UHC 18: DOH Budget, Healthcare Deregulation and PharmaWealth

After I posted UHC 17: First, Second and Third Lines of UHC for the Poor in the Advisory Council loop last week, July 30, DOH USec Madz replied that DOH budget is presented as DOH proper which is smaller and DON family which is bigger because it includes the fund of National Nutrition Council, PoPCoM, corporate hospitals PHC,Lung Center and NKTI.

Leonie Ocampo of PPhA also replied,

Thanks Nonoy. I know it is not easy to be done, but if we want to be serious in looking after the health especially of the poor who can not afford to buy their medicines, ways to ensure they get the right medicines (quality, safety and efficacy assured) must be done. As I write this comment I know someone is dying because of;  

1. medicines taken are not the right medicines for the condition, in short NOT the best choice for the condition but given because it is what is available. 

2. medicines taken maybe are what are needed as determined by the doctor but the quality is questionable; counterfeit, substandard, fake, spurious and falsified but purchased by LGU or a government agency because they are the cheapest. ( price is not only the consideration in buying medicines anyway) 

3. medicines are right and chosen right but not used right because of lack, no or misinformation  given to the patient and . . .  many more reasons.  

RESULT : GAP between the clinically-tested effects of the medicines and the actual effects when used by the patient happen. Is this not a GOOD WASTAGE of the people's money?This is why the PPhA and I am supporting the DOH to really put its IRON HANDS on this.

I thanked USec Madz for her reply. I checked the DBM’s Budget of Expenditures and Sources of Financing (BESF) 2014, and here’s what I got.

Source: http://www.dbm.gov.ph/wp-content/uploads/BESF/BESF2014/B12.pdf

So DOH’s regular plus special purpose funds was P51.05 billion in 2012, much larger than other DOH presentation saying they only have P42 billion last year. The infusion of P14 billion for PhilHealth last year, or one year before the elections this year, explained such huge jump in 2012 budget.

The combined regular fund + special purpose funds this year is P52.56 billion and P82.77 billion next year, or an increase of P30 billion over this year’s budget. That increase is huge, larger than the regular budget of the DENR (P23.7 billion this year and P23.91 billion next year) or DOJ (P10.9 billion this year and P11.6 billion next year).

The deregulation of health insurance that I mentioned in my earlier paper refers to allowing people to have health insurance  but it does not mean that it should be PhilHealth only. People, especially those in the formal sector, should have the freedom and choice to opt out or not contribute to PhilHealth if they wish to, so long as they get another health insurance provider – an NGO or corporate HMO, an LGU, a private health foundation, and so on..

I also thanked Leonie as her perspective as a pharmacist can inject new perspective, a wake up call for many sectors who only focus on "cheaper medicines" as the single most important consideration in incorporating government medicine procurement with UHC policy.

Also last week, July 29, I attended a forum on "Designing Competition Reforms in Developing Countries" at the Phil. Institute for Development Studies (PIDS), Makati. DOJ Assistant Secretary and a friend, Geronimo "Indian" Sy mentioned in his presentation that a local pharma owned by a Congressman is able to supply medicines to many government hospitals and there might be anti-competition acts there.

He did not stay long after his talk though. I spoke during the open forum and supplied the "missing info" referred to by ASec Sy. I said that it's PharmaWealth owned by the family of former Cong. Ferjenel Biron. I added that an anti-competition act is possible because as a Congressman approving, raising or reducing the budget of government hospitals and other agencies, the legislator has the advantage in "winning" a medicine supply contract with many DOH hospitals. I saw the data presented during a UHC forum at the AIM the week before that.  PharmaWealth can supply amlodipine 10mg for only P0.35 a tablet to some government hospitals, and sell at P2+ or P3+ per tablet to other government hospitals.