The Philippine College of Physicians (PCP), the 8,000-member-strong national umbrella organization of medical specialists in Internal Medicine and its sub-specialty fields is cognizant of the chronic problems that beset the health sector of the country and the perennial attempts to solve them with little success.  As an institution, it understands its role in maintaining the health of the nation not only as healthcare provider but most importantly, as a catalyst in effecting change in anything and everything that impacts health - whether positively or negatively.

 Our healthcare system is in dire need of help, specifically in 4 major areas:
1.         So much needs to be done to alleviate poverty and give access to healthcare to the majority of Filipinos.  Resource allocation for health is limited not necessarily because the resources are scarce but also because health is viewed as consumption rather than investment.

2.         The quality of care, including the efficiency of the health systems – both central and devolved – is inconsistent and unreliable. Lives are wasted because healthcare delivery is either delayed or inappropriate, or both.

3.         Intervening social, economic, political and cultural factors in governance create conflicts that disturb the people’s understanding of what health really is all about. Organized groups and institutions deter the passage and implementation of laws that are relevant to healthcare delivery.

4.         To make matters worse, our healthcare providers opt to go to foreign lands to earn more, leaving behind a shortage of human resources that are mal-distributed across the regions.

 Everyone’s Goals

Surely, we want a country where all its citizens have easy access to a decent healthcare, where the quality of care that they receive - on time and from an appropriately paid and contented workforce - has scientific basis.

We want a government that puts a premium on good governance and education, that tempers considerations for economic growth with considerations for the health and well-being of its citizens.

We want a people who have the proper appreciation of good health, who take responsibility for their own health and that of their offsprings, and are ready to accept accountability for their decisions and behavior. 

What we all agree on

All of these we wish for ourselves and for our country.  These are the things on which we all share a common ground regardless of the differences in the manner to achieve them.  There should be little or no disagreement on these things that we wish for.  Regardless of the political party that we may belong to, or the health platform that the candidates are currently establishing, everyone has the same dream and wish : Equity in health and development; a  healthy Philippines.

Why aren’t we there yet?

While healthcare resources are, indeed, limited, the availability of resources does not necessarily translate to the improvement in the delivery and quality of care.  That is because putting together a viable healthcare program involves the participation of various shareholders in the health sector, each of whom has legitimate agenda to pursue and interests to protect.  

The Players in Healthcare

We are all players in healthcare delivery but we belong to different groups with different agenda.

1.         There are the providers - the doctors, nurses, health professionals and the hospitals – who are driven by the latest technology as basis for service delivery.

2.         There are the funders – the HMOs, insurance companies, employers and Philhealth – who are driven by the strategy to keep costs low.

3.         There are the suppliers – the pharmaceutical and medical supplies companies that are driven by bottomline objectives.

4.         There are the policy-makers – the government institutions and legislators – who are driven by the desire to please its constituents and to maintain political power.

5.         The beneficiaries – the users – who are driven by claims to entitlement to health as full as possible and at the least cost to them. They have the right to health; oftentimes they forget that with the right also comes a responsibility for one’s health.

The difficulty in solving the issues in healthcare starts when each player tries to pull all the others to satisfy his own agenda.  This is where we are now.

The Next Philippine President’s take on Health

Whoever is going to be the next president of the Philippines must necessarily have a national perspective on health that integrates the individual perspectives of the healthcare players. If healthcare were an orchestra and the various healthcare players its vital components in producing music, the president is the conductor who prepares the musical score and ensures that each component blends perfectly with the rest. To be able to do this, he must address the foundational flaws in healthcare and get each player to confront himself.

Foundational Flaws that must be confronted

There are 2 foundational flaws that make addressing these issues difficult: First, health is understood wrongly as expenditures for treatment and cure, not as an investment in productivity and growth.

Second, while we know that health is a right, we oftentimes forget that it is also a responsibility. Everyone must be accountable for the consequences of his behavior on his health; our government cannot answer for everything.

Is health a top priority in the presidential campaign?

The PCP-sponsored Presidential Forum on Health: “What has health got to do with everything!”, is aimed to bring together all stakeholders in healthcare as well as the presidential candidates  to this common ground from which a substantive interaction can take off.  The PCP invited the top 5 presidential candidates in the hope the next president of the Philippines from one of them would have a deeper understanding of what a really good healthcare platform should be.

We had looked forward to our presidential candidates to say the truth about the state of Philippine healthcare and our capacity to confront the realities head-on.  We did not want to hear motherhood statements and promises; we wanted to know HOW they would lead and orchestrate the various players in addressing the 4 major issues in health considering the 2 foundational flaws that undermine their resolution.

The PCP Commitment

The PCP is committed to do its share, not only in providing expert and compassionate care but also in the promotion of relevant and effective health education. It has incorporated into its medium and long-term plan a more deliberate, fulsome and sustainable training, distribution and mobilization of its growing membership.  Where issues that affect health are not within our control, the PCP will closely collaborate with the other healthcare players.  The PCP prays for a president who can lead effectively because he knows fully well that health has a lot to do with everything in nation-building.

PHILIPPINE COLLEGE OF PHYSICIANS

March 16, 2010