I have been asked what I thought of that post from a young writer about the death of his four-year-old brother who was brought to the emergency room of Davao Doctors Hospital weeks ago.
From what I read, the patient was managed for his seizures and this was surely an emergency case that needed to be managed in the intensive care unit (ICU).
But it appeared like every information given to them was weighed by money, and from his story, it was like they had to weigh that matter first before deciding even with a cost of Php 50,000 to 100,000 a day. They were not even given information if an ICU bed was available until they decided, and they learned it was not available.
Then there were other issues such as charges for laboratory procedures that were not performed because the patient had died. Then his brother’s body did not get proper postmortem care. For such lack of service and care to the patient, the family received the bill, and a diligent review by a family member revealed charges for services that were not delivered and this prompted the hospital to deduct these items.
This was a grieving family and everything communicated to them from the hospital was hurtful. In all levels when something is not communicated compassionately, promptly and as matter of fact, things can be hurtful.
We see a family in crisis having to deal with commodification of health care. We see a system where health care is a business transaction between the patient and the health care provider. This reflection of mine is not about blaming either side.
Everything boils down to the health care system and how a country’s system considers health care. While the Philippine government is a signatory to the Declaration of Alma Ata in 1978, its health policies and programs are not consistent with the declaration.
The Alma Ata Declaration is based on the premise that health is a basic human right and should be accessible to all without consideration of age, race, sex, religion, economic status, social standing, political belief, and disability.
The family made the right choice about going to a premier hospital in the city where they believe, can provide the best of care to the four-year-old patient, and promptly.
But the government has gone to the direction of corporatization or privatization of health services. In the Philippine setting, there is a complex multiple payor system. Worst of all, we have this system go to politicians or elected officials, which subjects the health care to patronage politics.
This is in contrast to our neighbor, Taiwan, which has an excellent system that their public health workers are proud of. It has a single payor system which is the government. The only time the patient pays is when there is an excess in the cost allocated for each citizen.
With that, we see the reality that health institutions secure payment for health care every step of the way over the delivery of services and this is the reflection of a commodified health care system. Families want to get their money’s worth because they pay for the service. Families need to do due diligence to see if their bills reflect services delivered.
I can only laud the family for doing their part, not playing the learned helplessness card. The fact that there was rectification on the excessive charges show that it takes a human, a compassionate human, to correct a system. We simply cannot entrust our lives in a system, especially a system where human rights is not a core value.
Privatization of health care translates into more business establishments getting into health care. While I have seen health care models that had good intentions of reducing the impact of cost on the health care, but for real, these models are unsustainable and cannot be done only by the citizens, charity organizations or civil society organizations and the like. Only the governments have the economies of scale.
Unfortunately for us citizens, if presidents make a SONA where health is included in their report card, they will only report about infrastructures, additional generic drugs included in the drug formulary, and the like. These, if not translated into human development, are meaningless. I have yet to see a president tell the citizens that the government has improved the infant mortality rate, reduced malnutrition, reduced the prevalence of tuberculosis, and the like. Moreover, presidents should also show its citizens that it has improved its ranking in the Sustainable Development Goal Index, Sustainable Development Index, Gender-Related Development Index, and Inclusive Development Index. Programs aligned in these indices would reflect genuine human development. Health itself reflects the level of human development.
Going back to the family, if only the state took the obligation of caring for its citizens, the tone of the conversation between the health care institution and the affected family would have changed.
davao city, health care, privatization
