Tax Cut 17: BIR vs. Physicians

The Bureau of Internal Revenue (BIR) made this paid advertisement that appeared in several national newspapers last weekend I think. 

Posting below some comments by doctors expressed in facebook, posted on my friend Dr. Jed Inciong's fb wall, except those from change.org petition and Dr. Calimag. My own discussion at the end. Other posters/images are also posted in fb, copy-pasting them here.

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(1) Change.org Petition (around March 2, 2014, initiated by Minerva Calimag)

The medical profession and all physicians are always portrayed as tax evaders by the BIR. The recent BIR Ad that appeared in the Manila Bulletin is certainly discriminatory of the medical profession. Many of us physicians pay our taxes diligently...should the indiscretions of a few be invoked to penalize the entire medical profession? Many physicians also work in the countryside and they are often overworked and compensated less...this overgeneralization on the part of the BIR certainly maligns the medical profession. We demand that the BIR retract this Ad and issue a public apology in all newspapers for this act.

(2) Butch Tamesis, March 4, 2014

This picture shows the PHYSICIAN in general as a burden to the TEACHER, a representative of the MASA. I wonder if the BIR has really thought about this carefully? BIR is actually inciting the masa to revolt against the doctors and blame them as the cause of their poverty. PAMPABIGAT KAMING MGA MANGGAGAMOT SA MGA MAHIHIRAP! 

Does BIR honestly believe this? I will not repeat what my colleagues have said already against the BIR, but just enlighten you about my sentiments. 

In plain language, I am saddened by your portrayal of me as a burden to the society. After so many years of hard work, and sacrifice to help Filipinos (in general), I now live comfortably, able to sustain my family's needs. And this is how you treat me, as a burden to society!? My parent's left me with a wonderful name, a name I am constantly taking good care of. After my father died, the clinic he left was in shambles as his practice had diminished since he got sick. My sisters and I slowly picked up the pieces and built it back to its old glory. The taxes we pay the government ( yearly business tax, machinery tax, real property tax, tax on improvement, garbage tax, sanitation tax, fire and hazard tax), monthly SSS, Philhealth, Pag-Ibig contributions, VAT (not ours anyway since we collect it for the government) is so much that we barely have savings for the clinic on infrastructure improvements.

My clinic is a medical clinic, not a business enterprise, and yet the instruments to make my skills viable is taxed so much that I have no way of recovering the cost unless I charge my patients for its use. A lot of times I don't charge my patients since they cannot afford it. Medicines I prescribe are also taxed exorbitantly by government (i thought the government is pro people?). Electricity and water, and my gasoline expenses have been constantly going up. I am forced to buy electric fans and air conditioners to make my patients comfortable. That adds to my cost of electricity. And you Commissioner Henares and the BIR look at me as a burden to society???!

I have nothing else to say to you, no threats, no dirty finger, no nothing. At my senior age, I am no longer as violent as I was when i was younger since I saw the futility of being a hot head. I am done with that. But I would HUMBLY and RESPECTFULLY ask you to take a second look at this disgusting picture you have portrayed my profession to be. Please take it back because it slaps every physician (guilty or not) on the face. Prosecute these erring physicians, businessmen, lawyers, etc. but please, do not generalize because even JOSE RIZAL OUR NATIONAL HERO IS ALSO GETTING THE HEAT.

My comment comes from the heart, and I feel it every time I read it. Considering the amount of time I spend treating and caring for my patients, sometimes to the point of giving them free consult (in the clinic, by text, or by phone call anytime of the day,or by email) and medicine if they cannot afford it, I get this distasteful ad from BIR. I cannot NOT take it personally!

And the comments of some people against the doctors also hurt. But it does not matter. What matters most is one, our guilty colleagues must change their ways, and two, BIR must also take it back.

(3) Jed Inciong, March 3, 2014

Much like the persecution of jews in Nazi Germany. Our Doctors are being made "whipping boys" and scapegoats for a flawed income tax collection system. Our physicians are being portrayed as contemptuous cheaters.

All said, it pains me to admit I may have made the wrong choice to stay and practice medicine here in my beloved "Inang Bayan" katangi-tanging Pilipinas!
Ninais na manilbihan sa mga kababayang nangangailangan, kahit na higit na mas malaki ang kikitain sa ibang bayan. Dahil sa pagmamahal sa Bayang tinubuan!

FNF Philippines and Liberal Challenges 2013-2016

Yesterday, exactly one month from the May 13, 2013 elections, the Friedrich Naumann Foundation for Freedom (FNF) Manila office held a good conference, "Liberal Challenges 2013-2016" held at C3 Events Place in Greenhills, San Juan City, Metro Manila. Participants were some local executives (Mayors, Governors) and Congressmen/women of the Liberal Party (LP) who won in the elections last month, plus sectoral groups affiliated with LP (women, labor, youth, etc.). Some alumni of the International Academy for Leadership (IAF) in Gummersbach, Germany like me were also invited.

Below, Jules Maaten, the Resident Representative or Country Director of FNF Philippines gave the opening remarks, mainly his observation and assessment as FNF official and a foreigner observer (foreigners cannot vote in the Philippines even if they are long time residents and taxpayers in the country). Jules himself was a politician, a former Member of Parliament (MP) of the European Union. He said that despite "national pastime"  of skepticism of the performance of President "PNoy" Aquino, there has been marked improvement in the governance and public administration in the country, and recent fast economic growth is among the results of such improvement.

The panel speakers were (from left): LP's VP for Women Vicky Garchitorena, Batanes Rep. Djna Abad, Iloilo City Mayor Jed Mabilog, and Zamboanga City Mayor Beng Climaco. Journalist and Rappler Editor Marites Vitug was the moderator. 

Vicky talked about the role of civil society and NGO leaders in fiscalizing government, Congw. Dina talked about the important legislation passed in the last Congress and the priority bills, in her mind, that must be enacted in the next three years. Mayor Jed talked about the liberal reforms they introduced in Iloilo City, like reducing the period to get a business permit from City Hall, from the previous 10 months down to three months, down to 15 working days, down to three days, and finally down to just 30 minutes. We clapped on this good news.

Mayor Beng talked about how she and her team managed to beat the wide machinery of the Jalosjos clan. She is an articulate and fluent speaker lady.

I brought four friends of Minimal Government Thinkers. From left: Mike Perez, Dr. Jed Inciong (a physician, also with MG Board), Harry Santos and Carla Ezequiel. There could have been more who wanted to join us, but at least two were on provincial trips.

The venue was nice. It was my first time to see C3 Events Place. It was raining hard yesterday though, with heavy flooding in many streets in Metro Manila. One reason perhaps why some guests were not able to come. Food was great. Lots of them. Also an open bar, but I contented myself with two cans of beer, did not sip either white or red wine.

The speakers, moderator, Jules and my friend, Gladys Cruz-Sta Rita, in red dress holding flowers. Fredo, the FNF mascot for Freedom, gave Gladys those flowers. She was the LP Director General and was in the thick of the electoral campaigns. She's my friend, my batchmate at UP School of Economics, and we belong to the same student organization, the UP Economics Towards Consciousness (UP ETC). Before joining the LP, she was the longest-serving Provincial Administrator in the whole country, for 17 years I think, serving three different Governors of the big province of Bulacan.

Mike is among the hard core libertarians but he was happy to hear the good news on reducing the bureaucracy as shared by Mayor Jed Mabilog. Mike is also a fellow Ilongo from Negros Occidental. I told Mayor Jed that my wife and her family are from Iloilo City.

Before going home, we had a group photo with Jules and Lito Arlegui, second from left. Lito is the Regional Program Officer of the Council for Asian Liberals and Democrats (CALD). CALD is among the major programs of FNF in Asia, members are politicians and political parties. The Economic Freedom Network (EFN) Asia is another major project of FNF, members are free market leaning think tanks, NGOs and academics. MG Thinkers is an active member of EFN Asia.

I am a liberal, a classic liberal to be precise, or "libertarian" as often used. Between two wings of libertarianism, anarchy (zero authority, zero government) and minarchy (small and limited government), I obviously belong to the latter. There are certain policies of the LP that I do not agree with, like the drug price control policy as initiated by LP President and former Senator Mar Roxas; playing with populism and expanded welfarism. But there are also certain policies that I support, like the move towards free trade and reducing business bureaucracies.

My loyalty is to the ideology of liberalism -- individual liberty, personal freedom, personal responsibility, free market and competition, rule of law, tolerance and human rights. For me it is the most superior ideology in the planet. Many people may not be aware of the essence of liberalism, that is why they are enamored with populism and socialism. Some simply just love the racket of socialism -- they can centrally plan, regulate and regulate even micro concerns, they can tell and bully ordinary people how they should behave and run their own lives, and they can tax and tax all they want -- habits of insecure and dictatorial-leaning people.

I am happy that the FNF is around to advance the ideology of liberalism and individual freedom. The move by the FNF Board in Germany to put "Fur die Freiheit" or "For Freedom" in big letters, several times bigger than the letters of Friedrich Naumann Foundation itself, was a good move. Emphasize Freedom, emphasize liberty, individual liberty.
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See also:
FNF Freedom Run 2011, November 28, 2011 
Pol. Ideology 23: 25 Years of Liberalism in the Philippines, December 07, 2011 
Free Trade 23: FNF on Free Trade Agreements, February 10, 2012

Health Transparency 6: Physician Protectionism

Nearly 3 years ago, I wrote this:
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Physician Protectionism

July 24, 2009

My clubmate in Rotary, a board member of MG Thinkers and a physician friend, Dr. Jed Inciong, wrote about a certain bill in Congress that imposes what can be considered as "physician protectionism".

Jed said that certain elitist specialty societies and medical practioners who belong to private associations affiliated with the Philippine Medical Association (PMA), are now moving to corner the practice of specific aspects of medical practice in pushing for the Medical Integration Bill, House Bill 5575. Jed added,

In the guise of moving into self-regulation of the practice of medicine, the PMA follows meekly in the dictates of the specialty societies. What the House Bill actually aims for is to limit specialty practice to only those that these specialty societies approve. But the reality is these PMA affiliates are not the only "umbrella organization" of specific medical specialty practice. An example would be that there are 2 or 3 more umbrella organizations for the practitioners of dermatology not belonging to the derma society which is affiliated with the PMA.

If this bill becomes law, it shall discriminate against the vast majority of physicians practicing outside the major metropolitan Philippine cities. Even more so, it shall compromise the practice of the majority of physicians employed in government hospitals outside these same Metro areas.

It was the first time I've heard of this issue, I thanked Jed.

Protectionism -- only us, no competition -- by so many professions in the country is institutionalized in the Constitution itself: engineers, architects, lawyers, physicians, nurses, accountants, etc. are reserved only for Filipinos. Filipino doctors and nurses can practice almost anywhere in the world but foreign doctors and nurses cannot practice here! Talk about hypocrisy and double standard.

Now among Filipino physicians, there is this physician protectionism proposal in Congress. It never fails. People who have some protectionist, even evil, plans always run to the State.

In a free market environment, patients and the public have the freedom to choose who are the doctors and health professionals who can treat them. This pressures the health professionals and establishments (hospitals, clinics, HMOs, etc.) to have good professional reputation and good corporate integrity. They may be expensive but there is good quality of service attached to their names and patients hold on to that image.

No government coercion needed here, by forcing patients to seek treatment only to physicians affiliated with a particular medical association or society. And physicians outside of that medical association will be penalized with "non-accreditation" and hence, will get somehow a negative image from the patients, even if those physicians have good professional record.
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I think this bill did not  become a law, thanks.  Last week, a discussion with some friends in facebook about "open sky" policy and airline reciprocity moved to a discussion on reciprocity in the practice by professionals from other countries. Here's our brief exchange on the subject:

Nonoy: When Filipino doctors, nurses, engineers are allowed to work as doctors, nurses and engineers in the US, UK, Canada, etc., those countries did not ask for "reciprocity", that American, British, Canadian, etc. doctors, nurses and engineers should also be able to work here. They are banned from practicing here, Constitutional ban.

Steve: Nonoy, thanks for raising the issue of the closed doors of the Philippines to any non-citizens receiving licenses to practice, although our citizens can and do freely practice in many other nations, as long as they pass the test and pay the licensing fee. I think registered dietitions (or nutritionists) are the only ones allowed reciprocity and that only with the US.

Nonoy: Discussion of reciprocity, I think an "innocent" but hypocritical concept. "I open thiis so long as you open that too." So if one or both won't open, or just open up a bit, then both parties or both governments will be closing opportunities for their people. It's good that the US, UK, etc. are more open minded with regards to mobility of people, they allow Fil doctors, nurses, engineers, dentists, etc. to practice in their countries, did not ask for reciprocity from some slightly xenophobic governments like the Philippines.

Steve: I don't know the policies of openness in licensed professions for Japan and Korea, but the US and UK certainly allow any competent person to practice, regardless of citizenship. Perhaps a case could be made for that infusion of talent and "mind-power" adding to the power of the economy?

Nonoy: I think even the leaders of the local professional organizations (PMA for physicians, PNA for nurses, UAP for architects, IBP for lawyers, etc.) who probably lobbied for that provision in the constitution to ban foreign professionals from practicing in the country know the arrogance and hypocrisy of their position. They did not even cite "reciprocity", they simply wanted an outright ban and prohibition of foreign professionals.

All economic growth of any country mainly comes from one important resource: people, their brains and muscle. That is why big population countries usually have large economies -- more entrepreneurs, more workers, more professionals, more consumers. But some small population countries have big economies too, because of the entry of more brains, including foreign brains and muscle, into their country. LIke HK, Sing, Netherlands, etc.
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I hope that should a constitutional change become a reality someday, not only the 60-40 restrictions on foreign equity be removed, ie, foreigners can own 100 percent equity in more sectors and industries in the country, but also the restrictions on the practice of foreign professionals here will also be lifted. Especially for health professionals like physicians, dentists, nurses, med techs, pharmacists, and so on.

See also:
Health Transparency 1: MeTA Forum January 2009, January 26, 2009
Health Transparency 2: CHAT Discussion and Debates, June 15, 2009
Health Transparency 3: MeTA Forum January 2010 (Prevention vs. Medication), January 27, 2010
Health Transparency 4: Drug Promotions and Government, September 03, 2010
Health Transparency 5: Forum on Good Governance in Health, March 08, 2012