When our village association manager’s wife started having non-menstrual bleeding again after she was managed medically, I asked our class chat group for help in managing her. She needed total hysterectomy (taking out the uterus) since she had already completed their family size with grown daughters. A classmate, Leonardo Mangahas Jr., retired Tarlac Provincial Health Officer, messaged me that I should send her to Tarlac Provincial Hospital where she will receive excellent care to be paid for with PhilHealth coverage only with no additional cash outlay from her family.

Naturally, I was happy to hear that but was also amazed how TPH did it. So, I sent Bobby and his wife to Tarlac Provincial Hospital where she was examined by a board-certified OB-GYN trained at PGH. In short, she had a radical hysterectomy due to the surgeon finding gross evidence of endometrial cancer. Other than two units of blood which she needed to correct her anemia due to blood loss, which I supplied, she didn’t spend a single centavo.

Having had proof of concept, I had to ask Popoy, my classmate’s nickname, how they did it. Here’s his story.

It all started in 2011 when then governor Victor Yap conceived of the PhilHealth-only protocol after a ten-year annual cataract surgical missions operation headed by Popoy’s wife, Shelley Ann Mier-Mangahas, an ophthalmologist. She, together with Victor Yap, thought of having daily cataract activity year-round. On March 4, 2011, the Linaw Tingin program was approved by the Sangguniang Panlalawigan which will train Barangay Health workers (BHW) on basic eye disease identification.

Concurrently, the TPH Eye Center was being prepared, eye instruments purchased and nurse ocular training was done. Ophthalmologists from the private sector were invited as visiting consultants without pay. On Aug. 20, 2011, the first eye patients were seen. This was so successful that a similar program was conceived involving all other medical specialists.

This was the Silip Sakit Program, with its delivery arm, Service Delivery Network (SDN) of the DOH, conceived during the Aquino administration. Their guiding principle was “Ang duktor ng mayaman ay duktor din ng mahirap.” Popoy Mangahas is the Program Administrator. His wife, Shelly, is the SDN Communications Director.

Thus, the SDN Support Group, consisting of specialists and subspecialists from the private sector, will augment the manpower capacity and expertise of the SDN Core for both in- and out-patients. The budget for paying these specials/subspecialists will be drawn from the PhilHealth reimbursements of the hospitals for professional fees.

Apparently, this was enough to attract even private specialists/subspecialists from Metro Manila. Many came from PGH, who from the start of their training were attuned to the needs of the poor.

The program is so successful that they have backlogs even when they do 20-30 cases a day that TPH is looking at a 24-hour OR operation plus adding 100 more beds. Now, Tarlac has satellite SDN programs in all four district hospitals.

In 2025, more than 240,000 Tarlaquenos were given free medical care, including surgeries, consultation, telemedicine and other medical services.

These are all elective cases as emergency cases can’t be attended to by the volunteer doctors. I’m sure Popoy will find a way to do that, being hailed as a visionary doctor, a man of great dedication to bring quality health services to Tarlacquenos, who continuously steers SDN as a prime model of good health care delivery in the country. More details can be seen in the Facebook page, Silip Sakit Program-Provincial Government of Tarlac.

The question is, if Tarlac can do it, why can’t other provinces do it as well? Neither can Metro Manila government hospitals including PGH. Does the answer lie in lack of knowledge? Or is it because administrators are not keen enough to pursue such initiatives? Perhaps the answer lies in the way government hospitals are ran, or that corruption gets in the way and funds are drained into unscrupulous hospital employees’ pockets? Then there’s the scam operations ran by hospital employees and their cohorts that I have mentioned in my previous column (Scamming the Poor, May 12, 2026).

Whatever may be the reason/s, it is imperative that these laggards get up to speed, for they are now going to be compared to what Tarlac has achieved. Here is a template on which every government hospital can pattern their operations and services. The doctors in the private sector are willing to help even with the paltry remuneration PhilHealth gives. What’s needed is the political will to reform operating systems and allow them to participate in caring for our countrymen and women.

Universal health care is achievable. Tarlac province has done it. Kudos to my classmate, Dr. Leonardo Mangahas Jr. and his lovely wife, Dr. Shelly Anne Meir-Mangahas (UPCM 1979). May your tribe increase!