By BENJIE OLIVEROS
Government health workers have been consistently sounding the alarm, especially these past few weeks, regarding the Aquino government’s plans to privatize the provision of health services. They have been holding lunch break pickets in various government hospitals, specifically in those that would be affected in the near future such as the National Orthopedic Hospital, which will be transformed into the Center for Bone Diseases and Trauma. But the mainstream media has not been reporting about it and public concern about this life and death issue is still wanting.
The Aquino government, through Health Sec. Enrique Ona, has been denying this. Their packaging is that the government is just mobilizing resources from the private sector to invest in health services through public -private partnership schemes (PPP), with the government still retaining control through the Board of Directors. Just recently, Bayan Muna Rep. Teddy Casiño revealed that the Aquino government intends to do away with charity wards and replace it with PhilHealth wards. This was again denied by the government.
If we analyze all government pronouncements regarding the health sector, its plans would be clear. It intends to make government hospitals, especially the specialty ones such as the National Orthopedic Center and the San Lazaro Hospital, attractive to investors by allocating some budget for the improvement of its facilities while asking corporations to also do so.
Corporations, under a deal with the government, would run these hospitals with the government retaining some seats in the Board. This is no different from what the Episcopal Church did with the St. Luke’s Medical Center, and look at where it is now. It was turned into a world-class hospital with its hotel-like appearance and modern medical facilities. But it is no longer affordable for the poor majority.
Also, government health workers are reminding us of what happened to corporatized specialty hospitals such as the Philippine Heart Center, the National Kidney Transplant Institute and the Lung Center of the Philippines. The Philippine Heart Center (PHC) and the National Kidney and Transplant Institute (NKTI) charge as much as P415 ($9.65) to P430 ($10.23) for a chest x-ray while currently, the Jose Reyes Medical Center and the Rizal Medical Center, both of which are among the 26 hospitals being targeted for corporatization, charge only P290 ($6.90) to P310 ($7.38). For an ultrasound procedure, the Heart Center and Kidney Institute charge P1,650 ($39.28) and P1,800 ($42.85) respectively, while it costs only P750 ($17.85) at the Jose Reyes Medical Center. And these hospitals have not yet been opened up to a lot of private investors, but these have been corporatized, in the sense that their Board of Directors were given more powers such as in deciding to increase rates and were tasked with raising a substantial amount for their operational expenses.
The rates of these corporatized specialty hospitals would certainly increase more with the entry of private investors. After all, corporations who would be willing to invest in erstwhile government hospitals are there to earn profits and not provide charity.
What about the poor? Will charity wards have a place in corporatized and privatized government hospitals? Certainly not. This is the second part of the Aquino government’s design for the health sector.
This is why there is truth in what Bayan Muna Rep. Teddy Casiño said that eventually charity wards would be removed. It would be replaced by wards catering to PhilHealth card holders.
When the previous Arroyo administration began distributing PhilHealth cards in 2004, of course, it was part of its electoral campaign. However, it also served a long-term purpose: to replace the free provision of government health services with PhilHealth coverage. Notice that during the 2010 elections, the campaign promise of Benigno Aquino III was “health for all”, but immediately after, during his inaugural speech, this was changed to “PhilHealth for all.” The plan is that in a privatized health system, certain segments of the poor, perhaps the same Conditional Cash Transfer beneficiaries, will be provided with subsidized health services through the PhilHealth. All the rest would have to fend for themselves.
The problem with the government’s thrust of replacing the provision of free government health services with universal PhilHealth coverage is: first. not all medical services and expenses are covered by PhilHealth; second, how could those belonging to the poor majority, but would not be chosen as beneficiaries of free PhilHealth coverage afford the monthly premiums? Even the premium of PhilHealth would certainly increase because surely, it would also be subjected to corporatization.
It appears that the Aquino government is patterning the country’s health system to that of the US. In the US, there are no more government hospitals. To be able to afford health services, US citizens need to be covered by private health insurance, by Medicaid, which is jointly funded by the federal government and the state, or by Medicare, which is being funded solely by the federal government. Medicaid does not cover all poor citizens but certain categories of eligible groups, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing nursing home care. Medicare, on the other hand, covers people with ages 65 or older, people under age 65 with certain disabilities, and people of all ages with end stage renal disease. Thus, if one does not fall within the coverage of Medicaid or Medicare, is unemployed – and therefore, not covered by company-sponsored health insurance – and could not afford the premiums of private health insurance, he or she would not be able to avail of health services.
There are two things that are fundamentally wrong in the US health care system, which the Aquino government would like to emulate: it is being controlled by the private sector – corporate hospitals and health insurance companies – and therefore, geared toward profits; and it is not accessible to the poor majority.