The Philippine health system has been at a breaking point even before Covid-19, but the pandemic exposed and magnified the gaps in the fragmented system. Leadership is crucial in effecting reforms in the health system, with various issues such as corruption, inclusion, brain drain, and others necessitating attention and significant policy change anchored on a people-centered approach.
A special study by medical doctors Eleanor A. Jara, Magdalena A. Barcelon, and Katharina Anne D. Berza, which seek to shed light on reforming the country’s battered health system was launched last week at a virtual forum organized by leading think-tank Stratbase ADR Institute, with multi-sectoral stakeholder groups.
The paper is entitled “Beyond Health Measures: Toward a Genuine People’s Health Agenda.”
“Health services should neither be an issue of privilege nor charity. This may be ensured by empowering communities that are able to provide preventive services and assert their right to avail of curative services from public health facilities,” the authors said. “A people-centered health care system catering to the needs of the poor should be founded on the basic tenets of equity, social justice, and people’s rights. All social services, goods, and facilities must be available, accessible, culturally acceptable, and of good quality. Thus, even as the government seeks to address the most urgent health problems of Filipinos today, it must also solve long-standing issues to establish a free, comprehensive, and progressive health care system adhering to these universal principles.”
One of the authors, Dr. Berza, director for Advocacy, Public Information and Research Department Council for Health and Development, said that Filipinos were still dying of preventable and curable diseases, corruption compromises health financing, and barangay health stations’ manpower complement is sorely lacking given the rate of brain drain among health professionals.
“The Department of Health should be strengthened by making the agency more accountable to our national health care system and emboldened to cater to the health needs of the Filipino people,” she said.
But all is not lost.
Jara, Barcelon, and Berza, in their paper, wrote that change remains possible however bleak the public health situation is. Crucial to this is the will and sincerity of the country’s decision-makers to genuinely strengthen the public health system with an adequate budget to provide free and comprehensive health for the people, especially the poor.
They envision a system that “can weather all pandemics and value the people’s health needs and overall wellbeing.”
At the forum, Berza added, “The primary and overriding goal must be the provision of free health services for citizens as part of publicly-funded social services.”
Stakeholder reactor Maria Fatima Garcia-Lorenzo, Universal Healthcare Watch (UHC Watch) co-convenor and president of the Philippine Alliance of Patient Organizations, said that the use of digital technology can contribute to an integrated people-centered national healthcare system.
The authors envision a system that ‘can weather all pandemics and value the people’s health needs and overall wellbeing.’
“The use of electronic medical records will ease the patients’ navigation from one health center to another. And patients’ data, which includes information on cultural and family background, can assist medical teams in understanding the patient and reaching appropriate diagnosis and treatment,” said Berza. “This will also lessen the patients’ out-of-pocket expenses from diagnostic procedures.”
“The next secretary of health must have integrity, have very good managerial skills, and should be innovative enough to integrate into the health agenda programs that will address issues on hunger, environment, etc. and bold enough to shift the health system from being doctor-centric to becoming patient-centric,” Garcia-Lorenzo said.
Stratbase ADRI president Professor Victor Andres “Dindo” Manhit, in his statement during the forum, said the choice of a president in the May elections is crucial to achieving health reform.
“Our next leaders should give high priority to addressing the mounting socio-economic and health issues brought by the Covid-19 pandemic, as well as continuing political issues such as corruption,” he said.
Then again, change will not solely come from the top.
“The critical and facilitatory role of civil society, non-governmental organizations (NGOs), people’s organizations, the academe, and responsible private sector enterprises should be recognized and institutionalized to ensure transparency, accountability, and social inclusion in the overall health care system of the country,” said the paper’s authors.
And indeed, “it cannot be done by one president we will elect, but it needs a whole-of-society approach,” Manhit said.
Other panel members/reactors at the forum were Dr. Alma Salvador, associate professor at Ateneo de Manila University and co-convenor of the Department of Political Science-Working Group on Security Sector Reform; and Renato Redentor Constantino, executive director, Institute for Climate and Sustainable Cities (ICSC).