Health through PPP

The 2021 national budget allots about P127 billion for health, an allocation that represents an inadequate 2.8 percent of the total. An estimated $300 million will likely be added from loans providing the funds needed to buy COVID-19 vaccines. The bulk of the P127 billion will go to maintaining the operation of public hospitals, paying the salaries of medical frontliners, and procuring medical supplies and medicines, and to PhilHealth to alleviate the plight of the poor and the less well-off in recovering their health.

It’s no secret that many public hospitals still lack modern equipment, such as X-ray machines, let alone MRIs, especially those in rural communities. Add to that the new demand COVID-19 has shown the need for: ventilators. These are essential tools that public doctors and other medical frontliners must have to make informed decisions, but they aren’t there. We sorely lack too much of what doctors need to do their job in our public hospitals.

Back around 2000, the Philippines was one of the very first to have a PET-CT machine—a machine that does diagnostic tests for cancer. According to cancer.net, a PET-CT scan “is a way to help find cancer and learn its stage.” In many countries all over the world, a PET-CT is the standard in cancer diagnostics, which is one of the leading non-communicable diseases in the world. But having the machine in the country didn’t prosper because it was expensive and prohibitive for a single private entity. Ten years later, we were behind in Southeast Asia.

After many failed attempts, a Korean company (Khealth Corp.) agreed to a public-private partnership (PPP) with the National Kidney Transplant Institute to put up a cyclotron and also provide a PET-CT machine at no cost to the government, with the hope that other hospitals would then establish PET-CT centers. That would provide the revenues through a fee charged for the service needed to reimburse the company’s investment. So a high-volume cyclotron was brought in that could support at least five centers. The growth has been heartening; in a little less than five years from a single center, there are now seven more centers that can operate, because a successful PPP created a cyclotron center that can supply the needs of all PET-CT centers.

Today, this test is standard in Philippine medical practice. It has spearheaded the introduction of new radionuclides to test not just cancer but also specific indications like neurological problems (dementia, Alzheimer’s disease, etc.) and prostate cancer, which doesn’t respond to the basic test.

What this success says to me is, here is a way to modernize our hospitals at little cost to government. The private sector supplier gets his return by charging a fee for each usage. A fee that can come out of PhilHealth’s pocket instead of it going into PhilHealth employees’ pockets.

It’s a model that could be copied for many of the other machines a modern hospital needs. It’s an easy one to privatize, because it is standard practice for a fee to be charged for a medical test.

Another area we should privatize is the digitization of services and records, and the protection of such data from hacking. I was in the Asian Hospital and Medical Center for a few days a couple of years back. I had to fill out a paper form from entry through every process I had to go through—a form that required the same information every time. My Asian Hospital card was useless, yet presenting that once at the beginning should have been all that was needed.

The government is digitizing its services; hospitals, public and private, must, too. There are companies out there that have the experience and expertise to smoothly, and quickly, put in place a national system of interconnected digital systems a health system must have in this digital world, and protect those systems and records. The confidentiality of a patient’s record is essential.

Had we had a seamless, interconnected digital record system now, hospitals could have been automatically reimbursed by PhilHealth for the services they performed without any physical involvement at all. Health care workers could have been paid, also automatically, the salaries they so well deserve.

Let’s modernize our public hospitals with the help of the private sector. There should be an aggressive implementation of PPP in the health sector.

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