Welcome respite from the intramurals and jockeying for leadership now occupying the time and energies of our lawmakers was the recent passage by the House of Representatives of a bill providing free dialysis treatments for indigent patients.
Passed on third and final reading is House Bill No. 9156, with the rather unwieldy title of “Providing a Comprehensive Renal Replacement Therapy (RRT) for Patients with End Stage Renal Disease in National, Regional, and Provincial Government Hospitals, Increasing the PhilHealth Package Rate for Renal Replacement Therapy of Members.” It was voted on favorably by 177 legislators, with no opposition or abstention. Given the overwhelming support the bill received from the House, there’s little doubt a counterpart bill will find favor, too, in the Senate.
Dire indeed is the need for subsidies for poor Filipinos undergoing end-stage renal disease and other kidney ailments. Each year, studies reveal, an estimated 120 Filipinos per million population (PMP) develop kidney failure, translating to about 10,000 Filipinos each year. But the reality
is that only around 7,000 are able to start dialysis or receive a kidney transplant, with only 73 percent of those struggling with kidney complications receiving treatment.
Those who are left untreated simply walk away because they could not afford the therapy. A news article estimates that in a given year, “a quarter of Filipino patients probably just died without receiving any treatment.” Or perhaps without even knowing they had kidney disease.
The House bill also seeks to expand PhilHealth coverage for kidney transplant or renal replacement therapy from both living and deceased donors. The measure also expands PhilHealth coverage for kidney transplantation, from the evaluation and screening of kidney donors and recipients up to the transplant procedure and post transplantation procedures and remedies.
Bayan Muna Rep. Carlos Zarate said the measure, once implemented, could “save many lives.” He told reporters that “the steep cost of health services in our country will set you back P25,000 to P46,000 a month for dialysis treatment, a price very few can afford.” Zarate, a principal
author of HB 9156, said he and his colleagues “pushed for this measure knowing that many lives hang in the balance.”
The leading cause of kidney failure in the Philippines is diabetes (41 percent), according to the 2008 Philippine Renal Disease Registry
Annual Report, followed by an inflammation of the kidneys (24 percent) and high blood pressure (22 percent). The same report said that patients were predominantly male (57 percent) with a mean age of 53 years.
Thus, “diabetic males in the most productive years of their lives” comprise the major segment of the population in need of treatment for
kidney disease. “They require replacement of their kidney function to live. Without dialysis or kidney transplantation, patients with kidney failure die.”
Kidney disease takes a lifetime to develop, closely linked to a person’s diet and lifestyle. Salt and sugar (of all forms, including rice) are common culprits that lead to diabetes and hypertension, both key factors in kidney disease. For many poor Filipinos, the situation is made worse by the predominance of instant noodles and other processed food that are high in salt in their meals. Add to this harmful habits like smoking and drinking alcohol.
Thus, while the bill aims to make dialysis treatment and even kidney transplants more accessible and available to Filipinos regardless of economic class, these alleviating measures come only at the “end-stage” of not just the disease but of a lifetime of unhealthy choices. Easing the “burden of kidney disease” requires action by the health-giving and teaching community starting from childhood, to address weaknesses in nutrition and health awareness and education way before the kidneys themselves are affected.
Still, the free kidney treatment bill deserves all the support it can muster, and the political will needed to implement it fully and meaningfully.