Monday, January 28, 2008

Medical Tourism: More Bane Than Boon

The much ballyhooed promise of medical tourism being trumpeted by the Department of Health (DOH) and the Arroyo regime may well be more glitter than gold and should be regarded not just with caution but with firm opposition. Medical tourism is not strong medicine that heals but a poison pill that will hasten the demise of a public health care system already on the verge of collapse.

This is the position made by Health Alliance for Democracy (HEAD). "Why is the Arroyo government pushing for the commercial sale of our health services when it cannot even provide for the health needs of the vast majority of Filipinos?" asked Dr. Gene Alzona Nisperos, HEAD secretary-general. "Why is the DOH treating health care as merchandise for sale rather than an obligation it should provide the people?"

By its design and proposed implementation, medical tourism involves the fate of at least three DOH hospitals and four government-owned and controlled corporations (GOCC)/hospitals. The closure of the Jose Fabella Memorial Hospital and the Lung Center of the Philippines (LCP), as well as the planned "merger" of the National Children's Hospital with the Philippine Children's Medical Center (PCMC) and "transformation" of the East Avenue Medical Center will affect over 1,700 charity beds.

Coming at a time when 50% of Filipinos die without receiving any form of health care, the so-called development under medical tourism will significantly decrease services available to charity patients, even as it opens up services to paying patients and foreigners/tourists. Such institutionalized privatization of health care will only further marginalize poor Filipino patients.

The backlog of charity cases in the GOCC hospitals alone is a case in point. In 2004, the Philippine Heart Center (PHC) had as many as 4,000 patients waiting for heart surgery. At the National Kidney and Transplant Institute (NKTI), there are over 180 patients in the waiting list for kidney transplants. Many of these patients may die even before they get the procedure they need. What happens to these patients when PHC and NKTI open up their doors to foreign patients?

Heart surgeries and kidney transplants are also expensive for most Filipinos. A kidney transplant will cost a pay patient between P1M to P1.5M, while a charity patient will have to shell out almost P500,000 even if the kidneys are donated for free. But rather than act to make these procedures more affordable, government agencies are now advertising these procedures as "cheaper" alternatives for foreigners.

Recently, the DOH announced plans to construct massage centers located within government hospital complexes. All of a sudden, the government has funds to pipeline such construction when it has not even added to the capital outlay of its 11 public hospitals over the last 5 years!

"Over the years, the Arroyo government has done nothing to improve the state of our public hospitals, even amidst the demands of the patients and health personnel. Instead, the DOH has pushed for higher and more user fees, even for services that used to be offered for free." Added Dr. Nisperos, "It is clear that the impetus for these renewed 'improvements' under medical tourism is nothing more than the need to produce more dollar-denominated revenue."

Through medical tourism, paying patients, particularly foreigners/tourists, will be the principal clientele. As such, they will have priority over the use of medical facilities and even expertise. Thus, the message that the Arroyo government is sending is clear: health care in this country is available only to those who can afford it.

"The utter callousness of the Arroyo regime is revolting." Concluded Dr. Nisperos, "By selling to foreigners what it has virtually denied its own people, Gloria-Macapagal Arroyo is proving once and for all that her illegitimate rule is not the only reason why her removal from office remains a moral and political imperative."(Press Release, Feb.2006)

“PMA’s ‘Hospital Holiday’ Highlights REAL Issues and Interests”-HEAD

New legislation should strengthen existing legislation and not create a false conflict between the rights of doctors and the interests of patients. This is the position of Health Alliance for Democracy (HEAD), the 3,000-strong national organization of doctors and allied health professionals on the provision of generics-only-prescribing imposed by the Cheaper Medicine Bill and the aborted threat of a “hospital holiday” by the Philippine Medical Association in reaction to this.

“Making medicine affordable and accessible should not be contingent on the curtailment of the rights of physicians to prescribe what they deem to be best for their patients.” According to Dr. Gene Alzona Nisperos, HEAD secretary-general. “No law should abridge this right.”

“The draconian measure being imposed by congress is counterproductive at this juncture and distracts from the real issues that need to be addressed to make medicine cheaper in this country: dismantling existing monopolies and enforcing regulation.”

HEAD believes that the strong reaction by doctors is understandable in the light of what is clearly an attempt not just to subvert the prescribing rights of physicians but also to undermine the doctor-patient relationship that is the foundation of any treatment regimen.

Dr. Nisperos contends that if Congress is sincere in its efforts to make meaningful legislation that will make medicine affordable, they should focus on the roots of the problem, which will also explain why existing laws, like the Generics Law, has largely been irrelevant.

“For instance, while there is no question regarding the strong influence exerted by big pharmaceutical companies on the prescribing habits of physicians, gov’t has done nothing to wean doctors from this kind of relationship,” Dr. Nisperos said. “In terms of information on new or recently developed drugs, for example, gov’t has offered no viable alternative sources, forcing physicians to often rely on the product information given by pharmaceutical companies.”

HEAD also slammed Secretary of Health Francisco Duque III for threatening to sanction doctors who will join protest actions.

“Secretary Duque should first explain why the health department has done very little to avert this situation (of very expensive drugs) and why he has not given enough attention to the implementation of the National Drug Policy,” added Dr. Nisperos. The committee that implements this policy is directly under the Office of the Health Secretary.

At the same time, HEAD also cautioned doctors and the PMA from becoming unwitting pawns in the proxy war being conducted by big pharmaceuticals against generic drugs.

“Linking generic drugs with the proliferation of substandard drugs is a rehashed argument perpetuated by big pharmaceuticals to discredit generics and the policy of rational drug use. It is the same argument that these drug companies raised when they tried to block the passage and implementation of the Generics Act two decades ago,” according to Dr. Nisperos.

The proliferation of substandard and ineffective drugs is entirely within the purview of the Bureau of Food and Drug (BFAD) and the DOH, gov’t agencies tasked to monitor this. Yet both the BFAD and DOH have failed miserably in monitoring and regulating the drug industry.

HEAD is renewing calls for a stronger unity between doctors and patients, between prescribers and consumers, to ensure that the new law being crafted by Congress will not wind up being another token measure. “Doctors should join hands with their patients because we have a common interest: health for all. Together, we can be more vigilant against the infirmities of the new law and with the accountability of those who should be implementing the law.” ###

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On Remembering EDSA II, Gloria Macapagal-Arroyo's Must Submit to the Will of the People: OUT Now

As the nation remembers the people's uprising of EDSA II, the people is reminded of the seven years under the yoke of Gloria Macapagal-Arroyo's repressive and corrupt rule. The health sector under Rx Gloria Out Now! (Rx GO Now!) joins the broad masses of the people in shouting "Enough! Seven years of Gloria is enough!".

The last seven years under Mrs. Arroyo is characterized by seven deadly sins she has committed against the Filipino people. These are the sins for which she should be made accountable, sins for which her rule should end.

Corruption. The litany of corrupt multi-billion dollar and multi-million peso deals that have enriched Mrs. Arroyo and associates include the ZTE-National Broadband Network deal ($329B), Bolante fertilizer scam (P728M), IMPSA Hydroelectric Power Plant kickbacks ($14M), and overpricing of the Diosdado Macapagal Boulevard (P536M). On top of these is the P200,000-500,000 "cash gifts" doled out to congressmen and governors.

Electoral fraud. Not content with stealing presidency through widespread cheating in the 2004 elections, Gloria conspired with the COMELEC and repeated their act in the 2007 elections to ensure that pro-administration candidates win at the local and national levels.

Extra-judicial killings and desaperecidos. The families of more than 888 victims of summary and extra-judicial executions and 184 enforced disappearances, including Jonas Burgos and UP students Karen Empeño and Sherlyn Cadapan, continue to cry out for justice. Yet Mrs. Arroyo coddles the Armed Forces of the Philippines (AFP) and Philippine National Police (PNP), both of which remain in a state of denial regarding their responsibility.

Political violence and repression. Gloria Arroyo and her Department of (In)justice continue to file trumped-up charges against known critics of the administration. Labeling political enemies as "terrorists" and "destabilizers" have been the norm and have been used to justify the militarization of urban poor communities.

Human rights violations. Measures that violate basic human right are characteristic of Mrs. Arroyo's rule, including the DOJ memo that threatens media practitioners, the push for the National ID system, and the proposed resurrection of the Anti-Subversion Law.

Poverty. While oil prices skyrocket, wages remain way below what is necessary for daily living. Thus, abject poverty has worsened, affecting 70% of the population. Basic social services, such as health services, are lacking even if taxes are being raised and collected allegedly for these services.

Betrayal of national interests and patrimony. Mrs. Arroyo has entered into onerous agreements that are largely detrimental to the nation, such as the Japan-Philippines Economic Partnership Agreement (JPEPA) and the China-Philippines Economic Agreement. US troops continue to conduct military exercises in the country despite reports of abuses.

The sins of Gloria Macapagal-Arroyo are symptomatic of a morally bankrupt leadership. This tyranny and treachery must end. If Mrs. Arroyo recognizes the historic and political significance of EDSA II, then she must submit to the will of the people: Gloria OUT Now! ###

Welcome to our blog!

HEAD is composed of individuals from the health sector who adhere to the principles of the Filipino people's struggle for sovereignty and democracy. It advocates and works for a society where the promotion of the people's economic, social and cultural rights will bring about national prosperity and well-being.

HEAD struggles for a society where the State ensures the effective delivery of basic social services especially to the basic masses. It pushes for a quality health care system that is mass-based, scientific, and free from foreign and local monopoly control.