The PEOPLE’S HEALTH AGENDA

Health is a right that continues to be denied of Filipinos. Addressing the worsening state of the people’s health is one of the biggest challenges facing the Aquino administration.

The Filipinos continue to suffer from dismal health situation amidst projection from the past Arroyo administration of improved health outcomes. Infectious and preventable diseases continue to top causes of mortality and morbidity. Malnutrition and diseases of poverty like tuberculosis plague poor communities. Needless deaths of pregnant women remain high at 170 per 100,000 live births.

The inadequacy and inaccessibility of public health services is worsening. Seventy percent of Filipinos cannot afford to buy their medicines, even with the passage of the Universal Cheaper Medicine Law and the lowering of prices of medications through the Maximum Drug Retail Price (MDRP). Public hospitals have been charging for every supply, laboratory and diagnostic procedures that used to be free. Privatization of public hospitals has made health services more expensive.

Doctors, nurses and other health care providers are witnesses to the hardships of Filipino patients in the hospitals and the communities. Poor patients whose welfare should be prioritized by the government are drained of hard-earned income whenever they get sick or hospitalized. Many patients delay consulting with health personnel because they cannot afford the high cost of hospitalization and medicines.

Even with the presence of the National Health Insurance Program (Philhealth), there are still gaps in its coverage. Card issued by Phil health is not accepted by most private hospitals and also meaningless in poorly-provisioned public hospitals with no medicines.

Despite the commitment of health professionals and health workers to serve, with the prevailing condition – many of them are pushed to go abroad by extreme poverty, unemployment, low salaries and benefits, inhumane working conditions, and political instability. Some 3,000 Filipinos including health care providers leave for abroad everyday. This leads to the aggravation of present health crisis.

There are disparities in the distribution of the health workforce. Seventy percent of all health workers employed in the private sector serve 30 percent of the population, while 30 percent employed in government services cater to the majority. Vast majority of health care professionals are in lucrative private practice in urban areas despite the fact that 60 percent of Filipinos die without the benefit of health professional attention.

Local health systems are weakened due to loss of key staff and decreased capacity to deliver essential front-line health services by rural health units (RHU), barangay health stations (BHS) and private health sector. Referral hospitals (core referral and end referral) run mainly by provincial, city governments and the Department of Health (DOH) are unresponsive to current constraints and inefficient, near-empty hospitals coexist with overcrowded and resource-poor provincial and tertiary hospitals.

Health workers are still overworked yet underpaid. Salary increases under the Salary Standardization Law are inadequate based on experiences of health workers considering the high cost of basic commodities. There is no line allotment for Magna Carta benefits in many hospitals. Understaffing problems continue to exist as there is no allotment for additional plantilla positions despite increased bed capacity and building expansions. Volunteers and trainees fill up the staffing deficiencies as free labor force while paying for their “training”.

Due to poor working condition of the health workers, they are pushed to work abroad. The Philippines has been the number one exporter of nurses and number two exporter of doctors in the world for several years. Yet hundreds of hospitals have closed down throughout the country due to the lack of health personnel, with hundreds more on the brink of closure. Health workers working in rural communities are also subjected to various forms of harassment by the State, including arbitrary arrests like the Morong 43 health workers.

The onslaught of natural calamities has made worse the inadequacy of dismal state-run health care facilities.

During the term of Pres. Arroyo, the national health budget did not address the chronic health distress. This year 2010, a minuscule P33.7B budget for the Department of Health and attached agencies reflects the callousness of the administration of the then Arroyo administration to people’s health and welfare. The health budget comprises a measly 2.2 percent of the P1.54 trillion national budget. This translates to a measly P0.98/day per Filipino.

Spending on health is only 3 percent of the annual Gross National Product, a far cry from the recommendation of the World Health Organization of 5 percent spending. Most of spending for health is out of pocket at 49 percent, while government spends 40 percent and social insurance at 11 percent.

The dismal condition of our people’s health reflects the apathy of the outgoing Arroyo government to the plight of the poor. Hold the Arroyo government accountable for the worsening health situation of the people!

For this reason we are calling on the incoming Aquino administration to immediately (on its first 100 days) act on the following health agenda :

1. Free the 43 illegally arrested and detained health workers.
2. Provide an adequate health budget. Immediately increase the national budget for health to at least P 90 billion.
3. Provide free health services for the poor in all levels of health care.
4. Provide free essential medicines for the poor in rural health centers and public hospitals.
5. Full implemention of salary increase for health workers: Immediately implement legislated P3,000 increase in base pay. Implement Salary Grade 15 (P24,887) for entry position of Nurse I. Inrease salary of doctor to P50,000 monthly.
6. Ensure full implementation of health workers benefits like Cost of Living Allowance (COLA), subsistence pay and hazard pay. Allocate funds for benefits.
7. Stop privatization/commercialization of government hospitals.
8. Provide adequate number of health professionals like doctors, nurses, midwives and dentists to far flung areas nationwide.
9. Prosecute the Arroyo administration for human rights violations and other crimes against the people.

For substantial change, let us work for following people’s health agenda:

1. Ensure the people’s right to health

 Provide an adequate health budget that is commensurate to the needs of Filipinos. Allocate at least 5 percent (P440 billion) of the Gross National Product (GNP) for health in the national government budget. Immediately increase the national budget for health to at least P 90 billion.
 Provide efficient, affordable and accessible healthcare for the people. Provide free health services for the poor at all levels of care.
 Provide safe, affordable and accessible medicines for all. Provide free essential medicines for the poor in rural health centers, and government hospitals.
 Develop and strengthen public health care system. Promote and set up community-based approach to health care nationwide. Put emphasis on the following nutrition, immunization and environmental sanitation.
 Provide effective and efficient programs aimed to eliminate TB, malaria, dengue and other infectious diseases, as well as emerging and rising diseases like HIV/AIDS.
 Ensure adequate tertiary and curative healthcare. Set up public hospitals in far flung areas. Upgrade and rehabilitate existing hospitals --primary, secondary, and tertiary in far flung areas.
 Ensure the equitable distribution of health personnel, resources, and funds throughout the archipelago.
 Nationalize drug industry so as to provide safe, accessible, affordable, and effective medicine. Regulate operations of transnational pharmaceutical companies.

2. Promote and uphold the interests of health professionals and health workers

 Provide adequate remuneration for health personnel both public and private. Promote the viable personal and career development of health personnel to encourage them to stay and serve in the rural areas.
 Ensure job security and stop contractualization, job-order schemes, and similar anti-health workers programs in government hospitals, health institutions and agencies.
 Immediately provide benefits. Ensure safe and humane working conditions.
 Uphold the rights of health workers to organize and unionize. Promote their participation in decision-making.
 Uphold and protect the rights of community health workers as health care providers.

3. Implement progressive health policies and programs

 Institutionalize participatory decision and policy-making. Strengthen transparency and accountability at all levels of health governance.
 Ensure people’s participation in health policy and program formulation.
 Strengthen public health care. Stop privatization as the core health policy. Stop the corporatization and commercialization of public hospitals.
 Promote nationalist, scientific, and mass-based healthcare services and health education.
 Develop and train health human resources based on health needs of the Filipino people. Stop commercialization of nursing and medical education.
 Implement the national drug policy.
 Promote and develop indigenous health care knowledge and practices.
 Develop self-reliant research program anchored primarily on the needs of the Filipino people.
 Stop policies, programs and projects that are hazardous and inappropriate to the needs of the Filipino people, the like Japan Philippine Economic Partnership Agreement (JPEPA), and the Philippine Mining Act.
 Stop the labor export policy and brain-drain of health professionals.

4. Ensure the people’s overall well-being and address the social determinants of health

 Provide jobs. Provide living wages for workers and ensure job security.
 Ensure food security and eradicate malnutrition. Implement genuine land reform program and national industrialization.
 Ensure adequate shelter/housing and other social services for the people.

HEALTH SECTOR SUPPORTS PEOPLES’ AGENDA

Health is a direct result of the socio-economic well being of the people. In order to achieve better health for the Filipino people, genuine change in political and economic fields should take place. With this, the health sector actively supports the following people’s agenda for change:

1. Prosecute GMA and cohorts for crimes against the Filipino people:
• Human rights violations – enforced disappearances, extrajudicial killings, torture, illegal detention including the case of 43 health workers
• Electoral fraud
• Corruption
2. Provide immediate economic relief for the people:
• Repeal of VAT reform Law. No to additional taxes.
• Passage of a substantial legislated wage hike nationwide
• Moratorium of demolition of poor communities
• No tuition fee increase
• Provide free health services and medicines for the poor
3. Ensure that adequate resources are available to meet the people’s pressing needs:
• Ensure that the 2011 budget will provide adequate budget for social services
• Repeal the automatic appropriation act
4. Review/repeal the Visiting Forces Agreement (VFA), Japan Philippine Economic Partnership Agreement (JPEPA), and other anti-people laws
5. Resume peace negotiation. As confidence building and goodwill measures free all political prisoners including the 43 health workers
6. Legislate a genuine agrarian reform bill (GARB).

* Photo credit - People's Health Movement website http://www.phmovement.org/en