Commendable is the attempt of Health Secretary Enrique Ona to modernize state hospitals and health facilities with the limited allocations of the Department of Health.
Compared to the health budgets of other countries, that of the Philippines is the lowest. Whatever system is effective in upgrading and increasing the quality of healthcare, such as the privatization of hospitals, should be welcomed.
When I was president of the Philippine Medical Association (PMA), my research at the Library of Congress led me to the discovery that there were only 500 public and 1,500 private hospitals in the country. If there are now 700 government hospitals, then there has been a progressive movement to modernize and improve healthcare in answer to a decade of PMA prayers.
With 73,000 physicians in a country with a population of more than 90,000,000, one physician per 1,232 people can be comfortable. The problem is the uneven distribution of doctors. In a survey I made years ago, it was not exactly a financial factor that discouraged physicians from setting up practice in rural areas but, in the
order of importance: peace and order; security of the family from nongovernment forces and/or occasion of being caught in skirmishes between the government and insurgents; availability of health facilities and medicine; availability of schools for the children; distance of churches or chapels; good roads and transportation; presence of markets; friendliness of the community; and livelihood.
Depending on a country’s culture, state of civilization and affluence, the ratio of physicians to patients varies. When I was in training in New York City, the densest population of doctors was one per 250 New Yorkers on flashy Fifth Avenue. That same period at Caroliniska Institute (a hospital in Stockholm, Sweden) during my visit, 126 beds were reserved for patients. Those were the best examples of healthcare availability that I witnessed first hand.
The ethics of healthcare here are quite good. The Pharmaceutical Health Care Association of the Philippines is governed by a code of ethics which the PMA helped formulate at a workshop.
The latest code of ethics of the medical profession is a masterpiece that resulted from the combined efforts of the PMA and the Professional Regulation Commission (PRC) at a workshop that I organized. The participants were leaders of medical groups, the academe, pharmaceutical firms, advertisers, and the media, as well as lawyers. Both the PRC and the PMA are implementing it strictly. The courts refer to it and to the Medical Act of 1959—the law that governs medical education, training, licensing and practice—in hearing ethical and malpractice suits.
In the Philippines, the government erred in promoting generic drugs at the beginning by its slogan: Generic drugs are as good as brand drugs, only the packaging of the latter is better. That’s why they cost more. In reality, brand drugs are products of research and are an improvement on generic drugs, which is why they cost more and are more effective. In the United States, I walked into a drugstore and bought a nonsteroid/anti-inflammatory drug. I was told by the pharmacist that the drug is branded. A cheaper one is a generic that is 70 percent as effective.
These days generic drugs are advertised to be much better than the first generation because manufacturers of brand drugs likewise produce them. Hopefully so.
The push for healthcare transparency and accountability by Roberto Pagdanganan, chair of Medicines Transparency
Alliance Philippines, is well taken. But in the PMA and medical centers, I assure everyone that we are doing our share successfully.
Santiago A. del Rosario, MD, is a former president of the Philippine Medical Association.