By Anthony C. Leachon, MD
SIN TAX LAW on alcohol and tobacco: Where are we now on this landmark law? Where’s the money?
“The Philippines is in the midst of a healthcare crisis,” as expressed by the country’s health workers on their assessment of the nation’s health in “Declaration of a Healthcare Workforce Crisis” issued by The Coalition for Primary Care and the Philippine College of Physicians.
They supported their disturbing declaration with grim figures: 47.6 percent of deaths among Filipinos are unattended by a medical doctor or allied health providers.
Infectious diseases such as tuberculosis and pneumonia continue to kill a hundred thousand Filipinos each year, just as they have for the past several decades.
In addition, 5,000 birthing mothers and 70,000 children under five years of age die each year as maternal and under five mortality continue unabated.
On top of these persistent problems, a new epidemic of noncommunicable diseases (NCD) is upon us as a direct result of increased life expectancy, modernization, and deteriorating lifestyles. These diseases include heart disease, stroke, cancer, chronic lung disease and many other diseases.
The WHO reports that the NCD epidemic kills 175,000 men and 134,000 women every year – that’s more than 300,000 Filipinos a year, 30 deaths an hour. This is the equivalent of two jumbo jets crashing every day.
The health workers said about half of the deaths from noncommunicable diseases and the majority of infectious, maternal, and newborn deaths are preventable with proper healthcare.
Unfortunately, the healthcare system has been unable to manage these scourges. Consider the following facts:
1. Most Filipinos, especially the poor, use public facilities to seek medical care.
2. Of the 66,000 physicians, 500,000 nurses and 74,000 midwives who are actively practicing their profession and registered with the PRC, only 3,000, 5,000, and 17,000, respectively, work in a public facility as of 2013.
3. This translates to only 0.2 physicians, 0.4 nurses, and 1.7 midwives per 10,000 population, or a total of 2.3 healthcare workers per 10,000 population. This number is 10 times less than the 24/10,000 recommended by the WHO, as the minimum number needed to address just the Millennium Development Goals (MDG’s) of maternal and child health alone.
4. The shortage of healthcare workers affects not just the supply of doctors, nurses, and midwives, but also the supply of dentists, pharmacists, occupational therapists, physical therapists, speech pathologists, medical technologists, and other allied medical professionals, including our partners in healthcare, the community health workers.
They pledged “to fight for legislation and policies that promote the practice and teaching of primary care as the basic ingredient of true health for all.”
They zeroed in on five aspects of workforce management: Recruitment – of a sufficient number of health care workers; Retraining – so they can handle both communicable and non-communicable diseases; Retention – through provision of just salaries, deserved benefits, and better working conditions; Regulation – so that supply can be redistributed to areas in need; and Periodic Reassessment – because the workforce is a moving target that changes with the times.
The most important issue is about the lack of concern on healthcare professionals specifically the primary care physicians.
Our battle cry: Walang kalusugang pangkalahatan, kung walang mag-aalaga sa sambayanan. (Universal health care is not possible if there are no healthcare personnel who will take care of the citizens.)
The landmark Sin Tax Law was signed by Pres. Aquino on Dec 20, 2012 and we have yet to feel the impact of the revenues from sin tax law. Thus we are requesting the government agencies about our gains from the law and to strengthen support for implementation and execution of the different health programs to achieve the promise of P-Noy of the realization of UHC or universal healthcare supported by RA 10606 (UHC law): 1. Human resources 2. Public health infrastructures 3. Expansion of Philippine health coverage and benefits.
Vital Signs Issue 73 Vol. 4, March 1-31 2015