Cardinal Pablo Virgilio “Ambo” David of Caloocan has raised strong moral and constitutional objections to the expansion of the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) program in the proposed 2026 national budget, warning that its structure entrenches political patronage and undermines human dignity.

“I write this not as an adversary of public officials, but as a pastor concerned for the moral direction of our common life,” David said.

He stressed that the title “honorable legislator” carries a vocation “to serve the people through just laws, strong institutions, and fidelity to the Constitution.”

David said one of the “quiet but grave moral failures” of public life is the normalization of systems that compel the poor to seek political intervention for basic services.

“When access to health care, education, or emergency assistance depends on a politician’s endorsement, a guarantee letter, or personal intervention, something deeply wrong has taken root—not only legally, but morally,” he said.

“From a pastoral perspective, this is not a mere technical flaw in governance. It is a violation of human dignity,” he went on.

The cardinal cited the bicameral conference committee’s proposed increase in MAIFIP funding, from P24.4 billion under the 2026 National Expenditure Program to P51.64 billion, describing the program as “nothing but a health pork barrel in the national budget.”

“On paper, MAIFIP sounds compassionate. In practice, it is nothing but a health pork barrel in the national budget,” David pointed out.

MAIFIP, he said, largely operates through a guarantee letter system, placing control over medical assistance in the hands of legislators.

“This effectively places politicians in control of who gets assistance, how much, and when,” he said.

He warned that health care becomes “a favor mediated by political power—a classic system of patronage that turns illness into utang-na-loob.”

David said such arrangements corrode both governance and society.

“They teach people, subtly but persistently, that survival depends on proximity to power,” he said. 

“They replace trust in institutions with loyalty to patrons.”

He stressed that Catholic social teaching rejects the idea that basic services depend on political favor.

“Health care, basic education, and social protection are not acts of generosity dispensed by the powerful; they are demands of justice owed to every person,” David stressed.

Beyond moral concerns, the cardinal said the system also violates the Constitution, citing the Supreme Court’s ruling against pork barrel practices.

“The Supreme Court was unequivocal in striking down the pork barrel system: legislators may appropriate and oversee, but they may not intervene in the execution of the budget,” he said.

“MAIFIP, as currently structured, is a lump-sum appropriation that requires post-enactment intervention by legislators to be accessed,” he added.