Sectoral parochialism in health and the declining population net increase
September 17, 2024 | 12:01 am
My Cup Of Liberty
By Bienvenido S. Oplas, Jr.
https://www.bworldonline.com/opinion/2024/09/17/621858/sectoral-parochialism-in-health-and-the-declining-population-net-increase/
Three recent items in the Opinion Section of this paper have discussed using the idle funds of the Philippine Health Insurance Corp. (PhilHealth) to fund some unprogrammed appropriations in the 2024 budget.
These were the Sept. 11 Thinking Beyond Politics column, “Making public money work for the people: Idleness of funds is idleness in service,” by Victor “Dindo” Manhit, a Letter to the Editor by Department of Budget and Management (DBM) Undersecretary Goddes Hope O. Libiran which came out on Sept. 13, and the Sept. 16 Yellow Pad column, “Current demographic trends do not justify reduction of PhilHealth premiums,” by Charl Andrew Bautista, Elma Laguna and Michael Abrigo.
The Manhit article supports the move by the Department of Finance (DoF) and Secretary Ralph G. Recto, noting, for example “an initial remittance of P20 billion from PhilHealth was used to settle P27.5 billion in unpaid COVID-19 allowances for frontliners, covering 5.04 million claims. Is this not a good thing?” Good position there, Dindo.
The DBM letter was in response to four claims made in the Sept. 9 Yellow Pad column, “Patronage politics has caused the loss of health insurance coverage for millions of Filipinos,” by Juan Antonio Perez III which the DBM said was “in the interest of accuracy and balanced views to avoid unnecessary alarm to the public, perpetuated by false, fear-mongering, and misleading news reports such as this.” Good correction there, Ms. Libiran.
The Yellow Pad piece by Bautista, Laguna, and Abrigo suggests that to “maximize the benefits of the increased premium collections” they should, among others, “Invest the surplus in expanding PhilHealth packages” in order to “improve cost coverage to prevent catastrophic health expenditures for individuals and families,” and “prepare for the eventual population aging.”
A common practice of advocates of what I call “sectoral parochialism” is to argue that their favorite sector is so important that whatever budget is given to it by DBM and Congress will never be enough and must be increased significantly. Thus, the P90 billion in excess PhilHealth funds should not be used for other sectors. Instead, whenever possible, it should be increased, doubled, quadrupled, or higher.
The DoF, DBM, and the National Economic and Development Authority (NEDA), which comprise the government’s economic team, see the overall picture of all agencies and all possible sources of funds (taxation, regulatory fees, and borrowings). Since the Philippines’ public debt is already high — the annual borrowings and interest payment keep rising even without an economic or finance crisis — the economic team will tap other domestic sources and avoid additional borrowing whenever possible. The economic team is correct in doing this. And the lobbyists and advocates of “sectoral parochialism” dislike them, even attack them and produce “false, fear-mongering, and misleading news,” like the opponents of reallocating PhilHealth’s excess funds to unprogrammed appropriations.
From 2022 to 2024, during which time there has been no economic or health crisis, and no more lockdowns, some expenditures like temporary subsidies should have been cut in order to have a fiscal surplus, in order to reduce borrowings and reduce interest payments. But this did not happen and is not happening.
From 2022 to 2024, we still had an average deficit of P3 billion to P4.4 billion/day, our interest payments alone were P1.4 billion to P2.2 billion/day — principal amortization not included yet in that number. New net borrowings were P5.4 billion to P6.4 billion/day. And even when interest rates were hiked, like 6% for T-bills and 6.7% for T-bonds, government kept on borrowing (see Table 1).
Secretary Recto, Secretary Amenah Pangandaman, Secretary Arsenio Balisacan, please proceed with tapping any domestic revenues you can and avoid new borrowing whenever possible. Fiscal realism should prevail over sectoral parochialism.
On the Philippines’ changing demographics as discussed by the Bautista, Laguna, and Abrigo in their column, here are some statistics from the Philippine Statistics Authority (PSA) which they did not mention: rising deaths, declining births, and the declining population net increase.
In 2020, when hundreds of new COVID-19 cases were reported daily and a severe lockdown was imposed by the government, there were no excess deaths over those reported in 2019. But in 2021, when mandatory vaccination was imposed (otherwise it was the mandatory to present costly PCR-tests taken every two weeks at the individual’s cost), deaths increased from 1,682/day in 2020 to 2,410/day in 2021 then 1,862/day in 2022.
The average number of births declined, from 4,188/day in 2020 to 3,739 in 2021, and 3,776/day in 2023. The population net increase (births minus deaths) also declined significantly, from 2,506/day in 2020 to only 1,329 in 2021, and 1,960/day in 2023 (see Table 2). And we are seeing this ugly declining trend in population expansion.
The Philippines may have spent some P200+ billion on COVID-19 vaccines plus transport, storage, and other logistics in 2021-2022 alone, in both government (national and local) and corporate procurement.
Health is first and foremost a personal and parental responsibility, only secondarily is it a government responsibility. This is so whether dealing with communicable/infectious or non-communicable/non-infectious diseases. When people say that it is OK for the poor to buy alcohol, tobacco, fatty food, then say that it is not OK for the poor to contribute to their own health insurance even at a minimal amount, then we have a problem.
