E-health and price cap under the pandemic times


Telemedicine consultations

The pandemic has surfaced important lessons for us.  During the height of the lockdown, many clinicians decided not to open their clinics for consultations.  This scenario has created serious difficulties for many non-COVID patients who need continuing health care, procedures, and prescription refills.

 These challenges paved the way for advancing a long overdue information technology in the health sector, and this is telemedicine consultations.  Admittedly, tele-consultations may not provide all the critical information needed by doctors to evaluate your condition but it has created an environment of re-assurance that one can still be in touch with their health professionals.

What were the issues before?  Patients claimed they had trouble in setting an appointment with their own doctors.  Doctors and their clinic secretaries had similar challenges in setting the schedule as well.  Some demanded depositing consultation fees upfront, sending a photocopy of a confirmed deposit slip into the doctor’s bank account before the secretaries would schedule the patient. 

Payment platforms would allow the convenience of transferring pre-consultation professional fees into mobile phones of doctors and thus saving a trip to the bank as well as having a digital proof of payment.  Banks have also created online systems for payment too.  But these processes are not easy for some of the elderly to navigate.    There are also mobile phone service connection problems in some areas where the one-time pin sent through SMS are much delayed.

There are some other issues for the patients.  Who regulates the standardization of medical care when telemedicine consultations are made?  How will these charts or records be made and who has access to them?  Can patients record the consultation for their own files?

Some patients have complained of the pricing of professional fees citing those doctors are charging even higher than a face-to-face consultation and without the benefit of a proper physical examination.  There are hospitals who inform their doctors of a Professional Fee price floor and hospitals who set up the tele-consultation platform demand a percentage of the Professional Fee as well.  Who regulates these new business arrangements? Some patients asked about how official receipts will be issued.   The ease of scheduling has improved with these platforms and patients need not have to come to the clinic and wait for long hours as the schedule for consultation is fixed.  Given this, we also hear from patients that some doctors still come late to the appointed time citing other emergencies.  Clearly, these new tele-consultation practices will evolve and become the standard of practice even beyond the pandemic.  There are many gaps that need to be addressed.

Some of the issues for government include the absence of various regulatory authorities in establishing minimum standards of care when the health professional is offering tele-consultations.  For example, are there venues for redress by patients?  The other concern is equity.  How can government and the private sector help the poor access health services thru information communication and electronic technology? (I acknowledge the contribution of Dr. Kenneth Hartigan Go, an adjunct professor of the Asian Institute of Management and a Trustee of Laban Konsyumer Inc.).

Price cap on antigen test

The legal basis in setting the price cap is Executive Order No. 118 signed by President in November 2020 entitled “Directing the Department of Health, in coordination with the Department of Trade and Industry, to ensure Accessibility and Affordability of COVID-19 Tests and Tests Kits.”

 The public consultation discussed how to set the price cap for antigen testing. It revolved around breaking down the operational costs, looking at the median and ensuring that it is similar to the PCR pricing.

For your reference, RITM utilized a WHO laboratory test costing tool (2020 version): https://www.euro.who.int/en/health-topics/Health-systems/laboratory-services/better-labs-for-better-health/laboratory-test-costing.

The public consultation will recommend the price cap as follows:

The proposed price cap for antigen tests is reasonable and fair. I had the personal experience of spending for antigen tests that cost me P1,500.00 to P2, 500.00.

The price cap is especially important because the Delta variant is said to be 97 percent more transmissible, and an infected person can infect as many as eight people. Thus, it must be ensured that these kits and testing materials shall have the lowest possible costs in order for it to be easier and more accessible for everyone to be able to have their tests taken whenever needed.

Atty.  Vic Dimagiba

President, LabanKonsyumer Inc., a full term member of Consumers International

Email: [email protected]