Dr. Ivanhoe Escartin, Director of the National Center for
Health Promotion, DOH, gave the welcome remarks. Dr. Ramon Paterno of the UHC
Study Group and of UP College of Medicine was the moderator. He showed an
audiovisual (AV) primer on the Philippine Health System and UHC, and a video on
“Sa Ilalim ng Tulay”, a story of one of the families who live under the bridge,
have a sickly family member, family head works as pedicab driver. Then the free
wheeling discussion started.
I started a comment on Dr. Paterno’s AV presentation
where one chart showed that the total wealth of Henry Sy and family of $12
billion in 2011 or 2012 over total
health expenditures (THE, combined public and private spending on HC) of the
Philippines in 2011 was about close to 100%, I forget the result. I said that
the comparison is wrong. The numerator is accumulated wealth of the Sy family over
five or six decades while the denominator is THE for only one year. If we want
a more realistic comparison, the denominator should be THE over the past five
or six years too, adjusted for inflation.
The second comment I made was on the usual “Health is a
right” argument as it is explicitly stated in the Philippine Constitution, in
the WHO charter where the Philippine government is a signatory, and in various
UN and WHO gatherings. I said that while I agree that health is a right, people
and policy makers should also remember that health is a responsibility. For
every right, there should be a responsibility for people, otherwise people can
abuse their body or live in dirty places and invite many forms of diseases,
then demand that “health is a right.”
There were many other NGO leaders-participants who shared
their ideas and experiences, and the “health is a responsibility” subject was
expanded as many participants agreed with the formulation. Like the lady from
the League of Corporate Foundations. She said that they have a project in three
barangays in Nueva Ecija, to monitor and control non-communicable diseases
(NCDs), hypertension and diabetis in particular.
They put up a clinic with full time health staff in the
middle of the 3 barangays. With the help of the barangay leaders, they
identified 100 beneficiaries per barangay, total of 300 people. These people
will get free consultation and health monitoring, free maintenance drugs, the
League is spending about P100,000 a month just to maintain this facility.
At the start, compliance was high, all the 300
beneficiaries were showing up. Later on, drop out rate in two barangays was
rising, meaning less and less people are coming for their regular check up and
health monitoring. The League staff learned that the barangay leaders were
bringing the beneficiaries to the clinic on their barangay vehicles. After a
few months, two barangays stopped doing this due to costs involved. The
people-beneficiaries also did not want to pay on their own to go to the clinic.
Only one barangay kept this arrangement for their residents.
Even if there is free healthcare, “health is a right” coming
from a private entity and not from government, some people do not believe that “health
is a responsibility”.
Doc Ernie Domingo of the UHC Study Group and a Ramon
Magsaysay (RM) awardee also joined in and said that emphasizing individual
responsibility in healthcare promotion should be included in the design of UHC.
Cecile Sison of MeTA Philippines and fellow CHAT member
also observed that for many people, health is not a priority compared to food
and housing, that unless their disease is already in a serious stage, they will
endure it or try non-formal HC system.
Doc Paterno added that from what he heard, even some
Gawad Kalinga (GK) beneficiaries, poor families, were selling their house after
sometime and become squatters or informal settlers elsewhere. Perhaps waiting
that another round of free housing will be given them soon.
I am glad that many NGO leaders realize the need to
couple right and responsibility in healthcare, and even in all other services
in society.
See also:
UHC 15: On DOH Plan to Recentralize Healthcare, June 27, 2013
UHC 16: Dialogue on UHC and Medicine Access, AIM July 25-26, July 24, 2013
UHC 17: First, Second and Third Lines of UHC for the Poor, July 30, 2013
UHC 18: DOH Budget, Healthcare Deregulation and PharmaWealth, August 08, 2013
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