Accessible health care for all

Here’s good news for the health sector: State-owned specialty hospitals are getting a higher budget this year amounting to almost P7 billion — or P1 billion more than last year’s allocation. This would allow them to serve more patients suffering from specific conditions such as heart, kidney, or lung diseases, which are among the leading causes of mortality in the country.

Now here’s the rub. This budget is only for five specialty hospitals—and all of them are located in Metro Manila: the Lung Center of the Philippines, P835.2 million; the National Kidney and Transplant Institute (NKTI), P1.7 billion; the Philippine Children’s Medical Center (PCMC), P2.1 billion; the Philippine Heart Center, P2.1 billion; and the Philippine Institute of Traditional Alternative Health Care, P156.2 million.

There is no doubt that the government needs to decentralize specialized health services from Metro Manila to the provinces — this is mandated under the Philippine Health Facility Development Plan 2020-2040 which envisions the establishment of health care facilities throughout the country.

The idea to build regional heart, kidney, and lung centers is not new and was made as far back as the Arroyo administration in 2007. Today, 16 years later, per data from the Department of Health (DOH), the country has only 46 functional specialty centers for 16 priority specialties, including heart, lung, kidney, cancer, and neonatal.

The COVID-19 pandemic already highlighted the urgent need to establish government satellite hospitals that would provide specialized services in the provinces. The country’s geography already makes it very difficult to reach remote areas or far-flung islands for even the most basic of public health services — how much more during the pandemic when mobility was highly restricted. Even in the cities, stories about the difficulties experienced by those with cancer or chronic illness needing treatment at the height of the COVID lockdowns but were unable to do so for various reasons remain vivid. Many of them missed treatments due to a lack of public transport, limited hospital resources that shifted services to treating coronavirus patients, or no alternative medical facility within reach. One bone cancer patient who had lost a leg had to walk from her home in Antipolo City to a government checkpoint along the Marcos Highway to get transport, and from there had to travel about 20 kilometers to the Philippine General Hospital in Manila so she could show up for her monthly check-up. A dialysis patient had to walk from San Mateo, Rizal, to Quezon City. In many other places across the country, patients, especially the marginalized who couldn’t afford health care, must have felt the hopelessness a hundredfold.

Even without the conditions under a severe pandemic lockdown, many patients already face daunting challenges. Traveling to the specialty hospitals in Metro Manila entails huge transportation and accommodation costs on top of medical costs that the ordinary Filipino can barely afford. They are not even assured of getting the attention they need once they arrive at these hospitals which can also be overwhelmed by the high volume of patients. Many choose not to seek treatment anymore because of the prohibitive cost and complicated process involved, and more have died without getting the proper medical attention. A 1990 study by the UPecon Foundation of the University of the Philippines School of Economics found that up to six out of 10 Filipinos who succumb to sickness do so without seeing a medical professional — and one of the top factors cited was the inaccessibility of medical facilities.

One of President Marcos Jr.’s campaign promises was to build specialty hospitals in the provinces that he followed through in his first State of the Nation Address. Several bills seeking to establish satellite specialty hospitals in Northern Luzon, Southern Luzon, Visayas, Northern, and Southern Mindanao are already pending in Congress: four at the Senate and 14 at the House of Representatives. One measure, Senate Bill No. 93, requires Manila’s heart and lung centers, PCMC, and NKTI to establish satellite hospitals in the regions under their respective charters. Some of the bills suggest a more cost-efficient and practical solution: to establish these specialty health services within existing DOH hospitals and medical centers. This proposal could also see the improvement of facilities and technology for many government hospitals that are in dire need of upgrade.

But cancer and other types of illness will not wait until all the hospitals have been built — patients need to get medical attention as soon as they can, or their condition will only get worse and that will cost the government even more. Pouring money into specialized hospitals is noteworthy, but so is upgrading other state-owned hospitals. It is high time the government provides accessible health care for all Filipinos, not just those in Metro Manila.