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.