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Gabriel Ignacio P. Alejo, 3 BS Health Sciences Ateneo De Manila University

The Ultimate OPLAN: A Universal Health Care Policy for the Philippines

Two months ago, Baby Raul died. As sad as it may seem, the cause of this childs death is tuberculosis, one of the leading causes of death for Filipinos, but one of the diseases which can be treated easily if detected early. The little fellow has long exhibited signs of contracting the disease, but financial constraints prevented his parents from bringing him to the city hundreds of miles away in order to be examined by a health practitioner. His father is a simple farmer in the fields of Bukidnon, while the mother is a housewife. The albularyo, being the cheaper alternative, tried every ritual he knew in order to save the boy, but to no avail. A few days after the burial, a doctor on a personal outreach came to their town. It was a self-financed trip to the poorest barrios of the country to help provide medical assistance to those areas. There, he discovered that the real cause of Rauls death was the transmission of the disease from his grandmother who lives with them and who happens to have not spoken about contracting the symptoms at all. If only the grandmother was treated much earlier, Baby Raul would not have died. This situation can often be witnessed in soap operas, but the truth of the matter is, this is an ongoing phenomenon that has affected the lives of millions of Filipinos, especially those in the most underdeveloped areas of our country. How can so many people die just like that because of the lack of basic health care?

Whether the government admit it or not, there is certainly a great disparity between those at the top of the social ladder who will check-in at hotel-like hospitals at the earliest signs of flu, and the disadvantaged individual who will put medical treatment as the last priority in spending whatever is left of his money. Health is not the main concern of Juan dela Cruz, and one of the reasons on why this may be is the fact that even our leaders themselves have not invested much on it. The process in which a suitable health care program can fit an entire country entails a lot of time, effort and money on the part of the government, but if the Philippines does not start acting on it now, a lot more Baby Rauls will have to suffer such a tragic death, especially with our population expected to reach a hundred million in a few years. Nevertheless, a nationwide health care program without an enabling law is considered useless, however effectual it may be. The key to success lies in the dialogue between experts in the field and those in power, two sectors whose primary job is to help improve the lives of the regular Filipino. Dialogue should lead into action, and action should yield results. Given the inaccessibility of proper medical treatment to majority of Filipinos at present, there is an immediate need for a comprehensive health care policy to be created by the government. There are current provisions and set-ups for Filipinos to avail of medical insurance such as the Philippine Health Insurance Corporation or PhilHeatlh, which, sadly, claims a membership of only twenty million Filipinos as of 2009. However, in more ways than one, a real comprehensive health care policy should not only offer free or discounted medical treatment, but useful lifestyle, heightened medical research and wellness campaigns as well. The integration of the aspects of prevention and cure will in turn lead to a more vigorous and active Philippine society.

However ideal and promising a comprehensive health care policy may be, there are still some who believe that it will spell more problems than solutions if ever it is taken into effect. It is no doubt that executing such a plan entails a lot of money, and given a country like the Philippines with a frail economy, critics think that it is too risky to invest so much for health care alone. If a comprehensive health care policy is enacted by Congress, the said budget will surely balloon to three or four times more than its current level given that the access for health care will be for all Filipinos. Considering that this will happen, what is important to look at is how the allocation for the execution of the entire program will compare with the overall budget of the government, as well as ensuring the efficiency in spending among the different stakeholders of the health sector. Preventing corruption and allowing a wider field for different organizations and companies to research on more affordable treatment will result into a lot more of our countrymen having better access to basic medicines and vaccinations in Barangay Health Centers which they very much need. Other than the issue of money, some are not confident in creating a comprehensive health care policy due to the fact that there is a lack of manpower that will execute the said plan. With a shortage of medical and health practitioners who opt to do their practice abroad rather than in the country, a valid question an analyst will ask is: Where will the government get people who will be the prime movers and implementers of a comprehensive health care policy in the country? For a country such as ours, however, it is important that Filipinos give emphasis to the value of helping each other, as exhibited by the spirit of bayanihian. If ever there is a time to put this into action, then it might as well be in implementing universal health care. In a middle-income country like ours, the local community, one of the most basic units of ours society, will play a great role in determining the success of certain policies such as this. Therefore, it is of utmost

relevance that a lasting and healthy relationship within the community be imbibed among its members. Although many people are saying that the said policy is detrimental to the economy, one benefit it actually brings is its capacity to stimulate other areas of development that may generate the flow of money and eventually improve on the quality of service that can be offered to the people. By realigning and restructuring the current system into a more cohesive and wideranging law, more job opportunities will arise for both white and blue collar workers, as well as provide incentives for health related companies to engage in research for reasonably priced medicines that could serve as treatment for different prevalent diseases in our country. At the same time, health professionals such as physicians, nurses, medical technicians and the like will have the opportunity to practice here in the country without the risk of being overshadowed by the veterans at the big city hospitals, as well as create opportunities for them to have a decent income, without the stress and hassle of going and working abroad. The most effective way to do this is through the creation of avenues that will let them make use of their skills while at the same time decentralizing the hospital as the staple venue for diagnosis and treatment. According to Dr. Genejane Adarlo, a faculty member of the Health Sciences Program at the Ateneo de Manila University, one of the main problems in the countrys health system today is the weak authority that the Department of Health has over the Local Government Units, or defragmentation. Through the creation of a body that will help strengthen the ties of the central government to the local government and guide the creation of small to medium clinics (SMCs) nationwide, the doctors and other health professional will be brought closer to the people, and it is through this that Filipinos will eventually lose the mentality of letting the disease pass without proper treatment since it is very expensive in the

hospital which is almost four or five hours away from their homes. Setting up these SMCs will require the hiring of staff and personnel with specific skills and so the pool of fresh graduates and young professionals alike will be maximized in a way. In creating these businesses, the mindset should be that of sustainable development. This means that not only is a certain health-related business being put up if ever the plan becomes a reality, but more so a relationship between the health practitioners in the clinics and their clients, the immediate community, is being forged. By solving the problem of defragmentation, the doctors will slowly move out of the big hospitals and make their way into areas nearer to rural communities where they will set up their clinics. It is the turn then of companies and pharmaceutical companies to invest businesses in the country, in partnership with the major medical institutions, when it comes to the field of scientific research and medical advancement. This will enable Filipino scientists to study more thoroughly tropical diseases, surgical techniques, effective medicines and the like without the expense of going abroad. With the slow but sure integration of economy, technology and quality being put in priority, it is expected that the health care policy will help in the countrys economic development without sacrificing social responsibilities to those in need. In order for decentralization to really succeed, human resource should be given a holistic approach, with emphasis on consultation and representation of all health professionals in the discussion and conceptualizing part of the plan. Lawmakers and implementers should not only consult the experts but also those who will really be immersed to the towns, sitios and barrios. This will pave the way for a compromise on certain guidelines between the two sides to be reached. If other middle-income countries like Brazil and Thailand have been able to come to such a compromise, it is not impossible for the Philippines to follow suit.

With all these points in mind, it is but natural for the ordinary Filipino to ask if a comprehensive health care policy even has a fighting chance to become a reality. Given the many problems the stakeholders should face even before the positive effects can be felt, even the most optimistic analyst will say that the road to be faced is tough and that reaching the end point will take a lot of patience and effort from everybody. However, it all boils down to what is prescribed by the Philippine Constitution. It simply states that the access to basic health care is the right of each and every Filipino, whether he be rich or poor. Therefore, it is the obligation of the officials who govern this country to talk and come up with a fitting solution to this long standing problem. The time is right for a social transformation to take place. Besides the policy itself, the paradigm of the people towards health care should also be changed, shifting it from an only when its severely needed to an everyday necessity attitude. Formulating and executing a universal health care policy is a huge step forward for the Philippines, not only in terms of health care provision but in the maturity of its political system as well. This will create a big impact on the sincerity of the countrys leaders to set aside their differences in order to work towards achieving one goal for the betterment of the majority. More than this, it will highlight the very essence of our countrys democracy, an environment where people like Baby Raul need not die of a disease for which there is a cure. The challenge lies on us, the current and future set of Filipino health leaders who will manage our health centers, laboratories, hospitals, medical schools, health-related companies, government offices, the Department of Health and yes, even our country itself. It may still be an elusive dream, but it certainly is one thing that should be made a reality. This, my fellow countrymen, is the ultimate oplan.