Position on House Bill 6145 and Other Bills on Corporatization of Public Hospitals

Position Paper (edited) submitted by the Alliance of Health Workers to the Committee on Health, House of Representatives, Philippine Congress upon its invitation for public hearing (eventually postphoned) on September 4, 2012.

September 3, 2012

Reference:

Jossel I. Ebesate, RN

National President

We, the public health workers nationwide, under the Alliance of Health Workers strongly oppose the recent attempts of the government to corporatize public hospitals through House Bill 6145, House Bill 6069 and Senate Bill 3130. These bills are anti-people and anti-health worker thus will worsen the dismal state of people’s health.

The corporatization bill filed by Rep. Raul Daza will transform 26 public hospitals into public corporations run as private hospitals. It is similar to all other previous corporatization bills like HB 6069 filed by Rep. Anthony Rolando Golez, Jr. and Senate Bill 3130 filed by Sen. Franklin Drilon that gives  fiscal autonomy to hospitals to raise income for its operations thereby cutting off its dependence on government subsidy. These hospitals include the DOH flagship hospitals and almost all major public hospitals/medical centers in Manila Manila and regional centers as follows: Cagayan Valley Medical Center, Veterans Regional Hospital, Baguio General Hospital and Medical Center, Ilocos Training and Regional Medical Center, Region I Medical Center, Dr. Paulino J. Garcia Memorial Research and Medical Center, Jose B. Lingad Memorial Medical Center, Batangas Regional Medical, Bicol Medical Center, Bicol Research Training and Teaching Hospital, Quirino Memorial Medical Center, Jose R. Reyes Memorial Medical Center, Rizal Medical Center, Amang Rodriguez Medical Center, San Lazaro Hospital, Vicente Sotto Memorial Medical Center, Eastern Visayas Regional Medical Center, Corazon Locsin Montelibano Memorial Regional Hospital, Western Visayas Medical Center, Northern Mindanao Medical Center, Zamboanga City Medical Center, Southern Philippines Medical Center, Cotabato Regional and Medical Center, CARAGA Regional Hospital, Davao Regional Hospita, and the Mayor Hilarion A. Ramiro, Sr. Regional Training Hospital.

These bills essentially turn public hospital and its services into income generating and for-profit institutions. By opening the management of the public hospitals to private members means that private investors will make sure that there will be a return of investment and profit, and rendering health services will only come second.

Corporatization is not for the benefit of the people. Corporatization of public hospitals will mean no free health services and higher rates of services. This means deprivation of health services to the poor who are majority of the population. It would result to collateral of properties for payment of health services, or becoming chronically ill or dying without seeing a doctor.

The much touted Philhealth, as a safety net to pay for health services, is not the solution. Its coverage is limited to only 23 regular cases and limited number of catastrophic illnesses. Worse, even a liberal appreciation on Philhealth coverage showed that it could only cover for 30%-40% of the total cost of health services of regular members, outside of the Philhealth’s Sponsored Program. Thus, the resulting increase of health services as a result of the corporatization of public hospitals will be felt more by about 60% of our people who are outside of the lowest 20% of our population (covered by the sponsored program) and the richest 20%. This assumption is based on the data of the DOH itself where about 80% of our people relies on public health facilities especially these 26 public hospitas (for tertiary care) that will be corporatized.

Corporatization will not care for the wellbeing of health workers. Just like any private business, corporatization will streamline its expenses. This means security of tenure of health workers is threatened and will be replaced by contractual which is happening now. Salaries and benefits of health workers are being threatened. Down grading of positions, offer of early retirement and streamlining of health workers will soon be a standard procedure.  Doctors to the Barrios Program (where the RN-HEALS program is included) of the Department of Health is a form of contractualization and exploitation on health workers.

Corporatization is privatization. Lundqvist[1] (1991), say that it is sufficient that one of these functions (i.e., the financing, production or regulation) is transferred to private management to say that a privatization has taken place. Considering that the corporatization as designed in HB 6145, HB 6069 and SB 3130 calls for the transfer of health financing and production to the private sector, therefore corporatization is by itself the privatization of the corporatized hospitals. It is relying more to private business to operate the public hospitals, and the government is abandoning its responsibility to provide quality health services to the people as called by the Constitution.  The government is reneging on its responsibility to adequately provide for public hospitals through the shrinking budget allotment.  Providing health services for free is not dole out since people pay their taxes and should be returned to them through the form of services.  If the government could afford to pay hundreds of billion pesos for foreign debts and modernization of the military, why it cannot afford to develop and modernize public hospitals and health facilities that will save millions of lives? 

Corporatization is in fulfillment of the government’s plan to fully remove subsidies to public hospitals’ Maintenance and Other Operating Expenses (MOOE) by the year 2014 and including Personal Services (PS) by 2020 (Pnoy-DOH’s Health Care Financing Strategy 2010-2020).

Our CALLS:

1. Scrap bills that are for corporatization/privatization of public hospitals!
2. Allot 5% of Gross Domestic Product (GDP) or the amount of P527B by 2013 to fund for people’s health.  Provide adequate budget allotment for public hospitals to ensure and improve facilities, equipments, supplies and medicines. Fund health workers’ benefits.
3. Stop revenue enhancement schemes in public hospitals!
4. Stop privatization and entry of private business in different departments and functions of public hospitals.
5.  Fill up unfilled plantilla positions and create new plantilla positions to provide for adequate health worker to patient/population ratio. 

[1] Lundqvist, Lennart J. 1991: Dislodging the welfare state? Housing and privatization in four European nations., as cited by Falkenberg, Helena in  “How privatization and corporatization affect healthcare employees’ work

climate, work attitudes and ill-health”, 2010, Stockholm, Sweden.