Health is wealth

Why is it that we all agree that good health is essential (you can’t do much when you’re sick), yet don’t give it the attention it must have?

Universal health care, the goal of administrations in all countries, has been very rarely achieved. And availing of it for free, or at least at affordable rates, remains very much a dream.

Here, it’s no different. PhilHealth, the primary source of paying for health services, is poorly managed, badly run and seemingly unable to efficiently handle the funds allocated to it. In 2016 (latest official data available), because of the sin taxes, PhilHealth garnered an additional P31 billion, giving it a total of P134.8 billion (on the back of P103.8 premium contributions collected in 2016) to spend on 93.4 million beneficiaries. The PhilHealth 2016 report showed that P101.8 billion was spent on reimbursements or payment of services. That left P33 billion unspent.

Many hospitals are in poor shape and undermanned. They need more equipment. The good hospitals are privately run; only a handful of government hospitals are good in any way.

Then there’s medicine and the ability to pay for them. That’s the key phrase — “ability to pay.” It’s not the price, it’s “can I afford it?”

The answer, too often, is “no”. But, while we don’t want to pay for medicines, it’s a forced necessity. So the solution clamored for is to force lower prices, but that isn’t the solution. It may lead to lower prices for a while, but it will lead to no new drugs in the future.

You may die of cancer, but your kids won’t—if the pharmaceutical companies can spend the billions of dollars necessary to find a cure. But those billions have to come from somewhere, and they come from the prices of drugs today. We are paying for better health for our children, even better health for us.

Simply forcing a reduction in prices doesn’t work. It was tried during the Arroyo administration when a law was passed. Five years later (September 2013), a study was conducted by the Philippine Institute for Development Studies (PIDS) funded by the Department of Health. Titled “The Impact of Cheaper Medicines Act (CMA) on Households in Metro Manila: A Qualitative Study”, it was principally written by Dr. Eleonara de Guzman.

The study stated: “The Cheaper Medicines Act does not seem to have resulted in significantly reducing the financial burden of medicine costs among households. Respondents from all socioeconomic classes claimed that their expenditures for medicines were still heavy. The law has had little effect on low income respondents (Class DE) who rarely buy branded medicines, but avail themselves of free medicines from government health centers or purchase low-cost generics.”

Despite that failure, there’s a new attempt by Rep. Ferjenel Biron to pass a law to again control prices. If passed, it would likely fail as well. Why would a manufac turer sell at a loss or no profit here, when he can sell at a profit somewhere else? He’ll just withdraw the drug from the Philippine market. And don’t say the manufacturers are being heartless; it’s not their role to be philanthropic. They’d soon go into bankruptcy if they did much of that.

Blame the politicians who want to get reelected through popular decisions, regardless of the feasibility of their promises.

The solution to drug prices is already here. It’s generics. You can buy generics at a fraction of the cost of branded drugs. Or you can turn to PhilHealth.  Since the poor can’t afford drugs at any price, such drugs must be given free. That’s where PhilHealth comes in; it can buy in such huge volumes that it can negotiate very favorable prices.

Which brings me to the inoculation hysteria over Dengvaxia created by irresponsible people. You can put the head of the Public Attorney’s Office at the top of the list, but there’s also the media looking for headlines. And some politicians wanting the same.

Well, Dengvaxia works. What is particularly damning about those people is that their irresponsibility has led to the known deaths of 12 kids. Kids whose moms wouldn’t let them be vaccinated for measles because of the scare created over Dengvaxia.

No drug is perfect; all drugs have some side effects in some people to varying degrees. In some cases, people can die from taking a particular drug. What you have to look at is the numbers. Emotionalism should play no part. Dengvaxia and other vaccinations save far more people from illnesses and deaths compared to the few that succumb to their unintended side effects.

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