UNDER THE MICROSCOPE
Dr. Raymund W. Lo
Like it or not, health care is a political matter, especially in a pandemic with national elections happening in three months. Even in “normal” times, health care should be a government priority. Let’s examine the stand of the different major presidential candidates on health matters (sans one who is a perennial absentee in public fora).
Only Lacson and Robredo had pandemic-response proposals. Lacson will have a more proactive approach to health crises through early closure of borders. No to military officials in charge of pandemic response. Robredo will allot ₱500 billion for an encompassing COVID-19 plan, including aid for those under lockdown and free mobile testing hubs in high-risk areas. She has already proven herself with her pandemic response, and the administration has ended up merely copying her many initiatives. Lacson wants full funding of the Universal Health Care Act to the tune of ₱260 billion. Robredo will hasten the rollout of the universal health care system and reform Philhealth, to which she will assign experts in actuarial science and health insurance. Point for Robredo. Robredo explicitly stated raising the national budget for health care to make it better equipped, whereas it was implied in the other four candidates’ plans. Moreno, Lacson, and Robredo want to build more hospitals: Moreno specifies 107,000 hospital beds more, Lacson aims for a one bed per 800 population, while Robredo will build more tertiary hospitals in rural areas. All five will raise the salaries and benefits of HCWs, with Robredo being more specific with certain measures (more later). Agree with everything said so far, except that motherhood statements do little to ease the HCWs’ misgivings on what the candidates will do once elected. Government salaries are legislated and strictly controlled, based on Civil Service rules. But consider this: There is a big disconnect between government and private HCW salaries, with those in private hospitals getting much less; yet, majority are in 960 private hospitals compared to those in 476 government hospitals. Even with relatively higher government salaries, we are still suffering a major brain drain in medical professionals. The Philippines has always been the world’s major supplier of doctors, nurses, and medical technologists. The exodus continues, and the demand has gotten even higher with the pandemic. What will all the new hospitals do without HCWs? We can’t even keep them in our own hospitals, government or private. What we have is a chain of transfers from private to government hospitals, and those in both stay only for a year or two before they leave for more lucrative jobs abroad. We’re even losing nurses to non-health care businesses like BPOs, which pay salaries competitive with those abroad. We need to rethink how to keep our precious human resource in the country. For one, why are entry levels for health professionals like nurses, medical and radiation technologists, physical, speech and occupational therapists only at minimum wage? They’re college graduates who must pass board exams, and we treat them like menial workers with little or no education. Robredo is on the right track with giving full HCW Magna Carta implementation, sick leaves, medical insurance, and food and transport allowances, which will approximate and hopefully exceed the ₱50,000 combined income for them under the Bayanihan Act during this pandemic. However, much more needs to be done. Now that people have come to realize how essential HCWs are, the appreciation should translate into concrete action in raising their income commensurate to their education, training, skills, dedication, risks, and sacrifices. Otherwise, those hospitals will be very short of staff to look after the patients in them. Producing more doctors may seem like a good idea but it will be like pouring water through a sieve when they leave en masse for greener pastures abroad. So much for that, Isko. Our investments in health-professions education are vital to the health care system, which should benefit our fellow citizens more than it does others. We should prioritize raising salaries and benefits of ALL HCWs, not just nurses, to retain them here for a sustainable, just, and robust health system for all. This issue needs to be fixed once and for all. It has been long in the making and the pandemic has laid bare the looming crisis. A healthy citizenry is essential to a strong economy. A sickly workforce is a drag on progress. Our collective decision will determine how the Philippines will fare in terms of health care for all. Let us elect a leader with a good track record, proven competence, true “malasakit” for the people, and untainted by corruption, not those who just pay lip service and mouth empty promises. On May 9, my dear fellow health workers and our health care recipients, choose wisely, for your lives literally depend on it.