Nothing "universal" about proposed universal health coverage bill – HEAD

"It's befuddling why government policy insists on universal health coverage as a financing scheme and pours billions of people's money to PhilHealth, even as the corporation continues to be ineffective in decreasing Filipinos' out-of-pocket spending and covering all their health costs," said Health Alliance for Democracy secretary general Dr. Joseph Carabeo on the recent passing of the bill in congress. "The Universal Health Coverage (UHC) Bill will not universalize access to health care."

Under the proposed UHC bill, PhilHealth will be renamed as the Philippine Health Security Corporation (PHSC) and will be the "national purchaser" of health services. Coupled with the mandatory enrollment of all citizens to PHSC, this will ensure that aside from their taxes, everyone will have shell out more money to pay for their health needs through their P2,400-worth mandated contributions.

From 2011 to 2017, PhilHealth has enjoyed a steady increase in funding, with last year's allocation as its highest ever at P53 billion – more than 15 times its 2011 budget of 3.5 billion. Its share in the national health budget also increased from 10% in 2011 to 35% in 2017. And yet Filipinos still paid for more than half of their total health expenses out of their own pockets in 2014 (56%), according to data from the Philippine Statistics Authority. Social insurance paid for only 11%.

The mandatory enrollment will milk profit out of Filipinos with measly wages and unsteady sources of income. In the proposed bill, contributory members will include regular employees and those from the informal sector, such as contractual employees and small-time vendors. Even overseas workers who already have insurance abroad will not be spared from the mandated contribution.

The UHC bill expressly states that only certain benefits included in a "positive-list" will be covered by the PHSC. The PHSC will determine if the benefits to be covered will maintain the financial sustainability of the corporation. Therefore, if a service that patients need is not included in the list of benefits, they will have to pay for it. "How can they call this universal health coverage?" remarked Carabeo.

Finally, it will not be the Department of Health (DOH), but the PHSC as a corporation, which will ensure the quality of care, appropriateness of services, financial protection – for as long as it is financially sustainable and will return its investments. The DOH will fade into the background as a technical adviser with no real power. It is by this virtue that health care in the country will be corporatized.

"What is clear here is the responsibility of health services is relegated to an ineffective and inefficient corporation that is geared towards fiscal integrity. Through the UHC bill, health care in the country will be a commodity that must return its investment, and not as a genuine service to the people, a right to be ensured by the government," Carabeo ended. ###

Activist doctor receives threats anew

Health Alliance for Democracy strongly condemns the people behind harassment and threats from unknown elements to Dr. Darby Santiago. At 12:52 pm today, Dr. Santiago received his second death threat via text message.

In the past few weeks, Dr. Santiago, Doc Darbs to his patients and friends, has been vocal about hospital budget cuts and decreased budget for preventive health programs for 2018. "This is definitely alarming, in view of the fact that people get killed and get brushed aside because of the 'tokhang' campaign," said Dr. Santiago in his Facebook post. The text message read "Ingat ka. Dumadami atraso mo" from mobile number 09322374703. A few years back, Doc Darbs received a similar text message which read "Isang bala ka lang, ingat ka doc."

In the past months, five doctors have been killed mercilessly by unidentified men; justice still elusive. These killings, along with the growing number of killings perpetrated by state forces, has become a real threat to the common people, even professionals and doctors.

Dr. Darby Santiago is an ophthalmologist who specializes in retinal surgery and serves thousands of patients all around the Philippines. He is the first retina surgeon of the Ilocos Cordillera Region for the past 11 years. He is also a regular board examiner of the Philippine Board of Ophthalmology. Doc Darbs is also an academic professor at the University of the Philippines College of Medicine and De La Salle University College of Medicine. He is the chairperson of Health Alliance for Democracy.

HEAD calls on members of the health sector to be extra vigilant in these times of trouble. Despite harassments and threats, we encourage everyone to be strong and steadfast in their commitment to serve the people. Let us unite in the outrage against these threats to our colleagues. We also call on the public to condemn the brutal killings and unite in the call for justice.##

Health groups gather at the senate in support of Judy Taguiwalo

The progressive health sector joins the youth, teachers, the urban poor, workers, and farmers in support of Judy Taguiwalo, current Department of Social Welfare and Development chief. "We highly commend her service to the people, putting them in top priority and rejecting policies that permit corruption and patronage politics," said Dr. Darby Santiago, Health Alliance for Democracy chairperson.

With Judy as DSWD chief, the nation has seen one of the quickest responses from government agencies. Relief goods came quickly despite landslides and road blockades after Typhoon Lawin devastated Cagayan Province. The same was true after a magnitude 6.5 earthquake hit Leyte. DSWD was also one of the first relief teams on site during the Marawi conflict.

Taguiwalo, for most of her time in DSWD, rejected using DSWD funds as pork barrel for senators and congressmen. Patronage politics was out of the question. "This, we believe, is the reason why there are parties and/or individuals, members of the cabinet and militarists, who want her out of President Duterte's cabinet," said Dr. Santiago.

"Judy's rejection as DSWD chief will be a mere replay of what happened with Gina Lopez, who was rejected as Department of Environment and Natural Resources chief after instilling reforms that allowed the department to actually protect the environment," he added.

HEAD believes that the confirmation of Judy Taguiwalo, together with Rafael Mariano of the Department of Agrarian Reform, ultimately benefits the interests of the common people, farmers, and the urban poor. Their track record is proof of their success as public servants. Their rejection, on the other hand, would only serve the interests of the bureaucrats and oligarchs, whose greed is intent on exploiting government funds and laws through these government institutions.

"Upon their rejection from cabinet positions, the Duterte administration will be left with nothing: neither substantial reform nor change for the very same people that Duterte vowed to serve. Whatever achievement the Duterte administration had through these government institutions will be lost," added Dr. Santiago. "It is the coffers of corrupt politicians, bureaucrats, and the oligarchs that would prosper instead."

For these reasons, the health sector continues to support the confirmation of DSWD chief Judy Taguiwalo, and DAR chief Ka Paeng Mariano. The Duterte administration should stop listening to the dictates of the bureaucracy, as well as the whispers of his pro-US militarist officials. Duterte must uphold the interests of the masses. Confirm Judy!

2018 national budget for health: More money for curative, privatized health care

The proposed 2018 budget for health is bigger but not necessarily better. According to Health Alliance for Democracy, much of the P164 billion budget is focused on curative rather than on preventive healthcare and will mainly benefit the private sector.

"The Duterte administration inherited many complex health problems that require both short- and long-term solutions," according to Dr. Gene Nisperos, HEAD vice-chair. "But the 2018 health budget does not seem to reflect these solutions."

Once again, the National Health Insurance Corporation, or PhilHealth, will get the lion's share with P57 billion. This represents a 7% increase from its current budget and accounts for 35% of the entire national budget for health.

At the same time, almost all of the hospitals under the Department of Health will suffer an average of 24% cutback in their maintenance and operating expenses. Many will have 30% to 40% cuts.

The DOH-retained hospitals represent the last vestiges of health care services provided by the DOH. With such significant cuts in the budget for the maintenance and operating expenses of these hospitals, the DOH is practically crippling their ability to serve and leaving them to fend for themselves.

Moreover, preventive health programs, including those that focus on significant public health concerns, like tuberculosis, malaria, and HIV infections, will be short of P16.7 billion in budget as these suffer a whopping 52% budget cut.

"What does this all mean? That the DOH is allocating more money for curative care, which is more expensive and less cost-effective, rather than on preventive care. For a government that alleges limited resources, this is unsound policy." Nisperos said.

"But the curative care will be provided more by private hospitals and facilities rather than DOH hospitals. Right now, only 37% of hospitals accredited by PhilHealth are government run. So private hospitals and big pharmaceuticals will be grinning their way to the bank as they bilk PhilHealth of its billions," added Nisperos.

For HEAD, the DOH is sending the wrong message: with PhilHealth, the government is now a mere purchaser of health services rather than a provider of it.

"Once more, relevant health services and public health gives way to political expediency. This is the neoliberal program in health. Sadly, the people will be the ones to suffer for it," Nisperos concluded.

Is this really the kind of "legacy" this administration wants to leave?

Complete turnaround for health in Duterte’s second SONA

In his second State of the Nation's Address, President Rodrigo Roa Duterte reiterated his administration’s dependence on the Philippine Health Insurance Corporation, or PhilHealth. He said that PhilHealth coverage will be expanded and that the No Balance Billing policy will be strengthened.

For Health Alliance for Democracy, such statements are a complete reversal of his earlier stance against PhilHealth.

"More than a year after being elected into office, President Duterte has completely backtracked on PhilHealth and now continues with the Department of Health's band-aid solutions to age-old public health problems," said Dr. Darby Santiago, HEAD Chairperson. "He has forgotten that during the 2016 presidential debates, he was the only candidate to criticize PhilHealth, for which he was applauded and supported by many who wanted to see real changes in health care."

Protesters gather at Batasan ave. to ask President Duterte what has become of his
promised change on the president's second State of the Nation Address, July 24, 2017.

At that time, he was already convinced of the general ineffectiveness of PhilHealth that despite its ballooning budget and supposed coverage of the poor, patients still shouldered more than half the cost of their hospitalization.

"But now, Duterte is singing a different tune," Dr. Santiago said.

An effigy by the health sector, depicting Duterte and his health agenda,
where bureaucrat capitalists and imperialists benefit instead of the people.

Strengthening the No Balance Billing policy is useless when there are not enough government-run hospitals and when health facilities are poorly funded and understaffed. Even indigent members wind up paying for the medicines themselves or worse, go to private centers because these are the only ones nearby.

"Is this what President Duterte meant by change? That he will just do more of the same old things?"

The presidential backpedalling is not new. In his recent pronouncements, President Duterte has turned his back on the substantive issues and immediate concerns of Filipinos.

He promised to end labor contractualization, support genuine land reform, assert an independent foreign policy, and pursue the peace talks with the National Democratic Front of the Philippines before and after he won the presidency.

For HEAD, the direction that the Duterte administration is taking reveals much of the interests it now represents. "President Duterte is now far removed from the people he alleges to serve. This is not the leadership we deserve. This is not the change that we want," Dr. Santiago lamented.##

SONA 2017: Change in health, non-existent and intangible

"What change would you expect if the Duterte Health Agenda pursues the same neoliberal policies that the previous administrations pursued? The answer is nothing," said Dr. Darby Santiago, Health Alliance for Democracy Chairperson. "Change in health is non-existent and intangible."

Gomampong Gymnasium, Baloi, Lanao del Norte, jampacked with evacuees from Marawi City. Evacuees line up on the left side of the image for the medical mission/checkup. Photo taken June 15, 2017.

"Privatization and corporatization of healthcare in its various forms continue. Budget cuts plague our public healthcare delivery system. Medicine and vaccines remain lacking in communities, while millions worth of these rot in storage rooms," added Dr. Santiago. "Then there's the casual killing of doctors who serve communities, further depriving the poor of much-needed healthcare and medical attention."

"Malnutrition worsened. HIV cases increased. Countless data prove that the health of Filipinos has in fact worsened. Yet the Department of Health and the Duterte administration has yet to implement policies that would result to substantial change," added Dr. Santiago. "Insanity is doing the same thing and expecting different results, therefore DOH is insane to think that neoliberal policies will solve the ills of our healthcare system."

"One thing is clear: the fascist Duterte administration cannot bring real change; the change we need remains in the hands of the Filipino people through our collective action and empowerment," added Dr. Santiago. "Our struggle for a free, comprehensive, and progressive healthcare must continue. Our struggle for a just and peaceful society shall flourish."##

Martial law extension means extension of humanitarian crisis, state abuses – Health groups

Health Alliance for Democracy strongly condemns the extension of martial law in Mindanao up to

December 31, 2017. By voting for the extension, the Congress and the Senate have exposed themselves as mere tentacles to the President and his rabid dogs Lorenzana, Esperon, and Año.

As the bureaucrats pander to their precious soldiers, largely lost in the narrative is the massive humanitarian crisis that Duterte's martial law has brought upon the people of Mindanao. Half a million Moros have been displaced, the Lumad have been forced out of their communities by the military, and human rights violations abound not just in the south but in the entire country.

Students hold placards in front of the Philippine General Hospital in an action against Martial Law in Mindanao.

And yet, the political elite have dismissed the massive evacuation and civilian deaths as mere "collateral damage" to the US-AFP counter-terrorist agenda. It is clear which masters they serve.

HEAD likewise condemns the detention and calls for the release of the #Kabataan8 who launched a lightning protest during the session. The incident is a reminder of how a reactionary state responds to legitimate public dissent.

Without any hindsight, Duterte and his allies continue to address the conflict in Mindanao and in the entire country through a rightist, militarist policy. But time and time again, history has taught that the enduring socio-economic crisis in the country feeds the growth of rebellion. Because of this, his martial law, as that of his hero Ferdinand Marcos, will ultimately fail.

The health sector is resolute in standing with the Filipino people against Dutert's martial law and his fascist rule. It will march on Monday, during the president's SONA, to show its indignation and call for the lifting of martial law. President Duterte must serve the Filipino people, not the US imperialist agenda of waging war for its own profit.##

DOH blasted for ‘washing hands’ over Cavite provincial doctor slay

Health Alliance for Democracy blasted the Department of Health for again downplaying its responsibility in the protection of health personnel. This, following the killing of Cavite Provincial Health Officer, Dr. George R. Repique, Jr. Dr. Repique is the third physician to be shot and killed within the last five months.

HEAD together with PROJUST (Protection and Justice for Frontline Healthworkers) held a candle lighting action in front of the Philippine General Hospital on July 13 for the killing of Dr. George Repique Jr.

In an official statement on Friday, DOH Secretary Paulyn Ubial deplored the killing and acknowledged the string of unresolved killings of doctors, but she makes no mention of what the department will do in response to this.  In fact, in the five months since Dr. Dreyfuss Perlas and Dr. Shahid Sinolinding have died, no clear mechanism has been put in place to protect the other frontline health workers currently in the field.

All the DOH has done is to pass on this responsibility to local government units – an utter absence of commitment, sincerity, and leadership. While it continues to watch by idly, doctors are dying and health workers are being harassed. This is not the DOH we deserve.

Candles lit for Dr. George.

HEAD calls on the DOH to do the following:

1. The department should come up with a clear, unequivocal statement that it will protect its health workers at all cost and that it will work tirelessly to get justice for them;

2. It should set up a mechanism by which it can get complaints and immediately assist frontline health workers;

3. It should meet with the DILG to delineate their respective tasks and responsibilities in protecting health workers;

4. It should immediately undertake the thorough investigation of these cases as well as complaints raised by other frontline health personnel regarding harassments and threats;

5. It should insist that the PNP and DOJ bring the full force of the law against the perpetrators; and,

6. It should ask President Duterte to make a strong stance on protecting health workers, the same way that he persistently does for his soldiers.

The DOH should not simply "support efforts to obtain justice" in these killings, but should exercise clear leadership for the protection of those who serve.##

Third doctor killed under Duterte: Cavite provincial doctor shot outside hospital

Health Alliance for Democracy strongly condemns the murder of Dr. George R. Repique, Jr., Provincial Health Officer of Cavite. He is the third doctor to be killed in five months, after the killing of Dr. Dreyfuss Perlas in March and Dr. Jaja Sinolinding in April.

Justice is yet to be served for Dr. Drey and Dr. Jaja, and the death of Dr. Repique confirms the continuing impunity in our country. We demand justice for our killed colleagues. We demand that perpetrators be arrested and punished. The Department of Health cannot dismiss his death as another isolated case and must take concrete steps to protect frontline health workers.

Dr. Repique was a member of the University of the Philippines – College of Medicine class of 1993. He had a very strong public health perspective and had partnered with the UP Community Health and Development Program. He was the Provincial Health Officer of Cavite when he was shot on July 11, just outside General Emilio Aguinaldo Memorial Hospital. He died in the emergency room.

AFP and martial law: Direct threat to lives and well being of people

"Terrorism and state terrorism have always been threats to lives and well-being. But you do not solve a problem by creating a bigger problem. Maute is a problem, but the Armed Forces of the Philippines and their implementation of Martial Law is a bigger problem," said Dr. Joseph M. Carabeo, Secretary General of Health Alliance for Democracy.

"What should have been a simple police problem and failed intelligence has been rewarded with vast military powers and authoritarian rule, directly threatening people's rights," added Dr. Carabeo. "We must remember that even without Martial Law, the police and military have been the primary violators of human rights in the Philippines. With the suspension of basic rights under Martial Law, we fear worse human rights violations by state forces."

"It doesn't help that fake news probably fueled the declaration of Martial Law, throwing the people of Mindanao into chaos. The people now 'turn to' the foremost human rights violators, the military, as their knight in shining armor," said Dr. Carabeo. "This condition drowns out the voices of the victims of military abuse, at the same time diminishes the evil and discriminatory character of aerial bombings, as if it can only be directed to their target terrorists. But the picture of thousands of people fleeing their communities is enough testament to the worsening situation than the military frenzy hopes to address."

"The peace talks between the Government of the Republic of the Philippines and the National Democratic Front of the Philippines, which aims to address the roots of our social problems, have also become a casualty," lamented Carabeo. "The panel and the people's hard work towards attaining a just and lasting peace has gone down the drain, at least for now. No justice, no peace, no health."


Health Alliance for Democracy beseechs the help of fellow health professionals, health workers, health science students and health advocates to call for the end of Martial Law in Mindanao. Vast military powers and authoritarian rule under Martial Law is an additional threat to the people of Mindanao. Casualties among civilians will only increase through aerial bombings. Never again to Martial Law!##