Health views, news
By Alberto Romualdez, M.D.
31 March 2010
THE Philippine Health Insurance Corporation (better known as PhilHealth) has been in turmoil for a few months now. Even as the agency that was supposed to be the keystone of reforms in the health sector of the country celebrated its 15th anniversary on Valentine’s Day, senior level officers were already up in arms against a proposed reorganization that would have shuffled regional vice-presidents.
The corporate condition is serious as lawsuits are threatened and officials simply refuse to accept orders from their superiors.
Morale, especially among senior technical officers, is at rock-bottom – so low that some observers have labelled the situation a corporate crisis.
Perhaps this crisis is timely for the next administration. Advocates of health sector reform have long been recommending an overhaul of senior and middle management at PhilHealth as a major step towards the achievement of universal health care in any case.
The current turbulence over reshuffling of senior officials may just show whoever comes to power next May the way to proceed in changing PhilHealth into a lean and mean organization prepared to implement a true social health insurance program based on solidarity principles.
For one thing, it is axiomatic that regional officials who refuse to be transferred do so because they have interests (often selfish or vested and sometimes political) to protect. A true civil servant of integrity should willingly serve anywhere in the country.
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Except for the heat, Holy Week is arguably the only truly pleasant season in Metro Manila. Traffic is at its lightest as those who can afford it motor or fly to cooler places like Baguio, the beaches, and even abroad. As motor emissions fall, the air is less polluted and those with lung problems can breathe easier. Driving is a breeze. Dining out is easier. It is even possible that towards the end of the week, political noise associated with the coming elections may come down a decibel or two.
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Unfortunately for women in the poor communities of Manila, the future for reproductive health in the city is rather bleak. The two leading contenders for mayor rely strongly on conservative Catholic Church support. The situation in the city should have been ripe for a third force who would strongly advocate for truly pro-poor services like reproductive health and family planning. Unfortunately, the third mayoral candidate, Avelino "Sonny" Razon, is so far behind that he probably will not matter in any case. The fact that he is the candidate of a national administration that is itself allied to conservative extremists in the Church also prevents him from taking any strong positions on the issue.
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The party list system mandated by the 1987 Constitution is in shambles. Credit for this sad state of affairs belongs equally to a bumbling Congress that passed a nonsensical implementing law and a fumbling Comelec that issued equally nonsensical interpretations of that law. Of course, the current administration, in its inimitable predatory ways, has simply taken advantage of the weak law and its feckless implementation to improve its chances of retaining power by controlling the House of Representatives after 2010.
In principle, the intent of the Constitution was laudable. Political views that are held by minorities do deserve to be heard in the law-making process of the land. In a thoroughly conservative power structure, there is virtually no other chance for a progressive agenda to influence policy. Unfortunately, the party list system has been totally corrupted by a law and interpretation thereof that has favored individuals and groups completely devoid of principles in advancing their vested interests.
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In recent weeks, the Roman Catholic Church has again been buffeted by allegations of priestly misbehavior and massive cover-ups. More worrisome to many loyal Catholics is the fact that the trail now appears to lead all the way up to o Pope Benedict XVI himself.
The Pope’s letter to the Irish Church urging reforms in the way such scandals are handled while apologizing to the victims initially appeared to be acceptable in many quarters. However, in the matter of sexual abuses by priests in the Pope’s home country of Germany, the Pope himself as archbishop of Munich appeared to have been part of the cover-up in the case of a wayward priest from his own diocese. Lately, there seems to be some documentary evidence that the Holy Father, as Cardinal Ratzinger, may have participated in hushing up the case of a priest accused of molesting hundreds of deaf boys in the United States.
All Catholics, conservatives and liberals alike, should be deeply concerned about these threats to the stability of their Church as an organization and as the symbol of their Faith. Neither side should view these events as justification for further condemnation of the other. Rather, the situation could be an opportunity for the Church to once again review its systems of governance. In fact, if Pope Benedict takes this as a cue to reconvene Vatican II or a similar conclave it is just possible that he may reach the same level of greatness as the late beloved Pope John XXIII.
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Free market fundamentalism is one of the main forces that drive health inequities not just in the Philippines but throughout the world – including in that bastion of capitalism, the United States of America. In America, Barack Obama had to pass through the proverbial eye of the needle to get health reform legislation through an American Congress fearful of fundamentalist backlash. The fact is that the fight is not over yet as corporate America apparently persists in supporting a reactionary rear-guard action to prevent universal health care from taking root in that country.
Here in the Philippines, trade and commercial interests have been on the ascendancy over health for most of the country’s existence. For this reason, the government under the last three administrations have supported foreign investment legislation that has in effect commoditized health. The government has in fact interpreted the law to mean that hospitals are businesses that can be 100 percent foreign owned despite the fact that there is a provision that clearly exempts businesses "that have public health implications."
Even as the country’s poor suffer under an inequitable health system, the Department of Trade and Industry in connivance with NEDA not only encourages alien take-over of health institutions but is also pushing for full accreditation of foreign health professionals in contravention of constitutional requirements.
It is hoped that it is not too late to change this direction. A truly reformist new administration should consider replacing business and commerce at the center of development with health and education.
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