Department of Health is too busy trying to cope with a broken public health system that is also plagued with corruption. Our PhilHealth was defrauded by over P150 billion in fake claims.

We know President Duterte wants a better health care system. One of the first things he did was to send his first health secretary to Cuba to check out their affordable but effective health care system. She returned, she bowed out of her job as health secretary and we never found out if she learned anything we can use here to provide better health care to our people.

Another study, this time by a foreign consultancy, also reported last week that Filipinos could experience even more expensive health care costs this year.

The Philippines is the second most expensive country in terms of medical expenses in Southeast Asia according to the Mercer Marsh Benefits 2019 Medical Trends Around the World report.

Medical inflation in the Philippines is expected to increase to 13.7 percent in 2019 from 13 percent in 2018. Vietnam currently has the highest medical costs in the region at 14.2 percent this year, lower than the 14.5 percent in 2018.

Medical costs, the report stated, are bound to continue increasing and will even outpace inflation by close to three times this year and even higher in 2020.

“The gap between medical inflation and actual inflation continues in the Philippines…,” Teng Alday, Mercer Philippines chief executive officer told Business Mirror.

Health care is becoming more expensive due to “high-cost pharmaceuticals, new diagnostics and procedures, and overprescribing of low-value health tests and procedures,” the consulting firm observed.

Indeed, one of the readers of this column reacted to a recent column on health care costs and confirmed on a personal experience the need for a health care system overhaul.

“My mother was hospitalized early this year. She never left the hospital and passed away after a month. Our total bill amounted to about P2 million including doctors professional fees.

“During her confinement, she was subjected to so many tests one had to really wonder whether they were all necessary.

“On the day she was wheeled into the operating room for a surgical procedure, a nurse walked in to ask whether I was willing to pay P4,500 for a portable ventilator. I asked her why. She said that’s in case my mother had difficulty breathing while being transported to the 4th floor OR from her room on the 5th floor, a distance that cannot be more than 40 meters… 

“The hospital also has a strict policy that requires all medicines administered to the patient to be supplied only by the hospital pharmacy ostensibly to ensure the safety and quality UNLESS they are not available in their pharmacy. Upon counterchecking with a drugstore chain, I learned their medicines cost 100 - 200 percent higher at least.

“I tried to bring this all to the attention of their management several times. I never received the courtesy of a reply. I am not one to give up quickly but life, work and reality beckon so I just had to give up. Maybe people like you could help.”

Hospital managers tell me that the costs of running hospitals are high. Taxes imposed on medical equipment, even those donated or obtained second hand, are atrocious.

Even if hospital occupancy rates are high and they are underpaying nurses or even charging them tuition for “training”, it is difficult to make ends meet. The medical services making real money are those involved in cosmetic surgery and other beauty procedures. No wonder a conglomerate is selling down their hospital assets.

Something has to be really wrong somewhere and no one is paying attention. The Secretary of Health is busy responding to a conflict of interest complaint because his family-owned building in Pangasinan is being rented by PhilHealth.

The good news is, Arsenio Balisacan who chairs the Philippine Competition Commission responded to my tweet about drug prices. “The PCC has commissioned a study on the competition landscape in the pharmaceutical industry. The findings of the study will help inform the agency’s actions to address the high local prices of drugs.”

Making sure our people are healthy is an essential task of government and society. Otherwise, with sickly people, we are not going to be able to take advantage of our fast growing population as a force for economic growth. It is as simple as that.

Boo Chanco’s e-mail address is bchanco@gmail.com. Follow him on Twitter @boochanco

FERNANDO PARAGAS PHILIPPINE WELLNESS
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