P91-B sin tax windfall, but no share for doctors

Posted at 02/11/14 4:30 PM

PH health sector suffering from ‘brain hemorrhage’

6 out of 10 Filipinos die not ever seeing a doctor – study

MANILA - The country may have gotten P91 billion in windfall since the Sin Tax Law was implemented, but none of it is being used to address the problem of the lack of doctors and health workers in the country.

In a press conference on Tuesday, Health Undersecretary Teodoro Herbosa admitted this was not covered during the deliberations on the Sin Tax bill.

“Around 85% of the revenues will go to healthcare, and the 15% will go to tobacco farmers” whose livelihoods have been affected of the increase in sin taxes.

He said the majority of the revenues goes to covering premiums for the health care coverage of the poorest of the poor.

Doctors said that although Filipinos can be assured of coverage by the National Health Insurance System, the limited health care workforce – given their relatively low pay and lack of benefits – is not ready to handle the increasing demands for healthcare.


Dr. Moses Princesa

Dr. Moses Princesa, the lone public doctor in the third class municipality of Busuanga, Palawan said the problem “is not anymore a brain drain, but a brain hemorrhage.”

"The problems of the healthcare workforce need long-term and system-wide solutions if we are to overcome the nation's health crisis. Not only do we need to recruit more health workers and retain them within our shores, but we also must better regulate the workforce, retrain them, redistribute their deployments, and reassess the direction of present health policy," Philippine Society of General Internal Medicine (PSGIM) President Antonio Dans said.

Philippine College of Physicians incoming president Anthony Leachon said the problem has become so bad that the healthcare system “is already in the worst of times.”


Even DOH's Herbosa admits there is a crisis. He said some countries have the same problem, but they have responded by recruiting doctors from abroad, including the Philippines, he said.

Citing data from the Professional Regulation Commission, Herbosa said there were only 70,000 doctors registered in the country in 2013 even as the Philippines' population hit the 100-million mark.

This means seven doctors for every 10,000 patients. It also translates to only 15 minutes of consultation per patient.

Ideally, there should be 1 to 1.5 doctors for every 1,000 patients, he said.

In Busuanga, Princesa said one doctor attends to 20,000, and he even acts as a medico-legal physician.

He said doctors are not asking for much, but there is also a need for a return on their investments given that they spend half of their lives for their education and training.


Princesa, a graduate of UP Manila who had a choice to stay in the city, opted instead to go to the rural areas to serve the poor. While his salary can be stretched to accommodate his growing family – one kid and a baby on the way – he feels the need for more support from the national government.

He said he can’t just accept as normal the everyday deaths in Busuanga as a result of sicknesses. There is not even one ambulance to serve the community there, he said.

Health care facilities have been affected tremendously by super typhoon Yolanda, which also hit Busuanga, he said.

Dr. Adrian Paul Rabe, trustee of the Philippine Society of General Internal Medicine, said there are several factors behind this crisis.

Besides cross-country migration and urban migration of doctors, there is also the problem caused by “devolution” of the assistance for doctors from the Department of Health to local government units.

There is the “palakasan” system in LGUs, and there is no assistance left for doctors because “the LGUs have too much on their hands,” he said.

Rabe also cited the “medical mission mentality” which leads to short-term help for the public.

As an end result, 6 in every 10 Filipinos die without seeing a doctor, Rabe said, quoting a study.

Herbosa said, however, that the DOH is not toothless when it comes to helping provide for the benefits of the public doctors. This year, he said the DOH finally got the appropriation for the Magna Carta for Health Workers, he said.

Princesa can only wonder, however, if the benefits will trickle down to doctors in rural areas who are tied to the budgets of local governments.