Health for all
They say that the best things in life are free. Well, I don’t know about that, but I do know I’d be glad if one of the hardest things in life were free: curing illness.
Countries all over the world promise to provide it, but few do. Unsurprisingly, some of the best countries giving their citizens free, or heavily subsidized, health services are Nordic countries — Iceland, Sweden, Norway, Finland, Denmark and Greenland. I’m not quite sure why that is, but these countries rank at the top in many of the features most needed in life. From birth to death, they seem to handle it best. I’ve always liked the idea in Finland where every new mother is given a baby box that contains all the needs of a newborn. I will discuss this further in my next column.
I’m a firm believer in paying for what you get, but I think health is that one exception. It’s bad enough being sick, it’s worse going broke over it.
We need two systems: a public one that is completely free — from aspirin to open heart surgery —but, conversely, paid at market prices in private institutions. That includes medicines. Pay for them in Mercury Drug, Watsons, Generika Drugstore, but they should be provided at no charge in government health facilities, where the government has bought them at large discounts given the volume of need of such facilities, and with multiyear contracts to seal the price. However, putting a price cap on them in the private sector, as Congress is considering, would do more harm than good, and should not be done as I explained in my column, “You must pay the cost” (5/16/19).
The Duterte administration passed the Universal Health Care (UHC) Act in February 2019 and mandated the Philippine Health Insurance Corp. (PhilHealth) to administer it. It is a highly sensible measure, especially for poor Filipinos who die without even seeing a physician. The measure automatically enrolls all Filipino citizens in the National Health Insurance Program. According to the World Health Organization, the law gives Filipinos “access to the full continuum of health services they need, while protecting them from enduring financial hardship as a result.”
It’s a well-crafted law that now just needs funding and full implementation. Its main arm is PhilHealth, where most of the funding is needed—and it’s there, with the higher sin taxes Congress approved. A second increase will come soon. Health Secretary Francisco Duque III is responsible for the implementation, and considerable progress has been made already.
However, it is mired in a controversy today over the honest use of those funds. As you’d (sadly) expect, there has been cheating. PhilHealth, and the UHC overall, needs a well-designed computerized system to prevent scams from being possible. The proposed National ID, if well-designed, will help.
It was Duque who actively pushed for the passage of the UHC bill that was eventually signed into law by President Duterte. He’s done a lot since to get it up and working, so trying to implicate him in the recent fraudulent claims case would do the UHC—and him—a disservice. He played an important role in developing the implementing rules and regulations for the universal health care and national integrated cancer control laws so that these can now proceed, and they have.
It was also his recommendation that the leadership of the Food and Drug Administration (FDA) be changed, because he was unhappy with the leadership. Since then, those dealing with the FDA tell me it has been transformed. Regulatory processes have been reformed, approvals speeded up, and there’s the necessary interaction with stakeholders.
In December 2017, a woman called Persida Acosta, encouraged by a media looking for headlines, stirred up so much fear in people that mothers stopped immunizing their babies and children. As a consequence, immunization fell to 32 percent from 95 percent in previous years. In the first two months of 2019, the government recorded more than 13,000 measles cases and some 215 deaths
—much, much higher than last year. On Tuesday, the Department of Health declared a national dengue alert, with dengue cases rising 85 percent to 106,630 cases, with at least 450 deaths.
Mothers were scared to immunize. Dengvaxia could have prevented most of those cases. Duque has since brought immunization back to 90 percent through a concerted campaign to overcome the fears. I’ve worked with him, and I’m impressed. UHC could well work as intended under his leadership.
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