Nation’s health

Managing the COVID-19 pandemic exposed the shortcomings of the country’s health care system particularly in terms of prevention, control and mitigation of infectious diseases. It has also become obvious that the country lacks health care workers and that digital infrastructure and health information systems are fragmented and inefficient.

That’s not me talking but NEDA in its Updated Philippine Development Plan. Reading Chapter 10 on Human Capital Development was a surrealistic experience. Could it be that our government knows what the problems are? Well, the economists at NEDA are not like the propagandists at the Presidential Communications Office. But are they listened to?

Ultimately, NEDA says, the current capacity of the health agencies must be able to effectively implement its programs and provide quality services both at the national and local levels.

“Moving forward, the sector will expand its use of innovative delivery mechanisms, such as telemedicine, enhance outreach programs by improving the capacity of target beneficiaries for home-based care and use of other media to deliver information, education and communication services on proper nutrition and health…”

Now we are dreaming. Telemedicine? Outreach programs for home-based care? Deliver information, education and communication services on health?

Just now, I have verified through crowdsourcing on social media that there is an ongoing flu epidemic of sorts and we have heard little from the DOH on what to do. Outside of a PNA story saying DOH has seen a 40 percent uptick in flu cases and it is seasonal, we are on our own.

Malacañang has just said it is alright to ditch the face mask and DOH is not about to tell us to continue wearing one even if it is a good defense against catching the flu virus. Those who have caught it say it is a bad one, worse than the COVID they caught during the tail end of the pandemic.

We should be getting flu vaccines but there is no DOH plan to make that widely available. Those who can afford it can pay for one. Those who can’t, which is most Filipinos, bahala na kayo.

The NEDA document promises government (a) guarantees to provide care services at all life stages; (b) ensures a responsive and resilient health system; and (c) sustains equitable financing of nutrition and health services.

Let us stop there because we are getting in the realm of dreams. Deputy Speaker Ralph Recto set us back to reality with his analysis of the proposed DOH budget.

The “bad news,” according to Recto, is that the DOH’s proposed overall budget – pegged at P199.45 billion – will decrease by P10 billion from P209.62 billion under the 2023 national budget. Budget Secretary Amenah Pangandaman however, defended the P10-billion slash on the proposed 2024 budget of the DOH, saying that it is purely “congressional initiatives.” Is that pork barrel being excised?

Recto said DOH may get an increase of P500,000 for its cancer fund. Recto noted that this would bring to P2.2 billion the allocation for cancer control and cancer patient assistance funds. The line item for the prevention and control of non-communicable diseases has been earmarked with P1.7 billion, “a deep P1.2-billion cut from this year’s P2.9 billion, and even lower than the Palace’s original request of P2 billion for 2023,” according to Recto.

IBON, the leftist economic research arm, made their own analysis which seems accurate and alarming.

“Only 5.6 percent or about P325.4 billion of the P5.78 trillion proposed 2024 national budget will go to the health sector, and even a smaller percentage to direct health services and expansion of health system capacities…

“The Health Facility Operations Program (HFOP) gets the largest share (P70.3 billion) of the DOH budget. The HFOP contains government funding for the DOH-retained hospitals, publicly owned blood centers, national reference laboratories, and the dangerous drug abuse treatment and rehabilitation centers. But it only has a miniscule increase of 2.4 percent in the proposed budget. Also, budgets for the operations of blood centers and national laboratories decrease by 10.9 percent and 19.2 percent, respectively.

“Meanwhile, the increases in the operations budgets for the Metro Manila and regional DOH-retained hospitals and other facilities are barely enough to keep up with their growing needs. Also, upon closer look, about 21 hospitals across the country will have budget cuts, including major hospitals such as the Jose Fabella Memorial Hospital, National Children’s Hospital, Mariano Marcos Memorial Hospital, Eastern Visayas Regional Medical Center, and Southern Philippines Medical Center.

“The national government’s funding support to the four largest specialty hospitals have also drastically declined. The Lung Center of the Philippines (LCP), National Kidney and Transplant Institute (NKTI), Philippine Children’s Medical Center (PCMC), and Philippine Heart Center (PHC) have lower allocations for 2024 by 32.8 percent, 26.3 percent, 34.5 percent and 14.8 percent, respectively.

“These decreases will further result in the inaccessibility of health services to the poor, since the government is putting pressure on these facilities to generate their own income to augment the insufficient budget they receive from the national treasury. Hospitals will be more inclined to accept paying patients than indigent patients as such preference will contribute more to their operations funding.

“Additionally, devolution of health services has only worsened the insufficiency of resources for health facilities operations. Because local government units (LGUs) are to provide the operations budget of their respective hospitals, many hospitals in the poorer regions are receiving lower budgets resulting in increasing inaccessibility of health services to their constituents.”

The Philippine General Hospital, a place poor patients can get high quality care, has also been given a lower budget. Worse, the budget for the medical assistance for indigent patients (Maip) program was reduced at only P533.8 million for 2024, much lower than the P828.3 million allocated this year. With its increasing number of patients, it should have been increased to at least a billion pesos.

That’s reality. NEDA gives us a vision supposedly of our government. Now we see in their budget plan, how the political leadership regards their responsibility to provide for the people’s health needs. NEDA can dream all it wants but our situation on the ground will remain dire. The Philippine Development Plan isn’t worth the paper it is printed on.

Boo Chanco’s email address is [email protected]. Follow him on X (formely Twitter) @boochanco