[PHOTO - Candle of protest. A protester holds a lighted candle and a banner condemning the privatization of public hospitals and health services. DANNY PATA]

MANILA, JULY 21, 2012 (MANILA STANDARD) By Macon Ramos-Araneta - Health group sees patronage dictating lists of beneficiaries

A group of doctors, nurses and health workers on Thursday said the government’s Universal Health Care program will not cover the “poorest of the poor” because many of them will not make it to the Social Welfare Department’s roster of names under its National Household Targeting System.

Gene Nisperos, vice chairman of the Health Alliance for Democracy, described the people in the Welfare Department’s list as “the political poor” who were also beneficiaries of its conditional cash transfer program, a straight monthly dole.

“They are the ones who are closest to the barangay [village] chairman or the barangay captain or anybody who makes the list,” Nisperos said.

“They are the ‘political poor’ because the one who decided on their inclusion in the list considered them poor.”

Nisperos said the same Welfare Department list, and not “the poorest of the poor,” would become the basis of a full government subsidy from the state-run Philippine Health Insurance Inc.

“Those on the list can avail of a totally free medical treatment and the no billing-balance program,” he said.

“But under this scenario, what happens to the real poor–those who are the poorest among the poor? They will be bumped off,” Nisperos said.

He said the minimum wage earners would have to pay more for their health services because of the government’s policy of privatizing public hospitals. This was on top of rising PhilHealth premiums, he said.

Nisperos said the government’s privatization of health care was a ‘backward step” considering that countries such as the UK, Canada and Japan had achieved good results with government funding for their health care delivery system.

“Obviously, the [Health Department] didn’t study the global health system,” said Nisperos as he dared the Health Department to name one country that relied on private investors for its health care system to adequately provide acceptable services to its people.

Public-private partnerships would not work because investors would dictate what hospitals should charge for their patients, and would not invest in an industry that was tightly regulated.

The Health Department says there are 5.3 million poor families under the National Household Targeting System enrolled in PhilHealth, and an additional 4.55 million poor families enrolled in partnership with local government units.

The Palace has said the Welfare Department’s list of beneficiaries under its conditional cash transfer program is insulated from politics because local leaders are not allowed to pick the beneficiaries.

Presidential deputy spokeswoman Abigail Valte said those who were found to be unqualified were taken off the list.

On Thursday, PhilHealth president and chief executive Eduardo Banzon denied that the state-owned company owed more than P2 billion to private hospitals.

He said there were some “unpaid claims,” but that these were much less than P2 billion and would be paid within 60 days.

“First of all, it is incorrect to say we owe them P2 billion,” Banzon said of the claims by the Private Hospitals Association of the Philippines, a group of 900 private hospitals.

“We have been asking for details of that but those details have not been provided,” he said.

He said he was surprised by the claims of Private Hospitals Association president Rustico Jimenez, saying the group had been part of PhilHealth’s committee and could easily raise the matter anytime.

Banzon said nobody from Jimenez’s group had sent PhilHealth anything about unpaid debts.

On Sept. 1, PhilHealth will change its settlement system by paying hospitals directly.

Banzon said the agency had the budget to settle its obligations, and was in fact planning to increase its benefit payouts.

A large labor group, Partidong Manggagawa, on Thursday criticized the nonpayment of PhilHealth obligations.

Health Undersecretary Teodoro Herbosa back-pedalled on his statement that the department would phase out the charity wards in public hospitals nationwide.

“The charity wards will not be dissolved,” Herbosa said during a press briefing in Malacañang.

He said the charity wards would simply be “converted” into “PhilHealth wards” where 5.2 million poor families would not have to pay for hospitalization services.

“The charity wards will continue, the charity patients will continue because there are still patients out there who may be out of the insurance system,” he said.

“But because of our enrollment in PhilHealth, effectively their numbers will decline. If we achieve universal health care, they will be zero,” he added.

In the House, lawmakers demanded a congressional investigation of the government’s health care program, including PhilHealth’s reported debts and the plan to phase out charity wards.

“This buffoon in the government sector who claims to be a financial genius comes with the dangerous and harebrained scheme to remove charity wards in prime government hospitals and plans about PhilHealth taking care of it,” said Bayan Muna Rep. Teddy Casiño, referring to Hebosa.

“But the fact is, hospitals are already up in arms over the nonpayment of bills by PhilHealth in the amount of P2 billion.”

Gabriela Rep. Emmi de Jesus accused the Aquino administration of committing a “systematic violation of people’s right to health” with the miniscule budget allocated to health.

“The PhilHealth card is also useless in poorly provisioned public hospitals,” De Jesus said.

She also said the Health Department’s proposed P56.8 billion budget for 2013 fell “dismally short” of the World Health Organization’s recommended 5 percent of gross domestic product, and was in fact less than 2 percent.

Worse, she added, most of the additional budget would go to PhilHealth, not to the state-run hospitals.

Casiño said Health and PhilHealth officials should be warned that public health was a constitutional obligation of the government and not a financial matter.

Gabriela Rep. Luzviminda Ilagan called for a congressional investigation into PhilHealth’s unpaid bills despite its reserves of over P100 billion.

“Where will these reserves be used? To make the President look good in his State of the Nation Address?” Ilagan said. “This is a grand deception.” With Maricel Cruz and Vito Barcelo

PhilHealth useless in rural areas By Macon Ramos-Araneta | Posted on July 18, 2012 | 12:01am | 3 Comments

The government plan to provide health insurance coverage to the poor would be useless in the rural areas because of the wide gaps in the health care delivery system such as the lack of doctors and nurses and rural health center facilities, officials said on Tuesday.

Eduardo Banzon, president and chief executive of Philippine Health Insurance, said at least 300 municipalities did not have Rural Health Units where the poor could get medicines.

He said it wasn’t known how many of the 2,600 health centers spread out in 80 provinces and 1,634 towns and cities had full-time doctors and nurses and medical staff, which would put to doubt the government’s ability to provide blanket health insurance cover for the poor.

“How can 82 percent of the 79 million Filipinos who are poor avail of state insurance benefits if there are no PhilHealth-accredited [Rural Health Units] in their areas?” Quezon Rep. Danny Suarez said during a meeting of the Joint Congressional Oversight Committee on Public Expenditures in the Senate.

Masbate Rep. Narciso Bravo said his province had government hospitals but they lacked diagnostic equipment and other vital facilities and, in serious cases, the poor people had nowhere to go.

PhilHealth is useless. The poor people cannot avail of PhilHealth benefits because they [the hospitals] are not available,” Bravo said.

Health officials on Monday said the government would next year phase out the charity wards for poor people and replace them with PhilHealth coverage including free hospitalization, medicines and laboratory costs.

Up to 80 percent of the beds in government hospitals are in the charity wards, which offer minimum hospitalization cost to the poor. But under PhilHealth, everything would be free, the Health officials said.

Health Secretary Enrique Ona said PhilHealth coverage was part of the Aquino Administration’s Universal Health Care program aimed at giving the “poorest of the poor” access to quality health care services.

He said the provincial hospitals, which had been nationalized because the local governments could not afford to operate them, would be devolved again so the Health Department could concentrate on running the major medical centers that “we will also corporatize to make them run efficiently.”

But Gabriela party-list Rep. Luzviminda Ilagan, vice chairwoman of the House committee on women and gender equality, said: “This is part of the privatization agenda of the Aquino Administration.”

She said the government’s plan to replace the charity wards with full health-care coverage under PhilHealth was “deplorable and anti-poor.”

“We are opposing this. With this policy, more and more Filipinos will be deprived of health services,” Ilagan said.

PhilHealth coverage would be good for government hospitals because those would be rid of charity patients, but private hospitals faced the risk of losing patients who now had a choice of where to go for treatment, according to some members of hospital groups.

“It would be terrible in the transition period. What if the poorest of the poor need emergency treatment but are not yet enrolled in PhilHealth? Will they just let them die?” they said in a statement.

Asked to comment on the issue, presidential spokesman Edwin Lacierda said he was not informed about the easing out of charity wards, but said that when the sin tax bill was signed into law it would provide more revenue for universal health care coverage.

“We certainly hope that it will be able to capture more beneficiaries and more members in that coverage,” he told reporters. Maricel Cruz

Private hospitals to drop PhilHealth

By Macon Ramos-Araneta | Posted on July 19, 2012 | 12:01am | 7 Comments

Unless govt firm pays them over P2b in debts

The president of a group of more than 900 private hospitals on Wednesday said his group would no longer honor cards from Philippine Health Insurance Corp. if the state-owned company would not pay more than P2 billion it owed its members.

Rustico Jimenez, president of the Private Hospitals Association of the Philippines, said the government’s plan to phase out charity wards in public hospitals and enroll “the poorest of the poor” instead under PhilHealth was unsustainable given the state insurance company’s huge debt to its member hospitals.

“PhilHealth has simply ignored our pleas for them to settle their obligations,” Jimenez, a co-owner of the Parañaque Medical Center, said in a phone interview.

“We have been exacting payments from them for a long time.”

Earlier, Health officials led by Secretary Enrique Ona and PhilHealth president and chief executive Eduardo Banzon said they were getting closer to President Benigno Aquino III’s goal of universal health care for all.

But Jimenez said PhilHealth’s debts accumulated over the years could be even higher than the P2-billion estimate despite its reserves of more than P100 billion.

Testifying at Wednesday’s joint oversight hearing on public expenditure in Senate, Banzon said PhilHealth had P107 billion in reserves at the end of May, although its premium collection was only P13 billion or lower than the P16.9- billion payout.

Jimenez, who revealed the extent of PhilHealth’s debt in a radio interview, asked what the government was doing with those reserves, which were at the same level in December 2011.

“Are these only for the SONA?” he said, referring to the yearly State-of-the-Nation Address in which the President enumerates the government’s achievements.

Jimenez said the Philippine Hospital Association faced the same problem but would not speak up because some of its members are government hospitals.

Jimenez said Mr. Aquino’s universal health care was a good program, but it needed to be properly funded.

In a separate interview, Philippine Medical Association vice president Leo Olarte said the government shouldn’t pass the buck when it came to its obligation to provide free medical services to the poor.

He said it was wrong to phase out the charity wards in state-run hospitals next year.

“Not all Filipinos are covered by PhilHealth,” said Olarte who confirmed that there were hospitals and even doctors who had not yet been paid by PhilHeatlh for services rendered.

On Wednesday, Sean Velchez, lead convenor of the Network Opposed to Privatization, expressed outrage over Health Undersecretary Teodoro Herbosa’s announcement that the charity wards in public hospitals would be phased out next year.

Velchez disputed the government’s claim that the poor patients would not be made to pay.

“Poor patients are forced to shell out hard-earned cash to pay for medicines and laboratory fees even in public hospitals even though they are PhilHealth members,” Velchez said.

He said PhilHealth coverage was very limited and covered only a fraction of a patient’s hospital bill.

He said PhilHealth’s claim that it had 5.2- million poor beneficiaries enrolled was less than half of the estimated 11.1 million poor families in the country.

The group held a conference against privatization Wednesday at the Philippine General Hospital in Manila.

During the conference, health workers, health professionals, students and patients challenged President Aquino to immediately stop the privatization of government hospitals and health services, fulfill the state’s responsibility to provide for the health of its people, and allocate 5 percent of the gross domestic product or P487 billion for health.

Julie Caguiat, another convenor of the group, described as deceptive the Health Department’s explanation that PhilHealth would take care of the poor.

Many Filipinos were still not covered by PhilHealth, and those who were had limited coverage that was good for only 20 to 30 percent of their total hospital expenses, she said.

Lawmakers on Wednesday questioned the Aquino administration’s plan to phase out charity wards.

“Why spend P12.6 billion for the distribution of PhilHealth cards when the same amount can be allocated to public hospitals, rural health units and barangay health centers so that they can directly provide services to indigents for free?” Gabriela Rep. Luzviminda Ilagan said.

She also raised the possibility that the PhilHealth cards would be used to win votes in next year’s mid-term elections.

The Palace will submit its proposed P2.006- trillion national budget for 2013 next week.

Under its budget proposal, the Health Department is asking for P56.8 billion of which P12.6 billion would go to PhilHealth premiums covering 5.2 million households.

Ilagan slammed what she called the Aquino administration’s skewed priorities.

“President Aquino’s thrust towards the privatization of government hospitals inevitably makes health services unaffordable, making it extremely difficult for poor families to access health services,” Ilagan said.

Bayan Muna party-list Rep. Teddy Casiño also assailed the government’s plan to phase out the charity wards.

“Phasing out charity wards is grossly inhumane,” he said.

“This will displace the poor patients, especially those who are not covered by the PhilHealth sponsored program.”

Government data show there are 42,997 charity beds in 703 government hospitals.

Casiño, citing an Asian Development Bank report, said six out of 10 Filipinos were dying without having any medical attention.

“This situation may worsen since most patients cannot afford the increasing charges in government hospitals,” he said, adding that nearly half of all health care costs were “paid out-of-pocket.”

“Even those covered by PhilHealth have to pay out of their pockets. Given the limited coverage of PhilHeath, the poor will be further disenfranchised of the right to health.”

Compared to the other Southeast Asian countries, the Philippines had one of the highest out-of-pocket expenses of 54.7 percent and one of the lowest government expenses at only 34.7 percent, Casiño said.

“Replacing charity wards with ‘PhilHealth wards’ is actually making the people pay for health services themselves,” he said.

“The government is trying to justify its decreasing allotment to public hospitals and the privatization of public health services. Instead of adequately funding people’s health, it is transferring the burden of health financing to the people.” With Maricel Cruz


Chief News Editor: Sol Jose Vanzi

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