Thursday, February 2, 2017

Sec Ubial's Proposed 2017 DOH Budget: No Change Favorable to the Poor is Coming!

Press Release
5 September 2016

Proposed 2017 DOH budget
NO CHANGE favorable to the poor is coming! 

The 2017 proposed national budget is a whopping P3.35 trillion, P350 billion higher than the 2016national budget. But for the Department of Health, the proposed budget is only P92.9 billion or a measly 2.7% of the national budget. This allotment for health gives every Filipino a measly P927 per year or P2.54 per dayThus, contrary to the promise made by President Duterte to prioritize health, in this kind of budget, no realchange is coming for the betterment of people’s health.
The 2017 health budget promotes privatization/corporatization and further commercialization of healthcare rather than provide service to the people.  The budget for Maintenance and Other Operating Expenses (MOOE) that provides for medical supplies, medicine, laboratory supplies and other needs was cutdown by almost 50%. From the P74.4 billion budget in 2016, the proposed MOOE budget for 2017 was reduced to P38 billion resulting in the inadequacy of the needed services. Patient expenditure for hospital services such as laboratory, x-ray and other diagnostic examinations, hospital room rates and other healthcare service has dramatically increased; decreasing the MOOE would result in additional burden to the already suffering Filipinos. Meanwhile, budget for Capital Outlay (CO) was cut down from P27.7 billion in 2016 to P25 billion in 2017.
The reduction of the MOOE and CO would inevitably compel public health facilities to generate funds for their own financial requirements and require payment, another aggravation to the impoverished patients.Under the special provision no. 2 of the budget on hospital income, the government pushes public hospitals to charge patients higher fees to augment the deficiencies in MOOE and CO requirements, and embark on more income-generating activities similar with private hospitals and institutions.  
This is a continuation of the previous governments plan to convert public hospitals into corporationsgenerate profit out of health and privatize public healthcare.

It is biased towards developing health facilities for income generation and transforming government hospitals into corporations, rather than the improvement of public health services.  There is an increasing budget for Health Facilities Enhancement Program (HFEP) from P13.325 billion in 2014P13.271 billion in 2015, P26.872 billion in 2016 to P21.8 billion in the 2017 proposed budget. As in the past, the budget for facilities enhancement was spent more for infrastructures that would generate huge profit rather than for improving health services that would benefit the majority of our people who are poor.  Public health facilities like hospitals and health centers were renovated and have expanded and now offer pay services like x-ray and laboratory examinations, charging patients even higher than private facilities. This only further strengthens the government direction to privatize and commercialize healthcare.  Poor patients cannot afford to pay, hence it is anti-poor.  
The proposed 2017 HFEP budget does not even promote grassroots development. The budget for barangay health stations is zero while that of the rural health units has been slashed by P5.2 billion compared to the 2016 budget. Moreover, the questionable budget for “Other Health Care Facilities” has an increase of P5.3 billion compared with 2016 budget. 

In the proposed budget, the government transferred huge amounts to PhilHealth.  This means that the government is abandoning its responsibility to provide health services.  (We oppose the transfer of huge funds to PhilHealth even in the guise of premium subsidy because PhilHealth is a financial scheme, a corporation with paying members, generating funds from its members and ensuring its financial viability.  On the other hand, healthcare is essentially a service that should be funded from taxes.  This is why the 50 billion should be directly allocated to DOH MOOE and strengthening of public healthcare services).   The government has increased PhilHealth allocation from P43.8 billion in 2016 to P50.2 billion for 2017. Even if billions is allocated for premium subsidy to indigents under the National Health Insurance Program (NHIP), this does not guarantee accessibility of healthcare for the poor because like other health insurances, there are so many limitations.  First, benefits are enjoyed mainly by in-patients; out-patients have very little benefits.  Second, disease or medical conditions that do not fall within the list of case rates have no or very little benefits from PhilHealth.   Moreover, considering that 75% of Filipinos are poor and depends on public health services,  with the budget cut on MOOE, PhilHealth is useless because public health facilities lack medicines, medical supplies and worse, in far flung areas, there are no health facilities at all. 
History and government data have proven that despite billions poured into PhilHealth, it accounts for only 11% of total health expenditures.  On the other hand, out-of-pocket spending is still high at 60%. The growing dependence of the DOH on the role of PhilHealth for healthcare delivery manifests a very myopic approach to decades-old problems besetting the Philippine healthcare system. 

The budget does not address the overworked, underpaid situation of health personnel.  Although there is an increase in allotment for Personal Services by P7.6 billion, the increase will not be sufficient for the present health personnel who are currently receiving very low salaries.  

Aside from these, there is chronic understaffing: 22,905 plantilla positions of the 63,281 authorized positions that should be filled up that leads to overworked health personnelThere is a dire need for additional personnel.

Moreover, the P7.04 billion allotted for the program “Doctors to the Barrio and Rural Health Practicethat provides the salaries of doctors, nurses and midwives for a year who are hired on temporary basis is direly inadequate. These health personnel are exploited through low wages and contractualization. If the government is really serious in improving provision of health services, these temporary positions of health personnel should be converted into plantilla positions. 

The 2017 national health budget is replete with the same infirmities that afflict all previous government budgets. It does not assure the people especially the poor of any improvement in health services, and the health workers for living wage/salaries and better working conditions. As the government cuts down allocations for direct health services in the national budget, it pushes further the privatization of healthcare to generate more profit out of health.  
The people should be vigilant to ensure that the budget will reflect their welfare and benefits. The members of the health sector together with the other sectors must collectively struggle for free, comprehensive and progressive healthcare and for genuine independence, freedom and democracy.

Our calls: 
Fight for adequate health budget, 5% of Gross Domestic Product
Stop corporatization & other forms of privatization of public health services!
Strengthen public healthcare system.
Provide free medicines & health services in public hospitals!  
Allocate funds for health workers’ benefits! Better working condition for health workers!
Increase the basic salary of health personnel to 16,000 minimum wage, P25,000 entry salary for nurses and P50,000 entry salary for doctors!
Fight for free, comprehensive and progressive healthcare system!

For Congress Immediate Action:

Allocate funds to improve public healthcare system through: 
• Provision of free basic health services and free essential medicines 
• Additional 3,268 public health doctors for 1,634 towns/cities (2 doctors/town)
• Creation of plantilla position for 42,036 nurses (1 nurse/barangay)    
• Additional 42,026 midwives (1 per barangay)             
• Build and operationalize additional 25,000 barangay health stations in addition to the 17,000 existing barangay health stations                        
Re-align the P50 billion allocated for PhilHealth to MOOE/medicines, medical supplies for public hospitalsand public health!

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