The impending privatization of 26 public hospitals will only further deprive millions of Filipinos of their right to health.
The Philippines now has a population of over 94 million. But just two years ago, a study showed that six out of ten Filipinos had never seen a doctor.
While the latest government data pegs poverty at only 25.6 percent as of 2009, TWHA partner IBON said that this estimate is based on a revised methodology that has reset poverty at subsistence levels. Unemployment rates for the first two years of the Aquino administration are at an all-time high of 26.8 percent.
For those who have work, wages are not enough to sustain a decent life. According to IBON, the daily minimum wage of Php 446 covers only 44 percent of the Php 1,017 family living wage.
Even the Philippine government admits that the country's poor delivery of health services is one of the primary causes of its increasing maternal mortality rate. Health Secretary Enrique Ona told reporters last June that the mortality rate for Filipino mothers has increased to 221 per 100,000 live births in 2011 from 162 per 100,000 live births in 2009. The Millennium Development Goals call for the Philippines must lower the maternal mortality rate to 52 per 100,000 live births.
It is puzzling that while the government recognizes that the country's delivery of health services is already poor, its latest move will only exacerbate the problem.
The right to health is explicitly stated in the Philippine constitution, but the government's recent move to privatize 26 hospitals will deprive millions of Filipinos of access to quality health services.
During the People's Health Assembly the privatization of basic services was defined as “an abdication of responsibility by all levels of government, and the surrender to national and international corporations and private providers that do not recognize social responsibility or accountability to people and communities.”
“Privatization is the biggest threat to the lives and well-being of Filipinos today,” said Dr. Julie Caguiat, training office of TWHA partner Council for Health Development, during her presentation at a conference against the privatization of public hospitals and health services held last July. The conference was convened by the Network Opposed to the Privatization of Healthcare.
Privatization began during the Marcos administration, which set the legal framework for this policy. Succeeding presidents devolved health services and fast-tracked privatization. Privatization is a global phenomenon imposed by international financial institutions such as International Monetary Fund-World Bank (IMF-WB) and the Asian Development Bank upon developing countries like the Philippines. It has been a key thrust of the IMF-WB's structural adjustment program since the Marcos administration.
There are many faces of privatization in the Philippines's healthcare sector. There may be a complete take-over by a business enterprise, or an outright sale. One of the most onerous forms of privatization being proposed by the Aquino administration is the corporatization of 26 public hospitals.
“Privatization transforms state-provided health services into business, thus health becomes an expensive commodity. It ceases to be a right,” said Emma Manuel, the president emeritus of the Alliance of Health Workers, during her presentation at the conference. In the Philippine Heart Center (PHC), corporatization led to an increase in the professional fees of doctors for heart operations. The cost doubled from Php150,000 to Php300,000.
In terms of size, there is a great disparity between the PHC's pay ward, which has a 266-bed capacity, against the service ward, which is only allotted 25 beds.
The government has said that privatization will result in improved facilities and efficient health care. But Manuel argued that in a profit-driven institution, all improvements are meant for profit. “These will mean exorbitant fees which will not be accessible for the majority of the poor.” Under a rate hike this July, the cost of a urine smear at the PHC increased by a third, from Php 915 to Php 1,280. The costs for other procedures, like sputum, more than doubled, from Php 550 to Php 1,280.
Patients who cannot afford to pay their bills are forced to put up their cellphones, land titles, or motor vehicle registrations for “collateral”, which is then sold to PHC employees in an auction that is run by the PHC director, said Bonifacio Carmona Jr., president of the PHC Employees' Association. “In essence the patient is detained because of the lack of government budget and the hospital's maximization of profit,” Carmona said.
The benefits of hospital workers from the PHC and the Lung Center of the Philippines have also been removed or disallowed. Manuel added that privatization results in hospitals being run with as cheap labor as possible. This leads to overworked and underpaid health workers, contractualization, outsourcing, and workers who are hired through agencies or through job orders.
As a result of privatization, quality health care is enjoyed only by the rich, who can afford to pay. Once health care becomes inaccessible for the poor, it intensifies their deprivation and marginalization.
Another reason that the government provides for privatizing government hospitals is that it will generate more savings. To which Manuel responds, “Health is a basic right of the people. It is government’s responsibility to provide this.”
Hospital workers struggling against privatizaton and for the right to health
The government is touting health insurance called PhilHealth as the key to health financing. Yet Dr. Gene Nisperos, Vice Chairperson of the Health Alliance for Democracy, said during the conference that the PhilHealth system enhances inequity. He adds that utilization rates by PhilHealth members are highest among employed members and remain very low among sponsored members. Sponsored members who avail of health services in government hospitals do not have to pay a single centavo under PhilHealth's program. Employed members are better-off than sponsored members. In addition, the highest share of reimbursements go to rich, private institutions and clients.
During his presentation, Dr. Nisperos cited a study from the World Health Organization that showed that while the Philippines has health insurance mechanisms in place, financial protection is still low. Most health expenses are covered by out of pocket expenses, rather than government spending or PhilHealth.
Although the government claims that PhilHealth covers 87 percent of Filipinos, Dr. Nisperos said that according to the National Statistics Office, PhilHealth coverage was less than 40 percent. Private research puts PhilHealth coverage at less than 50 percent.
“Benefits without regulation only leads to more profits for private hospitals,” said Nisperos. The increase in PhilHealth benefit ceilings in secondary and tertiary hospitals, where most common health problems are treated, has led private hospitals to increase their prices.
At the end of the conference, a unity statement was drafted containing the following challenges:
For the Aquino government:
1. Immediately stop the privatization of government hospitals and health services.
2. Fulfill the state’s responsibility to provide for the health of its people.
3. Immediately allocate 5% of the GDP or P487 billion for health
For the Filipino people:
1. Expose and oppose all forms of privatization in all levels
2. Demand a stop to the program of PPP and the policy of privatization
3. Resolutely pursue free, progressive and comprehensive health care for the people
Bron :
INGEDIEND DOOR HANS SCHAAP OP VRIJ, 31/08/2012 - 06:07.
Hans coordonne les activités d’intal aux Philippines.
Written by Isa Lorenzo
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