PGH: Hospital for the Poor No More: Employees, health groups oppose hospital fee increases

The management of the country's premier public hospital said that there is a need to increase fees to have funds for improving facilities and services. Various groups, however, argued that increasing fees will be done at the expense of the poor who are supposed to be the main beneficiaries of public health services.

BY AUBREY MAKILAN
Bulatlat

The University of the Philippines-Philippine General Hospital (UP-PGH) community and other health groups last week said that there is no reason for increasing fees of PGH's services, arguing that it is being done at the expense of poor patients.

Rate increases

In a Feb. 8 dialogue with PGH-based health groups, UP-Manila Chancellor Ramon Arcadio and PGH Director Carmelo Alfiler said that they will push through with the imposition of the operating room (OR) fee of P1,500 ($31.05) despite protests from various groups. In the past, the use of the OR was free.

Present in the dialogue included representatives of the UP Manila Coalition against PGH Rates Increases, All-UP Workers Union (AUPWU), All-UP Academic Employees Union and the associations of physicians, nurses, nursing attendants and utility workers.

In end-January, the planned rate increases for blue card acquisition and medical certificate releasing were deferred. The payment for the blue card 'which every patient should have to transact with PGH' was supposed to increase by 114% from P7 to P15 ($0.14 to $0.31). On the other hand, the "fast-lane" payment for getting a medical certificate was proposed to be increased by 400% from P20 to P100 ($0.41 to $2.07).

The UP-PGH's rate increase proposals were made immediately after the UP Board of Regents' (BOR) approval of the tuition increase for incoming freshmen students.

During the BOR's 1216^th meeting on Dec. 15, the highest policy-making body of the UP did not only approve a 233-percent hike in tuition and miscellaneous fees. The BOR also ruled that "tuition will be subsequently adjusted annually based on the national inflation rate."

At whose expense?

With the proposed P1,500 ($31.05) OR fee, the administration would not give up the projected annual income of about P16 million ($331,228.65), said Jossel Ebesate, president of AUPWU and secretary-general of the Alliance of Health Workers (AHW).

According to Ebesate, the administration claimed that the income will be allocated for the development efforts of the hospital.

"Profit at whose expense?" he asked. "Hindi tama na ang development efforts to improve facilities and services ay kukunin mo sa patients na dapat ay sineserbisyuhan mo." (It is not right that development efforts to improve facilities and services will be sourced from patients whom you are supposed to serve.)

PGH has 500 pay beds, 800 charity beds and 200 special beds or for the intensive care unit (ICU). PGH accommodates about 1,500 patients every day in the out-patient department (OPD) and 350 patients every day in the emergency room (ER). Most of these patients, Ebesate said, are charity patients.

At first, the PGH management claimed that only holders of the Philippine Health Insurance, Inc. (PhilHealth) card would be required to pay the OR fee. However, since 70 percent of patients undergoing surgical operations are not covered by PhilHealth, Ebesate said that everybody will now be affected by the imposition of the OR fee.

In case of non-PhilHealth coverage, patients will be assessed by the hospital's social service which will then find donors to help them. If no donor is found, Ebesate said that the OR fee would be waived. His group, however, doubt if this will be implemented.

In many cases, Ebesate said that nurses and physicians shoulder the charges passed on even to poorest-of-the-poor patients. "Wala pa nga 'yung OR fee, hindi na kaya ng mga pasyente 'yung mga (simpleng) bayarin. Paano pa kapag nagtaas na?" (Even now that there is no OR fee, patients cannot afford basic fees. What more if the fees increase?)

Wrong priority

Ebesate, chief nurse of the PGH nursing service, said that it is not true that there is no fund available for health services. "Mali lang ang priority," (The priority is wrong) he said, citing misappropriations in the national budget as a result of higher allocation for debt service and military expenditures.

Since 1983, Ebesate said that the PGH budget for personnel services (PS) and maintenance and other operating expenses (MOOE) has never reached P1 billion ($20.7 million). Their actual computations showed that they need about P2 billion ($41.4 million).

He said that the PGH has been generating income to augment the government's meager budgetary allocation. From three percent in the past, Ebesate said that PGH has been earning 30 percent of its total budget at present.

To show their firm opposition to the rate increases, Ebesate said that all groups of the UP-PGH plan to stage mass actions at the offices of concerned government agencies like the Departments of Budget and Management (DBM) and Finance (DOF). Bulatlat

(Computation of dollar equivalents based on an exchange rate of P48.305 per US dollar)