As if it has not received enough wake up calls, the Department of Health should act quickly and boldly to prevent our public hospitals from turning into pawnshops.
During the budget briefing of the DOH last week, I asked health secretary Enrique Ona about the Philippine Children’s Medical Center’s practice of asking indigent patients to pawn personal items like mobile phones and watches in exchange for releasing patients who could not pay their bills.
Under Republic Act 8439, which prohibits the detention of patients in hospitals and clinics on grounds of nonpayment of bills or medical expenses, a promissory note backed by a mortgage or a guarantee of a co-maker should suffice to allow the release of patients and their medical records.
I showed Secretary Ona two PCMC memos based on RA 8439 which provides guidelines on the sale of said collaterals through what we commonly know as a subasta.
Along with the two memos was an announcement for the sale of unsold collaterals, including a list of items, most of them cheap, dilapidated Nokia mobile phones and two Seiko watches. The stuff were being sold at P200-P300 each.
Unfortunately, the PCMC director was absent at the budget briefing and therefore could not explain the whys and hows of his directives. Secretary Ona, himself known to be one of the most innovative when it comes to raising revenues from public hospitals, said he was not aware of such a policy in other public hospitals. He promised to look into the matter but expressed disagreement with the way RA 8439 was being implemented in PCMC. Last Friday, the department announced it would stop such practices.
It can certainly be argued that the practice in PCMC is legal under RA 8439. After all, a mortgage is a mortgage, whether a house, car or low-end mobile phone. What just bothered me is that the list of “collaterals” reflected their owners – the poor and destitute. Who else would pawn a Nokia 3310 with a fake casing (subasta price P200) or a Seiko 5 model 7S26 (subasta price P400)?
Thus the practice reeked of squeezing every ounce of blood from the very poor. Not very nice for an institution that is supposed to help the poor.
The underlying issue here, of course, is the dwindling budget of our public hospitals and the desperate measures that our hospital administrators are taking to raise revenues. Last year, there were no increases for the maintenance and operating expenses of our public hospitals. In fact, there was hardly any amount for capital outlay.
For 2012, Secretary Ona said the DOH’s original budget proposal was P80 billion. This was reduced by the budget dapartment to P42 billion, the rest placed under the unprogrammed fund allocations. This means that only P42 billion of the P80 billion proposed appropriations are sure to be funded, the balance dependent on whether the government would be able to earn revenues over and above its targets.
Just as in education, the Philippines lags behind its neighbors in health spending. The World Health Organization (WHO) recommends health spending to be at least 5% of gross domestic product (GDP). The Philippines is at around 3%, not taking into account our low GDP figure to start with.
Because of our underspending on health, our public hospitals are underfunded, understaffed, and lack even the most basic equipment and supplies. So numerous are the horror stories told about them.
Recently, my wife’s grandmother was rushed to the Philippine General Hospital after breaking her hip. She was confined for two days at the emergency ward. My sister in law recounted how the overcrowded, non-airconditioned ward reeked of bodily smells. The floors and walls were dirty, the beds and tables unkempt. It was so bad my mother in law prohibited my wife from visiting for fear that she would get an asthma attack.
My wife’s grandmother was eventually sent home after doctors feared that she would get an infection from the hospital’s unsanitary surroundings. Imagine that.#