Health quality, access and cost

“For the poor, the issue is access,” said Dr. Jaime Aristotle Alip, managing director of CARD MRI, a highly successful microfinance institution. “Even if the government seeks to provide health services to all citizens through health centers in all towns and cities, for the poor who live in remote, isolated barangays, it is still difficult to reach health centers.”

For these citizens, said Alip, it still takes time and money to seek health care. “Mahal ang pamasahe  (The fare is expensive),” thus discouraging ordinary folk from seeking health advice, services and medicine, he explained.

In some localities, said former mayor Sonia Lorenzo, now executive director of the Union of Local Authorities of the Philippines, mayors have tried to bridge the gap by building barangay or village health stations where visiting midwives conduct clinics for simple ailments or complaints and monitor the health of infants, children and the elderly.

But, said Lorenzo, there is a need to “synchronize all our initiatives,” making sure that local governments, the Department of Health, NGOs and communities work and plan together to ensure better health for all Filipinos.

They were all part of a multistakeholder forum on universal health care sponsored by the Philippine Health Insurance Corp., Ateneo School of Medicine and Public Health (ASMPH), and Novartis Healthcare Philippines, who partnered last year for the first such forum.

This year’s forum, with the theme “In Pursuit of Access, Quality and Financial Protection,” drew about 120 participants including officials of the DOH and PhilHealth, local government executives, representatives of public hospitals and of patient groups, including an organization of parents of children with disabilities.

Health Secretary Enrique Ona had been scheduled to deliver the keynote speech but was compelled to join the Cabinet delegation visiting earthquake-struck Bohol and Cebu and so sent Undersecretary Nemesio Gaco in his place.

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THE goal of universal healthcare—that is, healthcare for all regardless of social and economic status, ethnicity, age and residence—has been brought closer to fruition by policies decided by the national government and implemented through the DOH.

More particularly, the policy is anchored on the “liberalization” of health insurance policies, with PhilHealth making it easier for hospitals, clinics and even individual doctors to gain accreditation and thus giving them an incentive to treat even the “poorest of the poor,” whose healthcare costs are now shouldered by PhilHealth.

Thus, the forum was seen as an “ideal venue” to “discuss ways to enhance existing programs to maximize point-of-care coverage.”

One problem seen was the lack of communication at the local level, with many of the poorest citizens unaware of the existence of health insurance and of the benefits of which they could avail themselves.

“Public-private partnerships offer a truly viable and sustainable way to make quality healthcare more accessible and more affordable to the Filipino people, especially the poorest segment of the population. We are privileged to work with PhilHealth and Novartis to make universal healthcare a reality in our country,” said ASMPH Dean Manuel M. Dayrit, a former health secretary.

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ON THE issue of assuring quality of care, the speakers emphasized the need to work closely with caregivers in ensuring that quality care is rendered even as costs are kept down.

“Quality and cost are complimentary, not conflicting,” said Dr. Aileen Riego Javier of the National Kidney and Transplant Institute. She emphasized the need to train hospital staff in standards such as infection control, patient management and keeping processes simple and intelligible. “Poor quality is NOT free,” Javier stressed, saying that costs are shouldered not just by patients but by the entire health system.

Flying in from Liverpool in the United Kingdom (and on his nth cup of coffee) was Dr. Alan Haycox, director of the Liverpool Health Economics Group, who spoke on the experiences gained since Britain’s National Health Service was established in 1948. The function of a national health insurance program, Haycox stressed, is to “focus on the weak and powerless.”

This columnist was invited to address the forum as a “consumer advocate” on the issue of quality and care. I focused on the need for greater dialogue and openness between the patient and the healthcare provider, given that doctors and even nurses and midwives are considered figures of respect and authority and that a real exchange of ideas and options may not be that common in the Philippine setting. The work facing the medical establishment, then, is to open lines of communication and give real “choices” to the people coming to them for help with their ailments.

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CONDO owners, resort owners, homemakers, interior decorators and the public are invited to view “ArtMoves,” an exhibit where eight dynamic artists mount art works in different mediums with soothing subjects.

Among those exhibiting are singer-turned-artist Kuh Ledesma, Roland Santos and Mandy Navasero. Navasero collaborates with Bobby Nuestro for her Batanes photos, and with Evie Roque who gave each portrait subject a “touch of Warhol” in digital art.

Also exhibiting are surrealist Jethro Jocson, Katrina Pallon, the “Frida  Kahlo of the Philippines,” Monchot Ongsiako with his serene and calming subjects of the sea, seashore, ships, shipwrecks, sampans, Venice gondolas, etc., and Vinson Yap with brilliant depictions of nature in all her illuminating colors.

“ArtMoves” opens on Oct. 25 at the LRI Art Pavilion, second floor, LRI Design Plaza, Nicanor Garcia St., Makati.