TWO groups called out presidential aspirants to reveal their health agenda while expressing concern over the worsening condition of health care in the Philippines.

In a recent media briefing in Quezon City, Dr. Junice Melgar, co-founder and executive director executive director of women's health body Likhaan, said health care has been in the hands of private entities whose bills are higher compared to state-run hospitals.

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Individuals and families shelled out almost half of health care expenditures in 2005 as social insurance covered a measly 11.1 percent of the total health bill while government funds accounted for 28.7 percent, data from the National Statistical Coordination Board show.

At this rate, Melgar said the financial burden on families remains heavy, leaving access to health care highly inequitable.

While the share of out-of-pocket spending in total expenditure — an important indicator of the inequality of the distribution of health care charges — fell steadily from 1998, reaching 40.5 percent in 2000, it reverted back to its upward trend, reaching 48.4 percent in 2005.

This as contributions from employer-based plans, private insurance, and health maintenance organizations seesawed during the period.

In the same way, the share of social insurance to health care spending expanded to 11.1 percent in 2005 from 3.8 percent in 1998.

On the other hand, spending by national and local governments shrank to 28.7 percent in 2005 from 39.1 percent in 1998.

Total annual health expenditure nearly doubled in the same period to P180.8 billion in 2005 from P94.5 billion in 1998.

“We are asking the presidential candidates to really present their agenda on health given its deplorable condition. The figures are coming from the government, so we really have to do something about this,” Melgar said.

She added that the lack of medical professionals due to migration has also taken its toll in the country’s health care situation.

In a separate interview, the Health Alliance for Democracy (Head), a national organization of health professionals, workers, and students, said the issue of health and health care in general has never been a government priority since the time of the late strongman Ferdinand Marcos.

“Health has always been regarded as something that can be conveniently used as a popular issue for elections or as a ‘deodorizer’ whenever government needs to show the people that it is doing something,” said Dr. Gene Nisperos, Head vice chairperson.

Nisperos also scored the government for promoting medical tourism at the expense of providing state support on health.

“What is worse with the Arroyo government is that aside from constantly decreasing the budgetary allocation for health, it is transforming health care into a business for profit. That is why there is a strong push for medical tourism that includes government hospitals, even if seven out of 10 Filipinos die without getting medical attention. Through medical tourism, it is selling health care to foreigners, the same health care it is denying its own people. This is on top of the policy of user-fees, where government hospitals now charge fees for services that use to be for free,” he added.

The continuing decline of state support to health care in the country is not surprising at all.

The national budget for 2010 is P1.541 trillion and the budget allocation for health is P29.28 billion for a 1.9 percent share. Debt servicing took up a fifth or P340.8 billion.

The health budget is also way below the five percent of GDP recommended by the World Health Organization (WHO) for developing countries like the Philippines. Moreover, the share had remained practically unchanged during the eight-year period, still hanging at near zero levels.

The low priority the Arroyo government places on health has also branded the Philippines among the worst in Southeast Asia when it comes to providing health services to its people.

The WHO, in its World Health Statistics 2009, ranks the country at fifth out of 11 countries in the region in terms of government spending as a share to total health spending for 2000. The Philippines was only ahead of Laos, Cambodia, Vietnam, Myanmar and Indonesia.

Nisperos, meanwhile, advised politicians to look seriously into the issue.

“Health policy should be anchored on the precept that health is a service and an obligation by the national government, not a business venture. As such, instead of the current push for privatization, there should be a push for self-reliance (like in the drug industry) and people directed programs that will make health care a truly relevant government service,” he said. (Virgil Lopez/Sunnex)