UNDER THE MICROSCOPE
During an interview of a Pathology residency applicant, she was asked how she envisioned her Pathology practice 10 years after graduating. Her answer was: “The health system in our country is now better than it was before. Hospitals have improved histopathology laboratories and advancements in molecular and digital pathology were applied. New biomarkers were discovered which paved the way for early detection and treatment of different types of diseases. Better compensations are given to healthcare workers and more doctors are trained and deployed throughout the different regions of the country. A lot have changed from where we stand before. It was a dream but now steps are already taken to achieve its goals.”
Oh, how I wish it were all true! But she was applying in an elite hospital after having graduated from a prestigious medical school affiliated with that hospital, where she had also done her internship. She was actually describing her experience, which unfortunately does not reflect the state of the country’s health system. True enough, these top hospitals employ the best equipment and staff to care for their patients. But they represent a very small fraction of the hospital system, which is beset by many issues.
Healthcare worker compensation is still miniscule compared to other countries, including even those that are comparable in economic status. While we do have many good nurses, medical technologists, physical and occupational therapists, and other allied healthcare workers, they are leaving by the hundreds to work in other countries, where they are better compensated and have better working conditions and higher quality of life. Many countries are now offering instant immigrant status to health workers, among them, the USA, Canada, and New Zealand.
Suffice to say, their pay scales top ours by many orders of magnitude. Our best hospitals are just training grounds for these health workers, who leave the moment they qualify for jobs abroad. I have seen hundreds of my medical technologists leave for foreign hospitals, and then they act as conduits for these hospitals to recruit more and more of our staff. It’s a never-ending losing battle, which we must fight to maintain quality of service in our own institutions.
It is true that we now have modern technology in our laboratories and hospitals, but again, these are present in a small percentage of hospitals, mainly the upper 10 precent in the large urban centers. Of course, there is a corresponding price for such advanced instrumentation, which is beyond the ability of most Filipinos to avail themselves of, even with Philhealth, which does not cover all medical expenses.
Another issue is the state of hospitals’ poor reimbursement by PhilHealth. They threaten to refuse patients who use their health benefits. When the government is moving toward universal health care, this will cause widespread dislocation in the hospitals if the reimbursement issues are not addressed.
Due to technological advances in medicine, healthcare is becoming more expensive and out of reach for ordinary folks, such that many are forgoing preventive checkups only resort to medical intervention when their conditions are more serious, thus, more expensive to treat.
Many times, I hear of women who waited until the small lump in their breasts grew huge and beyond treatment, because they feared the medical costs. Or the patients whose kidneys failed because they did not seek medical advice early on, again for financial reasons. Especially pitiful are the babies and children of poor families who are brought to hospitals in advanced disease states, like those I see in the Philippine Childrens Medical Center. They arrive with heads massively distended by excess fluid in the brain, a condition called hydrocephalus, such that they appear to be aliens in movies.
We have different standards of health: one for those who can afford the best care available; the other, for the rest who have to line up for hours, even days, just to be seen at our intensely crowded public hospitals, where treatment is either sub-standard or not available due to lack of funding or staffing.
What needs to be done? Budgets for health need to be increased. At the same time, the Department of Health has to increase its absorptive capacity, since even its limited budget doesn’t get fully utilized within the year. Thus, lawmakers argue against increasing its budget. Corruption is the biggest obstacle as in other government agencies and must be curbed.
It is my wish for this Christmas season that we will improve our health system to eliminate this obscene inequality that further defines the divide between the haves and the have-nots in the country. We cannot make good progress economically without a healthy citizenry.
We’ve got a long way to go to have medical care fit for all. But we can dream, can’t we?