…Sharing
his experience with Rappler, the 26-year-old doctor said he was shocked by the
steep prices of purchased medicines and medical supply. He had requested for
the drugs for his RHU some time in December 2012.
"Even
test tube brushes, which cost around P10-P20 perhaps, cost P350! Gloves which
cost P120-P150 pesos are priced P550 in that receipt. Amoxicillin syrup which
costs P15-P20 is priced P115," he said in an interview. The receipt was
dated Jan 13, 2013.
The
system is simple, based on what the doctor deduced from his experience: the
supplier and mayor "agree on a certain jacked-up price" where both
get to have their share from the extra amount added on top of the medicine's
real price.
"If
I did the purchase myself and not thru the Bids and Awards Committee, the
amount would just have been around P60,000-P80,000," he said, adding that
it could have saved the municipality some P320,000….
The
same doctor sees around 20 patients a day. As in Casuga's case, medicines are
dispensed to residents at the Office of the Mayor and not at the rural health
unit (RHU).
"All
patients who need medicines as per my prescription have to go to his (mayor's)
office to get the medicines themselves... Even this much jacked-up medicines
are used as political tools," he said.
Casuga
said this set-up affects the "continuity of care" delivered to the town
residents.
I
hope I can also see they are getting the right medicines. Those who dispense
the drugs are waiters of the mayor with no health background..
Casuga
narrated an instance when a patient came back to him with the wrong medicine
and said “that's what they gave upstairs [in the mayor's office.]"
A
mother with her 5-year-old suffering from pneumonia was also hesitant to go to
the mayor's office to ask for the prescribed medicine, as she was not a voter….
----------
Another case of local government corruption. This largely explains why medicines constitute a big
portion of government health spending, both national and local agencies. What could be a P2 million medicines
procurement can become P5 million or P10 million or even higher. Then some sectors complain
why "medicine prices are high... and thus government should intervene more
in pricing." Very often we are talking about
government failure and blame or call it as market failure.
In one MeTA-Philippines forum at the AIM in Makati last year, the DOH
showed some tables, procurement of medicines by some government hospitals, DOH and
LGUs owned. Same medicines from the same supplier, PharmaWealth (owned by
former Cong. Ferjenel Biron) have different prices, the price range sometimes 10x
among government hospitals.
Transparency, DOH itself is hiding this
and other data. NCPAM presented it before MeTA, they said they will verify the
numbers further, and that was the last news I or we heard from them. I have several friends at NCPAM, I think they are not allowed to release such data without clearance from the DOH Secretary or Undersecretary.
I remember also a few years back, the WB-funded survey
done by ANSA-EAP, or of Ateneo School of Government, of medicines procurement by different
government hospitals, from UP-PGH to AFP Medical Center to some DOH and LGU hospitals. Same
medicines and prices range up to nearly 100x, with the AFP hospital having the
highest procurement prices. The WB itself hide that data, then WB talks about
transparency and "good governance". Double talk can happen anywhere.
--------
See also:
UHC 16: Dialogue on UHC and Medicine Access, AIM July 25-26, July 24, 2013
UHC 20: Health Equality Will Never Happen, September 20, 2013
UHC 21: The PGH, Manila City Government and Civil Society, December 10, 2013
UHC 22: Shortage of Doctors in the Philippines, February 10, 2014
UHC 23: Orthopedic Hospital Corporatization, Not Privatization, February 21, 2014
Drug Price Control 39: Presentation at USC, Cebu, March 2014, March 25, 2014
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