The ‘Corporatization’ of the Public Health System
show that seven out of every 10 Filipinos die without ever seeing a doctor
and that the nearly 75 percent of the population living below poverty line
are mainly in rural areas where there is no access to basic services such
as health and medical care. Yet the government has allotted a mere 30
centavos per Filipino per day for health care. And now, its thrust is the
“corporatization” of the health system translating into higher fees and
eventually the privatization of public health care services.
By Karl G. Ombion & Ranie Azue
Corazon Locsin Montelibano
Memorial Regional Hospital in Negros Occidental
The reality in
private hospitals where an in-patient must first give a down payment of
P2,000 upon admission is now also true in public hospitals today. A public
hospital patient now has to pay a deposit of P500 to P1,000 first.
This is why,
according to health activists, the health situation of Filipinos has
become deplorable. Official statistics show that seven out of every 10
Filipinos die without even seeing a doctor. Nearly 75 percent of Filipinos
live below the poverty line, most of them from the rural areas. These are
the people who have no access to the most basic services including health
care and medical treatment.
conclude that the inaccessibility of health services and the worsening
health situation are due to the government’s thrust of pursuing the policy
of privatization, where ownership and control of public services and
utilities, like power, water, schools, and hospitals, are being turned
over to private corporations whose main objective is to profit. This trend
is called the “corporatization” of public services.
In 1998, the
government formed a “Task Force on Corporatization” led by the Department
of Health (DOH). It evaluated public hospitals regarding their viability
for fiscal autonomy and restructuring, in line with the thrust towards
“corporatization” of 38 state-run hospitals nationwide.
The evaluation showed
most public hospitals are inefficient, unprofitable and unsustainable.
Hence, the government implemented the Health Sector Reform Agenda (HSRA)
aiming for: hospital revitalization or modernization, financing system
expansion, conversion into public corporation, improvement of hospital
networking and patient referral system, and organizational changes.
Higher tariff for
In line with the
national government’s thrust, the Negros Occidental provincial government
raised the tariff for medical services in government hospitals.
Data obtained by
Bulatlat revealed that the provincial government passed Provincial Tax
Ordinance No. 92-002, amending Provincial Tax Ordinance 97-001, raising
the fees being charged by government hospitals at an unprecedented rate of
250% compared to the year 2000.
In Article C of the
said Provincial Tax Ordinance, the following standard rates are set:
Rates for the use of
laboratory facilitates vary from a minimum of P45 to a high of P400.
Oftentimes laboratory needs of patients are referred to private
laboratories since most of the procedures needed are not available. Worse
is the reported blatant collaboration between hospital personnel
particularly laboratory technicians and physicians and private
The charge for
ultrasound service ranges from P350 to P900.Use of x-ray machines is
pegged at P150; incubator fee at P240 a day or P10 per hour; respirator
machine excluding oxygen at P250; cardio monitor at P500; and respirator
tubing, P950 per piece.
Governor Joseph Maranon said the imposition of standard rates is intended
to generate revenues for better services. The funds generated are used for
the replenishment of hospital supplies and upgrading of facilities, the
A long time resident
nursing aide however belied the Governor’s statement saying that the
provincial hospital looks modern outside but is dilapidated inside.
Requesting not to be identified, she took Bulatlat around the
buildings and showed how some of the rooms and ceilings have remained
unfinished while some have been severely damaged or poorly maintained.
Worse, she added, patients are charged for the use of medical equipment
donated by politicians and benevolent groups for the use of the
defined the Center for Investigative Research and Media Services (CIRMS),
is the process of take over by private corporate interest of a public
utility entity, which eventually leads to full privatization.
In its study of
selected cases of privatized government utilities, CIRMS said
corporatization has two types. One is the direct sale of a government or
public utility to a private company. The most common reasons given for
this are government inefficiency, slow modernization, and indebtedness of
the utility. CIRMS cited the case of national government companies as
The second is the
indirect takeover by a private corporate interest of a public utility firm
for the same reasons as above. CIRMS cited the case of local water units,
financial institutions, and the Corazon Locsin Montelibano Memorial
Regional Hospital (CLMMRH), which have heavy private investments.
The CLMMRH, a case
The Corazon Locsin
Montelibano Memorial Regional Hospital (CLMMRH) started as a district
hospital. It became a regional hospital in the late ‘80s. But according to
sources, its status was elevated without the standards of a regional
hospital being fully satisfied. These include having separate buildings
for each medical function, standard medical equipments, a 300-bed
capacity, a certain number of doctors, nurses & health staff, including
resident doctors, among others.
In mid ‘90s, the
CLMMRH was listed as one of the pilot hospitals out of 38 priority
state-run hospitals nationwide by the Department of Health (DOH) for its
privatization cum corporatization thrust. Since 1998, it has carried out
sweeping changes in hospital management and systems in accordance with the
government’s health reform agenda.
But after several
years of experimentation, CLMMRH has only turned for the worse.
hospital modernization and delivery of affordable and quality services did
not materialize. Inside sources who requested anonymity said the new
buildings were erected from 1997 to 2000 but their construction was
reportedly full of irregularity. The medical isolation building for one
remains unfinished despite the P10 million spent on its construction.
Three other buildings remain under-utilized and one, which is supposed to
be a modern laboratory building, remains empty of modern equipment.
including children and infants, are cramped in small, old and dilapidated
wards. Many lie in the corridors, vulnerable to passing people who may be
carriers of communicable diseases.
Higher cost of
Out-patients are now
required to pay a minimum of P30 per consultation. A nursing aide tells
the patient to first pay before being taken to the doctor. This was not
the case before, a nursing staff said.
hospital pharmacy often does not have basic medicines like paracetamol and
aspirin, and supplies like syringes and dextrose. Indigents and PhilHealth
cardholders interviewed by Bulatlat said even hospital patients are
often told to go outside and buy their prescribed medicines and supplies.
A midwife interviewed
by Bulatlat confirmed this, saying some nurses and doctors at the
emergency room would often give purchase orders to their new patients with
specific instructions to buy them at private drugstores outside of the
The midwife scored
the lack of the most basic medicines and supplies which could be crucial
in the immediate treatment of some deadly illnesses.
Health system in
The Philippine health
sector is in a state of calamity. For decades, the health system reflects
the ill state of the people and the wrong priorities of the national
government & leadership.
Data obtained by
Bulatlat revealed that from 1986 to 2004, government spending for
health has dropped significantly. In 1997, health appropriation was 2.9%
of the national budget. It was reduced to a mere 1.5% in 2004. This year,
national budget for health has dropped further to 1.3%.
The bigger chunk of
the national budget goes to paying off foreign debts (up to 40 percent of
the budget in the past, and more than 60% this year) and funding military
spending (15-20 percent).
efficiency, better and affordable health services under the HSRA never
came. The opposite happened.
Profit has dictated
the supply and distribution of vital medicines and vaccines, and the
accessibility of medical facilities. Increasingly, it will determine the
thrust of the country’s health care system and services. Bulatlat
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© 2005 Bulatlat
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