Wednesday, August 29, 2012

Health Spending 5: Raising DOH Budget for Childhood Cancer

A fellow member of our Coalition for Health Advocacy and Transparency (CHAT), James Auste, the head of the Cancer Warriors Foundation (CWF) has lobbied other CHAT members and CWF supporters, to lobby and write the Senators to demand:

1. Increase DOH budget for Acute Lymphocotic Leukemia (ALL) patient assistance program from P30 million to P100 million, to cover some 3,500 kids with cancer will be given proper care and treatment.

2. Increase DOH budget for non-communicable diseases (NCDs) from P70 million to P280 million for four
diseases: cardiovascular, lung cancer, diabetes,...

I replied that I support more government funding for (a) pediatric diseases, including NCDs for children like childhood cancer, (b) infectious or communicable diseases like leptospirosis, dengue and malaria, (c) people with physical and mental problems, both children and adults.

But I do not support more government funding for NCDs for adults. Why should the rest of society pay for diseases of people who over-eat, over-smoke, over-drink, over-sit? Lifestyle is a choice, not inherited.

Legislators, Congressmen/women and Senators, receive all types of higher budget request from:

(a) Departments and other Agencies themselves which suffer budgetary cut at the Department of Budget and Management (DBM).

(b) NGOs, media, other civil society groups lobbying for additional budget for their respective sectors (ie, health NGOs asking for higher DOH budget, education NGOs asking for higher DepEd and SUCs budget, etc.).

(c) Rent-seekers and contractors lobbying for bigger budget of agencies that will get their services (ie, suppliers of jet fighters and battle ships seeking higher DND budget, road contractors seeking higher DPWH budget, etc.),

(d) Foreign aid or multilateral bodies like the WB and ADB pushing for new loans that will require local counterpart funding.

(e) Other sectors and interest groups.

One will hear all types of justifications and even alibi from these sectors, interest groups and lobbyists. They know that they are indirectly competing with each other as taxpayers' money is not a bottomless pit, so some tend to shout or lobby louder than the others.

But legislators are also under pressure where to get the additional funding other than the usual, never say die "more borrowings, more borrowings, more borrowings". The annual budget deficit (expenditures larger than revenues) is around P300 billion a year, and that is also the similar amount of new borrowings each year. Our public debt has become so huge that we pay about P350 billion a year on average on interest payment alone. Utang lang ng utang, let the future administrations and taxpayers worry about those debts later.

So legislators would tend to ask, "kindly help us identify where to get the additional money and we will give your request." Good. And here are possible sources of additional money for one's favored sector or department.

1. Higher rates for existing taxes and fees, like the proposed increase in excise tax for tobacco and alcohol products, higher excise tax for mining revenues, etc. Or a proposal to hike VAT from 12 to 15 percent. Or DFA hike in passport fee, NBI hike in NBI clearance fee, DOTC hike in motor vehicle registration tax, etc.

2. New taxes and fees, say an excise tax on junk food and bottled water (now more expensive than oil).

Please note that those taxes and fees refer only to national government agencies. The local government units (LGUs) can also increase their respective taxes and fees, like the community residence tax, real property tax, business permit tax, etc. They can also create new taxes like the proposed dog ownership tax in Pasay or Paranaque, or increase penalties like penalty for dog shit on the streets, penalties for men who walk topless on the streets, etc.

3. Privatization, like privatizing PAGCOR, some military facilities or camps, some state universities, etc.

4. Shrink the budget of other agencies and rechannel the savings to one's favorite sector or department.

If one will go for option #1 like the proposed sin tax hike, malabo na, not practical. So many sectors are already salivating at the huge money that will come from it -- the universal healthcare (UHC) of PhilHealth and DOH, the condoms and pills of the RH bill, the pork barrel of legislators themselves, etc.

If option #2, it is a highly sensitive issue and next year being an election year, politicians would rather borrow like crazy than create new taxes that can spell defeat for them at the precincts.

If option #3, I myself will go for it. Prioritize PAGCOR privatization, I think up to P200 billion can be realized from it. There is a bill by Sen. Ralph Rector on this, but I think it's not moving fast enough.

If option #4, I will also support it myself. My favorite is to drastically cut the budget of the Department of National Defense (DND)-AFP. I am actually in favor of abolishing the AFP itself as I believe we have no threat of external aggression in the sense that foreign armies will invade Metro Manila and the rest of the country. The bigger threat here is internal -- those thieves and carnappers, killers and murderers, kidnappers and rapists, extortionists and terrorists, corrupt officials and plunderers, many other criminals. The noise over the WPS/SCS is hyped mainly by the rent seekers and suppliers of jet fighters and battle ships, some legislators and the DND guys themselves. I read that one battle ship from Italy will cost about P6 billion each, and the DND plans to buy two ships soon. Not included there are bombs, missiles, ammunitions, training of personnel, oil consumption, replacement of parts, that will cost several billions more.

The Philippine Military Academy (PMA) should be privatized. Our subsidy for those guys is P500,000 per student per year, or P2 million per student over four years. The same with the National Defense College of the Philippines (NDCP), which has a subsidy of about P1 million per student, and those masteral "students" are not exactly poor.  They are mid-level or senior level government officials, congressmen, governors, mayors, etc.

So if people have to write to those Senators and Congressmen, their request will have a better chance of being granted if they can pinpoint where to get new money or savings.

My suggestion, go for option #4. Target the DND, or the state universities and colleges (SUCs), or DPWH.

Then over the next few years, target option #3.

See also:
Health Spending 1: Wastes in US health spending, June 23, 2011
Health Spendng 2: DOH, Public Health Budget, June 18, 2012
Health Spending 3: Obamacare and Huge Tax Hikes, June 30, 2012
Health Spending 4: Global Aid on Health, 1990-2011, August 28, 2012

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