Country�s health system in the throes of death
The majority of the Filipino people do not enjoy proper health services because of commercialization and bureaucratic anomalies.
Many Filipinos die from complications arising from the most common and curable diseases like influenza, measles, hypertension and pulmonary ailments. Many of those who fall ill are unable to avail of hospitalization and do not receive any medical attention.
The most crushing problems besetting the health system are due to the reactionary regime�s implementation of the antipeople policies contained in the Health Sector Reform Agenda (HSR) and Executive Order 102 (EO 102), which were initiated by the Estrada regime. Within this framework, the DOH has been continuously divesting itself of the capacity to deliver health services and passing this on to the private sector and local governments.
MINUSCULE ALLOCATION FOR HEALTH. The budget for health services has been steadily reduced these past few years: only 2.58% (P11.3 billion) of the national budget was earmarked for health in 1999, 2.26% (P10.2 billion) in 2000 and 2.08% (P13.64 billion) in 2001.
The seeming growth in the amount allotted for health (P14.52 billion) is due merely to the increase in the overall government budget for this year. In reality, its share of the total has decreased (1.8%). The Macapagal-Arroyo regime still allocates the biggest chunks of the national budget to debt servicing (P359.8 billion) and the military (P60.24 billion).
DEVOLUTION. Along with the implementation of the Local Government Code back in 1991, the DOH began the process of devolution or passing on the responsibility for health services to the local governments. Devolution�s alleged objective is to bring health services closer to the people. As of last October, only 72 out of 616 public hospitals remained under the DOH. Due to lack of funds, hospitals administered by local governments could no longer be maintained and suffered a breakdown in services. Meanwhile, only one fourth of all barangays in the Philippines still have health centers. They are often closed and lack equipment, medicines and staff. Alongside the devolution of health services came the devolution and expansion of anomalies in the local bureaucracy.
CORPORATIZATION. The Macapagal-Arroyo regime continues to push public hospitals to increase their incomes with the goal of making all of them �quality� hospitals earning corporate-level incomes by 2010 to 2015. It wants to transform about 20 major public hospitals in the country into corporations before the end of this year (see table). With this comes the commercialization of public hospitals and their journey towards privatization. Some hospitals set to be corporatized (2002):- East Avenue Medican Center
- Quirino Memorial Medical Center
- Rizal Medical Center
- National Children�s Hospital
- Philippine Orthopedic Center
- Jose R. Reyes Memorial Medical Center
- Jose Fabella Memorial Hospital
- Mariano Marcos Memorial Medical Center
- Western Visayas Medical Center
- Cotabato City Medical Center
- Zamboanga City Medical
Center
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DETERIORATING CONDITIONS OF HEALTH WORKERS. The conditions of about 74,000 public health workers remain miserable under the current regime. They receive very low monthly salaries. Utility workers receive P4,975.70; nurses, P6,664.11; and medical officers, P11,664 compared to the National Economic and Development Authority�s (NEDA) estimate of P15,042 as the minimum monthly wage needed by a family of six. Due to budget cuts and streamlining within the sector, they are often made to work for more than eight hours or compelled to perform tasks beyond their designated job descriptions without pay due to lack of personnel.
Health workers suffer from a lack of equipment to protect them from the hazards of working in hospitals; from damaged and deteriorating facilities; and severe lack of medicines. Continuous streamlining, mergers and closures of public hospitals, health offices and services all pose a big threat to their job security. The right of health workers to freedom of expression and self-organization is likewise suppressed.
As a result, many of them are forced to go abroad. In fact, there are up to 150,000 Filipino nurses working overseas. With the promise of higher incomes and better working conditions, there has been an unstoppable exodus of professionals and other health workers from the country.
As early as 1993, the World Bank (WB) ordered the governments of semicolonies to reduce public spending for health services and encourage the privatization of medical services and health insurance. This has made health a commodity; and made health care an arena for self-enrichment. (See related article in AB�s September 2000 issue).
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