A ‘win-win’ for ‘Orthopedic’

“Public” is good, “private” is bad. “Government service” stands for cheap, if not entirely free, service. “Private service” is exclusive, expensive and elitist.

So if a government facility is supposed to be transformed into a private entity, it means the poor, the “can’t afford,” will be left out and deprived of necessary services, right?

Not necessarily. All too often, “public” also means poor quality service, shoddy facilities and lack of care, simply because government often lacks the wherewithal to improve the services it should provide, overwhelmed as it is by sheer demand and the difficulties it faces in finding the resources it needs.

Sometimes, too, there is a happy middle ground—with the private sector providing the funding for the construction and operation of a hospital that will nonetheless remain under government control, the majority of its beds and services devoted to poor patients who can avail of care through health insurance.

This is the envisaged system for the Modernized Philippine Orthopedic Hospital (MPOH) which will soon be rising behind the National Kidney and Transplant Institute. Under a public-private partnership (PPP) scheme, the MPOH will serve as a “centralized super-specialty orthopedic hospital” with 70 percent of its 700 beds available for poor or service patients, while the remaining 30 percent can be availed of by pay patients.

The old Philippine Orthopedic Center (POC) on Maria Clara corner Banawe streets in Quezon City will remain a fully state-subsidized institution, and its employees and staff will remain government employees. But the 68-year-old POC only has 300 usable beds out of the 700 in the hospital, while its equipment has long been outdated and unusable.

How then will the private sector (which bidded for the project and will manage the hospital) benefit from running the MPOH? And how will the government—and the public—benefit from it?
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FIRST, say representatives of Megawide World-Citi, the consortium which won the project after a public bidding, the MPOH will not be privatized, with the government retaining ownership and regulating services. Moreover, majority of the beds will be used for poor patients who could be either outright charity cases or those paying through PhilHealth.

The private sector, which will build the hospital, purchase the equipment and manage the operations of the hospital, on the other hand, will gain an income from the fees paid by patients occupying the remaining 30 percent of the beds.

To those “worrying” whether the investors will make money from the scheme, observers point out that, for one, there is no need for massive marketing of the hospital’s services  since “Orthopedic” has long been branded as the country’s primary care facility for patients with broken bones or musculoskeletal diseases.

Indeed, it’s been observed that orthopedic cases are on the rise because of our aging population. But with better management and equipment, the hospital is expecting a faster turnover of patients, thus higher revenue.

This greater efficiency will also redound to the benefit of poor patients, who could be operated on faster, and shorten both their waiting period (sometimes lasting as long as a year in the old POC) and their hospital stay (now estimated to last an average of 22 days). With the MPOH, the average hospital stay could be reduced to as short as four or five days, thus increasing the number of poor patients the hospital can treat.

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A REPORT published in another newspaper in 2013 highlights the case of Mario Maniego, 49. Maniego suffers from a spinal cord injury after an operation meant to address a spinal problem  left him confined to a bed for the last 17 (now 19) years.

Maniego needs a respirator to breathe and other life-sustaining equipment, and through the years his medical costs have reached a total of P1 million. Despite running to politicians for aid (not with the Priority Development Assistance Fund abolished, though) and to groups like the PCSO, the family remains caught in a seemingly unending race after funds.

Maniego’s almost two decades’ stay at the POC also means that for this length of time, his bed has not been made available to other, perhaps just as needy, patients. His case also partly explains why, for more than 50 years, the POC has not had any new construction work done, no new equipment purchased, its facilities rundown.

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FORMER Health Secretary Enrique Ona, under whose term the PPP scheme for government hospitals was first hatched, once said that he would want nothing more than to upgrade the facilities and services of all government hospitals, but that “the government does not have the money to do this all on its own.”

The private sector needs to step in and evolve a “win-win” situation where everyone—patients, doctors, workers—comes out a winner.

In recent months, we have seen a series of rallies held either in front of the POC or the Department of Health’s headquarters, by employees of “Orthopedic” and their allies in various protest groups. The fears of the workers seem patently self-serving: the threatened loss of jobs, longer commutes, apprehensions about working in the private sector. Other observers cynically attribute the protests to the loss of potential money-making rackets, such as making patients pay extra for priority consultations and additional services.

But let’s not get into that. Suffice it to say that a “new” Orthopedic should in the long run benefit both poor and rich patients, upgrade the knowledge and skills of medical practitioners, and bring a sense of professionalism into a field in which the Philippines has been left behind through sheer neglect.