It is bad enough that the congressmen have cut funds from public health and moved them to their pet projects – or that PhilHealth funds were taken away by mere administrative order. It is worse that the government budgetary system squeezes the funds and prevents them from flowing to the frontline services.
The freshly installed health secretary must at least pay the Calbayog District Hospital a visit to see how the front lines of our public health system looks like.
The Calbayog District Hospital is authorized to operate 75 beds. Last Oct. 19, as during most days of the year, the hospital recorded 181 inpatients, 58 admissions and 238 outpatient consultations. This is a usual day for the constantly harried hospital staff.
At the Samar Provincial Hospital in Catbalogan City, the facility is authorized for 100 beds. On any normal day, the facility holds 200 to 250 patients. As in the district hospital, patients in folding cots line the corridors. Families help the hospital staff tend to the sick.
Sick people could not be given a number and told to come back at a more convenient time. The hospital needs to treat them regardless of what its bed capacity authorization says.
Overcrowded provincial hospitals is not something unique to Samar. The same congestion happens in other second-tier hospitals everywhere. Our public health hospitals – the last recourse for poor Filipinos – are horribly congested.
Samar Provincial Hospital officer-in-charge Dr. Jansenn Y. Mutya reports that pateints awaiting admission often remain in the emergency room for prolonged periods because there are not available beds. The chief of the Calbayog District Hospital Dr. Jonathan Gabriel J. Paquit recommends urgent infrastructure expansion, review of authorized bed capacity and stronger referral coordination among health institutions in the vicinity.
The sheer congestion in provincial hospitals magnifies the misery sick Filipinos have to endure. It causes families to be even more anxious for their loved ones. An it keeps health workers exasperatingly overworked.
Even more disturbing: doctors a the frontline facilities were told that funds have already been appropriated – at least for the Samar hospitals. But their release and the implementation of expansion programs are held up by the the slow bureaucracy at the Department of Health. Even the DBM has raised concerns about the DOH’s budget utilization.
A serious (and unintended) side effect of the flood control scandal is that most government agencies have increased safeguards to ensure responsible use of budget allocations. This slowed down project implementation across the whole of government such that it contributed to the economic slowdown we are now enduring.
But investments in expanding government hospital capacity should be a special class of spending. Funding for additional bed capacity and increases in hospital staff need to be deployed with urgency. There are people out there dying on plastic folding beds with doctors working beyond the call of duty using obsolete equipment.
International reserves
Not only is the peso falling through the floor. Our gross international reserves are seriously diminished.
During better times, when we actually managed a positive balance of payments, I recall participating in debates over whether our reserves were growing too large. I remember one time when the country actually lent out some money to a multilateral financial institution to avoid bloating our reserves and forcing our currency to inconveniently appreciate.
That was another time and nearly another world. It was certainly a different administration then running our government.
Today, at last count, our international reserves have fallen to below $100 billion. This covers only about six months of imports – even shorter should crude oil prices continue rising and drought forces us to import more rice.
The prudential level we maintained before was to hold international reserves equivalent to between eight and 10 months of imports. Today, holding the equivalent of just six months worth of imports, our situation might be considered precarious.
Even more concerning is the dynamic surrounding this diminution. The peso continues to fall. Our reliance on imports continues to rise. The arithmetic of it is scary.
Our vulnerabilities intersect in many ways.
Our agriculture long ago lost its ability to independently feed our people. Our industries failed to be competitive. We entered into chronic trade and payments deficits.
Our ability to build a strong domestic economy was sabotaged by inferior political leadership. Our national budget was designed to be looted. Our addiction to debt could not be cured. We ran a transactional political system dependent on dole-outs as a condition for political support. Now we are saddled with a huge debt we could not possibly repay in 10 generations.
Over the past few years, our economic governance simply fell flat on its face. Investors lost confidence in the reliability of our policies. Our own businessmen moved their money abroad. The public decided the political leadership cannot be trusted.
Politicians seeking votes for themselves commandeered our foreign policy. The ruling faction long ago decided to win the coming battle for succession by politically assassinating the sitting Vice President. We have a Congress that legislates according to how the gravy train runs. Give our congressmen enough projects they could milk and they will impeach anyone the political lords find inconvenient.
Should a major crisis grip the global economy, we have few weapons in our armory to fight for our people’s survival. Our anemic economy is a sitting duck.