"We are all at risk, so we must take all precautions to stay healthy."
The recent and alarming declaration of a measles outbreak in Metro Manila and other regions has put a spotlight on health as a rising political issue. This has, after all, consistently been a top personal priority for most Filipinos.
DOH’s Epidemiology Bureau recorded 196 measles cases in the National Capital Region in the first 19 days of the year, a sharp jump from the 20 cases posted a year ago. During the same period, 58 fatalities were recorded at San Lazaro Hospital.
Four more regions were recently added to the list where an outbreak was detected—Central Luzon, Calabarzon, Western and Eastern Visayas—all of which similarly posted sharp increases in cases and as many as 18 deaths just last month.
DOH Secretary Francisco Duque said the declaration of an outbreak is to help increase public awareness on the matter. “We are declaring an outbreak as cases have increased in the past weeks and to strengthen surveillance for new cases and alert mothers and caregivers to be more vigilant,” he said.
Health has consistently been the most urgent personal concern for Filipinos, a trend that has not changed across many administrations. “Urgent Personal and National Concerns of Filipinos” surveys conducted by Pulse Asia over the years reveal as much. The most recent iteration, made in December of last year, said 68 percent of Filipinos identify staying healthy and avoiding illnesses as the “most urgent personal concern.”
This incomparable regard for staying healthy has remained the most steadfast personal concern since 2012, minor fluctuations notwithstanding. Trailing by around 20 percentage points are next on the list: finishing school or providing schooling for children, avoiding being a victim of any serious crime, and having a secure and well-paying job.
It is easy to understand why health is the top personal concern. For many Filipinos, from the most vulnerable to the rising middle class, an unwanted medical diagnosis or sudden injury can spell the difference between a passably comfortable life and utter financial ruin. Cancer diagnosis, for instance, often entails not only untold emotional distress but, more critically, hundreds of thousands of pesos in hospital bills and medicines all the way toward after care, which, if not covered by insurance, can easily bankrupt a household.
The data on the matter reveal a disconcerting picture. According to the Philippine National Health Accounts released by the Philippine Statistics Authority (PSA), the out-of-pocket health expenses incurred by Filipinos continued to rise in 2017, hiking by a troubling 8.8 percent year-on-year. In real terms, household out-of-pocket expenses amounted to P372.8-billion in 2017, which accounted for a little over half of Current Health Expenditures in the same year.
The PSA includes in “out of pocket expenses” medicines, food supplements, other medical products, therapeutic appliances, outpatient medical care, dental care, diagnostic services, and private and public hospital care.
Out of the P372.8-billion, more than half, or P186.6-billion, went to pharmacies, while P97.5-billion, or 26.1 percent, went to private general hospitals, and P50.3-billion, or 13.5 percent, went to providers of ambulatory health care.
Meanwhile, Total Health Expenditure swelled by 8 percent to P712.3-billion, contributing some 4.5 percent to the Philippine GDP. This translates to a 6.3-percent increase in per capita health spending of Filipinos, or P6,090, in 2017.
Research by the government think tank Philippine Institute for Development Studies said Filipinos carried a so-called “triple burden of disease” that has historically led to losses of centuries of life and billions in public and out-of-pocket expenditures. For instance, for every million Filipinos, they found that around 580 years of life have been lost to heart disease and stroke and 95 and 75 years lost to tuberculosis and interpersonal violence, respectively.
This worrying trend, the PIDS researchers said, indicates the continuing need to improve the country’s healthcare system, including service delivery and health infrastructure. An effective health insurance program, they added, can be instrumental in guaranteeing that Filipinos get the healthcare they need, without the need to break the bank.
The Universal Health Care Bill, which has been approved by the bicameral conference committee, proposes a system in which all Filipinos are enrolled in a “National Health Insurance Program” and whose membership is classified into two: those who have the capacity to pay as direct contributors and those who are sponsored by the government, like indigents, senior citizens and persons with disabilities.
“For us to have a universal health care na kompleto ang target natin by five to ten years in time,” Senate Committee on Health Chairman JV Ejercito said.
Funds for the measure, estimated at some P257-billion for its first year of implementation, will come from the incremental sin tax collections, the Philippine Charity Sweepstakes Office’s charity fund, the Philippine Gaming Corporation, premium contributions, government subsidy to PhilHealth, and the DOH’s annual budget.
With elections coming up, however, and with the measles outbreak freshly shining a spotlight on health as a key concern, the subject will no doubt be politicized. Candidates know that there is political capital to be gained when dealing with things that resonate deeply with the people. The key is to discern when pro-health rhetoric is just being used to abet populist sentiments and when there is a real desire to make quality healthcare truly accessible.
Two landmark health legislations are now waiting to be signed into law by President Duterte: the National Cancer Control Act and the Universal Health Care Law. This will give the DOH a powerful legal mandate to expand access to adequate health care to all Filipinos. When the new Congress convenes to tackle the 2020 budget, these laws must be given enough funding for effective implementation.
I pray that these outbreaks do not deteriorate to pandemic proportions. We are all at risk, so we must take all precautions to stay healthy.