Medical Groups Challenge Presidential Candidates To Come Out With Solutions To Health Issues

Medical doctors who are aware of the existing problems in the healthcare system in the country presented on Tuesday major health issues which the 2016 presidential candidates need to face and deal with clear solutions.

In a health forum held at Annabel’s Restaurant along Tomas Morato Ave. in Quezon City, officials of three national associations of doctors said the health problems need comprehensive solutions and real commitments from the next leaders who will be elected in the May 9 polls.

In the forum spearheaded by the Philippine College of Physicians (PCP), the doctors mentioned three top health issues that the presidential aspirants must be aware of or have clear and better understanding so that they will include them in their priority of actions and not apply “band aid solutions” to remedy them.

They said these issues are: Inequities in health; shortage of health human resources; and administrative fragmentation in healthcare delivery.

The doctors who presented them were Dr. Minerva Calimag, president of the Philippine Medical Association (PMA); Dr. Anthony Leachon, president of the PCP Foundation; and Dr. Antonio Dans, president of the Philippine Society of General Internal Medicine (PSGIM).

“Inequities in health is a great injustice,” said Dr. Dans as he mentioned that because of this problem, the poor sometimes, especially in the farthest areas, cannot access healthcare in hospitals and find themselves lacking doctors to serve them right away when they get sick.

Dans said while it is true that there is PhilHealth (Philippine Health Insurance Corporation) coverage for the poor, the problem comes in terms of the compounding situation wherein the poor cannot be attended by a doctor because of lack or limitation of its presence in the farthest or underdeveloped areas in the country and the absence of enough facilities and equipment.

In his presentation of data, Dans showed that half of births in the poorest quintile (bottom 20 percent) of the population is unattended by a doctor or health worker while only two percent in the highest quintile is left unattended.

“More than double ang death sa mga newborn among the poor compared to among the rich,” he said.

In terms of vaccination, he said there are regions with low vaccination rates which fall on the problem of lack of access.

He also said that in non-communicable diseases (NCDs), such as stroke, heart attack, cancer and chronic lung disease among men and women, there are 300,000 deaths occurring each year.

“This is one big problem we’re facing,” he said as he compared it to “unnoticed two airplanes crashing every day.”

In effect, he said that the healthcare system has become somehow “overloaded” with problems such as persistent occurrence of infections, additional number of NCDs and deaths of mothers and infants.

“These lead to inequities, kasi hindi makayang sagutan ng gobyerno lahat, sino ang unang maapektuhan, siyempre ‘yung mas mahirap,” Dr. Dans explained.

He said that such problem is further worsened by the “fragmentation of healthcare delivery.”

“May ‘disconnect’ between the national government, ibig sabihin, ang Department of Health (DOH) is only advisory to the local government units (LGUs),” he added.

To illustrate that statement, he said that for instance, “the DOH says to the LGU that there should be an anti-HIV (human immunodeficiency virus) program.”

However, the LGU is in no way required to follow the DOH, he added.

Dr. Dans said that because of that, the healthcare system is suffering a condition of fragmentation — a problem that requires immediate solution.

“If we will never solve ‘manpower’ problem and fragmentation, we will never have equity,” he explained as he said that the three top problems are interrelated together.

However, he emphasized that in fairness to LGUs, he said that LGUs are not propagators of decentralization.

“They are also victims of it,” he said.

He said that the problem on decentralization began during the time of former Health Secretary Jimmy Galvez Tan wherein proposals were made for decentralization which was very good in concept at that time it was introduced.

However, the problem came along in the implementation.

“The problem was because of decentralization, the responsibility on the concerns on health was transferred to LGUs — kayo na ang bahala sa kalusugan pero hindi na-decentralized ang budget. So ang tawag namin doon ay incomplete decentralization. So ngayon, gagamitin nila (LGUs) ang budget nila na hindi naman talaga para mag-hire ng tao at magpaganda ng facilities. Malaking tunkulin nila ‘yun at napakahirap kung walang kasamang budget,” he further said.

“Because of decentralized health system, there is really a problem. What is happening is there is no open or proper communications — in other words, the priorities of the national government and the LGUs differ, but what we really need to understand here is that there should be an oversight body that will look on the strategies that are being done,” Dr. Calimag said.

She mentioned that the actual target for doctor density in the government is 1 to 1,000 patients, while the target number of doctors for the government sector is 63,000.

“But the actual number is 3,000 government doctors, meaning, kulang pa tayo ng 60,000,” she said.

In the private sector, on the other hand, she said that the target number is 33,000 doctors but the actual number is 63,000, which means that there are many doctors enticed to serve in private practice.

“If we will take a close look at the map of the Philippines, we can see that most of our doctors are in the cities, and if you can see, the challenge really is archipelagic in nature,” she explained.

She said that there are still many far-flung communities where one has to ride in boats in order to be reached.

In mountainous areas, she said that the problem is one has to walk and cannot ride in motor vehicles for convenience.

“The terrain is very difficult, kaya ito nga, wala tayong deficit (in doctors) sa private sector, and in fact sobra pa nga,” she said.

As to nurses, she also said that it can be seen that there are more nurses in the private sector compared to the public sector.

Dr. Leachon, for his part, said that because of devolution, the country’s nurses and doctors find themselves going out of the country to seek better-paying jobs overseas.

“Sa personal na tingin ko, napabayaan sila through the years… Kaya nag-alisan ang mga doctors at nurses ay dahil sa tingin ko, kulang ang sweldo, maraming job orders, maraming casuals, walang infrastruktura, ‘yung perang dapat gamitin sa health ay nalilipat sa ibang bagay…So napabayaan po siya (health problems); ang tingin ko kailangan ng bagong stratehiya,” said Leachon.

He further said that not everything will pertain to the budget at all.

“Marami ka mang pera, kung mali ang pinagkakagastusan mo mauubos din yun…As you can see, while the Sin tax funds are there, some problems in the healthcare system remain unsolved because of lack of focus,” he further said.

He said that while they have in mind some solutions that they want to suggest to the candidates for president and vice president, they want to hear their positions on the mentioned health problems and what will be the solutions that are in their minds.

He said they are awaiting that the candidates will be able to come out with the proposed solutions during the coming presidential debates on Sunday.

“We need to think about a certain strategy from different vantage points,” he further said as he pointed out that they are expecting the candidates to deviate from giving solutions to the old problems with just “new promises” but come out with new and brilliant ideas applicable in solving the existing problems. (PNA) SCS/LSJ