Pinoy Kasi
Social protection
By Michael Tan
Philippine Daily Inquirer
First Posted 22:01:00 05/22/2008
Filed Under: Poverty, Health
SAVE THE CHILDREN RECENTLY RELEASED THEIR “2008 State of the World Mothers” report showing the Philippines ranked the highest among a group of developing countries in terms of quality of child health services. Yet the same report notes that we also have serious inequities in these services, reflected in child death rates. Among children from better-off households -- meaning the top 40 percent in terms of income -- for every 1,000 children born, 21 will die before the age of 5. With the poorest 60 percent of the population, the death rate is three times higher, at 66 per 1,000. I am certain that if we compared the richest 10 percent with the poorest 10 percent, the difference would be even more appalling.
Shortly after “Save the Children’s State of the World Mothers” yearbook came out, the Asian Development Bank (ADB) released a study on a social protection index (SPI) in Asia, based on the quality of services around jobs (both creating them, and providing skills), and reducing the impact of unemployment, illness and other social risks. In this area of social protection, the Philippines rates “below average” compared with the other countries in the region. In a table summarizing social protection among Asian countries, the ADB notes that the Philippines has “little in the way of major pro-people targeted programs, social insurance system for formal sector only.”
As with the Save the Children report, the ADB report notes a paradox: while the Philippines is a middle-income country and rates fairly well in terms of a Human Development Index, we have a low SPI, lagging behind many poorer countries.
Informal sector
The reports from ADB and Save the Children help to put “advance” in perspective. An advance often reflects the lack of social safety nets, especially for those working in the informal sector. My parents recently hired a new driver. He is 32 and has worked since he was 16, as a houseboy, then utilities helper, then as a driver, for a small family business. He has never had a Social Security System number, and had never heard of PhilHealth.
I’m always pushing friends to make sure they have SSS and PhilHealth for their domestic employees (household helpers, drivers, houseboys). Besides the issue of social justice, it’s a matter of being practical. Without SSS and PhilHealth, you end up dealing with more requests for salary advances, as well as handling some very large expenses, mainly medical.
Let’s use family drivers as an example. When they’re young, they’re always asking for advances to cover a child delivery. Then there’s the usual share of child illnesses and accidents. As the driver grows older, his own health problems begin to emerge, and he’ll need medicines for his hypertension, diabetes, etc. Heaven forbid, he gets a stroke or heart attack, or that his wife gets a cancer.
PhilHealth coverage protects your employees and their immediate family, including their parents, but not their brothers and sisters, but again that’s where SSS can help. Encourage them to use their SSS benefits, taking out loans that can be used to help their wider extended family, for example, to start a small business.
SSS is also indispensable when it comes to retirement. Our family had a driver who had a stroke when he was in his 50s -- with SSS, he was able to get disability pay and retire. He used his money to build extra rooms in his house, which he then rented out. His wife also used some of the money to stock up a tiny sari-sari store.
Another former employee, my parents’ mayordoma, retired a few years ago and lives comfortably in Bacolod on a monthly SSS pension, even able to support a granddaughter. She also learned how to get a senior citizens’ card, but tells me she hardly uses it because, knock on wood, she’s not had any health problems.
SSS and PhilHealth have improved over the years, with PhilHealth constantly adding medical services and procedures that can be reimbursed. Retired UP professors praise PhilHealth to high heavens when they get their cataracts removed, with PhilHealth coverage. You can imagine how miserable a professor’s life would be with impaired eyesight.
If you’re self-employed, or have a small business, or have domestic workers, check for ways to get SSS and PhilHealth coverage. Unfortunately, the procedures can be quite cumbersome, especially to get the remittance system going. But you can also teach your own employees to handle the paperwork. In fact, I think it’s essential that they learn to go through the bureaucracies with the forms, so when they need to get a loan, or a reimbursement, or when they move on to another job, they can continue to handle their own SSS and PhilHealth.
Teaching responsibility
Our social protection systems still need to be complemented. Some offices, like the NGO I used to work with, use a health maintenance organization (HMO) in addition to PhilHealth. It’s interesting to note that HMOs also require PhilHealth coverage. That NGO also had a revolving fund, from its employees own salary contributions, that could be used for emergencies or livelihood projects, a kind of internal micro finance scheme. Employees are under pressure to pay back right away because if they don’t, others can’t borrow from the fund. That’s still a form of social protection.
Use SSS and PhilHealth to educate your employees not just on social protection but on setting priorities. SSS and PhilHealth require responsibility—being consistent with payments, for example. Note that you need to have 36 consecutive SSS payments before you can apply for a loan. With PhilHealth, you need to have paid six monthly premiums (consecutively, if I remember right) before you’re eligible for certain reimbursements, say, a caesarian section.
Do some health education as well, reminding them PhilHealth can only pay for so much of medicines and hospital expenses. I have friends who didn’t believe in family planning, until their drivers asked for an advance, for the third, fourth and fifth baby. One of them asked me if PhilHealth reimburses for vasectomies, and I said, yes, they do, but warned him, you can’t force your driver to have one. I did suggest he warn his driver that PhilHealth does not reimburse delivery expenses for mistresses.
Point out, too, that SSS will not allow loans for frivolous expenses like birthday celebrations, or fiestas, and that such rules should apply as well when they ask you for a salary advance. I am amazed at how a poor couple will walk into a maternity ward without any money, but a year later, would have saved and splurged for the child’s birthday celebration. I’m not blaming the poor -- they pick up these values from watching the rich, ending up being more conscious about status, as expressed through conspicuous consumption, rather than paying attention to basic needs.
Social protection programs should be biased toward the ones most vulnerable, and we just might find they’re in our own households, or offices.
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Email comments to mtan@inquirer.com.ph
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