Philippines Battles Health Inequities: From Medical Costs To Worker Shortage | CNA Correspondent
Summary
TLDRThe video script highlights the struggles of Filipinos with healthcare, focusing on the story of Amita, a mother diagnosed with an enlarged thyroid who can't afford medication. It delves into the high cost of medicines, the reliance on unregulated supplements, and the challenges faced by healthcare workers, including low pay and job insecurity. The script also touches on the government's efforts to improve healthcare access, such as creating economic zones for pharmaceutical companies and establishing multipurpose health centers for the poor.
Takeaways
- 🏥 Amita Depra, a Filipino manicurist, was diagnosed with an enlarged thyroid but struggles to afford her prescribed medication due to high costs in the Philippines.
- 💊 Filipinos often turn to cheaper, unregulated supplements as an alternative to expensive prescribed medicines, which can be harmful and ineffective.
- 🌍 Medicine prices in the Philippines are significantly higher than international prices, causing financial strain on patients and their families.
- 💼 The Philippine government is urged to create a national pool of medicines through bulk procurement to lower costs and improve access.
- 🛑 The pharmaceutical sector argues that cheaper medicines may compromise patient safety and that revenue from innovator brands funds research for new medicines.
- 🏥 Geography and logistics in the Philippines, with over 7,000 islands, make storing and distributing medicines challenging and contribute to high costs.
- 🏥 Healthcare workers in the Philippines face low pay, job insecurity, and are often owed allowances, leading many to seek work abroad.
- 🚑 The government's plan includes building more primary and urgent care centers to prevent overloading hospitals and improve access to care.
- 💉 Sy taxes on products like cigarettes and alcohol fund the health department and state health insurance, with advocates pushing to include e-cigarettes.
- 🏥 The Philippine General Hospital serves as a training ground for doctors and a last resort for complex medical cases, often operating over capacity.
- 🔥 Despite challenges such as a fire incident at the hospital, healthcare workers remain dedicated to providing care and saving lives.
Q & A
What medical condition was Amita Depra diagnosed with two months ago?
-Amita Depra was diagnosed with goiter, an enlarged thyroid gland.
What is Amita's current occupation and why is she seeking an overseas job opportunity?
-Amita is currently working as a freelance manicurist at a salon in Metro Manila. She is hoping to secure an overseas job opportunity to work as a domestic worker in the Middle East, likely due to better financial prospects.
Why does Amita turn to supplements instead of her prescribed medication?
-Amita turns to supplements because they are cheaper than her prescribed medication, which she cannot afford.
What is the issue with the cost of essential medicines in the Philippines according to the Department of Health?
-Essential medicines in the Philippines cost at least three times more than international prices, making them unaffordable for many Filipinos.
What are the risks associated with using non-prescribed supplements as per the World Health Organization?
-The World Health Organization states that substandard and falsified medical products may cause harm to patients and fail to treat diseases.
What is the significance of Bongabon Street in Manila and why is it mentioned in the script?
-Bongabon Street is famous in Manila for its pharmacies that sell cheap medicines and medical supplies. It is mentioned to highlight the issue of affordability and accessibility of medicines in the Philippines.
What is the proposed solution by advocates for lowering the cost of medicines in the Philippines?
-Advocates suggest that the government should create a national pool of medicines through bulk procurements to lower costs, instead of having each locality and medical facility buy medicines separately at different volumes and price points.
What is the pharmaceutical sector's argument against the use of cheaper medicines?
-The pharmaceutical sector argues that cheap does not always mean good for the patient and emphasizes the importance of patient safety and adherence to regulations set by the Philippine FDA.
How do high medicine prices in the Philippines affect both the rich and the poor?
-High medicine prices affect both the rich and the poor by consuming a significant portion of their out-of-pocket health spending, with the poorest Filipinos spending up to 75% and the richest spending 58% on medicines.
What are the challenges faced by healthcare workers in the Philippines, according to Rene Capito?
-Healthcare workers in the Philippines face challenges such as delayed allowances, low pay, job insecurity, and the lack of care for their own health needs, which is driving many to seek jobs abroad.
What is the government's long-term plan to address the issue of high medicine prices and improve healthcare in the Philippines?
-The government's long-term plan includes encouraging local drug manufacturing by creating economic zones for pharmaceutical companies, promoting competition, and building more primary and urgent care multipurpose centers to prevent overloading hospitals.
Outlines
💼 Financial Struggles and Healthcare Access in the Philippines
The first paragraph introduces the story of Amita Depra, a Filipino mother of four, who was diagnosed with an enlarged thyroid gland. Amita works as a freelance manicurist in Metro Manila and hopes to secure a job in the Middle East as a domestic worker. The high cost of essential medicines in the Philippines, which are three times more expensive than international prices, forces many, like Amita, to seek cheaper, unregulated supplements. The World Health Organization warns that such products may be harmful and ineffective. The segment also explores the issue of high out-of-pocket healthcare spending and the challenges of medicine distribution across the country's 7,000 islands.
🏥 Healthcare Worker Challenges and the Need for Local Manufacturing
The second paragraph delves into the difficulties faced by healthcare workers in the Philippines, such as Rene Capito, who heads the largest union of private hospital workers. The government's debt to these workers for pandemic-related allowances is highlighted, along with the broader issue of low pay and job insecurity. The narrative also touches on the country's geography, which complicates medicine storage and distribution. The government's long-term plan to encourage local drug manufacturing to promote competition and reduce reliance on imports is discussed, as well as the risks faced by healthcare workers in rural areas, such as the tragic death of a midwife at sea.
🛑 The Impact of Health Inequities and the COVID-19 Pandemic
This paragraph discusses the aftermath of the COVID-19 pandemic on the healthcare system in the Philippines, focusing on the case of a family burdened with debt due to hospital bills for a relative infected with leptospirosis. The narrative highlights the limitations of state health insurance, which only covered a small fraction of the costs, and the reliance on private funding for healthcare infrastructure. It also touches on the government's plans to build multipurpose health centers to bridge the gap between rural health centers and tertiary hospitals, and the need for funding to support these reforms.
🏥📈 Syringe Taxes and the Expansion of Public Healthcare Facilities
The fourth paragraph examines the financing of public healthcare in the Philippines, including the use of sin taxes on products like cigarettes and alcohol to fund the health department and state health insurance. It also mentions the potential inclusion of e-cigarettes in these taxes. The narrative discusses the government's efforts to expand the Philippine General Hospital and establish similar facilities in the provinces to improve healthcare access and training opportunities for healthcare workers. The challenges faced by the hospital, including overcrowding and the need for additional funding, are also highlighted.
🌆 Vision for the Future of Philippine General Hospital
The final paragraph presents the vision of Dr. Gerardo Legaspi, the director of the Philippine General Hospital, for the future of the institution. Despite the challenges, Dr. Gap aims to expand the hospital's capacity to serve more patients and provide training and research opportunities. The narrative underscores the hospital's role as a last resort for complex medical cases and the dedication of its doctors, who have even used their own allowances to provide care for patients in need.
Mindmap
Keywords
💡Guer
💡Manicurist
💡Out-of-pocket health spending
💡Supplements
💡National pool of medicines
💡Innovator Brands
💡Healthcare workers
💡Health equity
💡Sy taxes
💡Primary and Urgent Care multip specialty centers
💡Philippine General Hospital (PGH)
Highlights
Amila Depra, a Filipino mother of four, was diagnosed with goiter, an enlarged thyroid gland, and struggles with the high cost of medication in the Philippines.
Many Filipinos, like Amita, turn to cheaper supplements due to the high cost of essential medicines, which can be three times more expensive than international prices.
The World Health Organization warns that substandard and falsified medical products may cause harm and fail to treat diseases.
In Manila, pharmacies on Bomang Street sell cheap medicines, raising questions about the reasons behind the low prices.
Advocates suggest the government should create a national pool of medicines through bulk procurement to lower costs.
The pharmaceutical sector in the Philippines argues that patient safety should be the priority over cheap medicines.
Some big pharmaceutical companies have started selling drugs at a low cost in countries with greater need to make access to medicines more equitable.
High medicine prices in the Philippines affect both the rich and the poor, with a significant portion of out-of-pocket health spending going to medicines.
The geography of the Philippines, with over 7,000 islands, poses challenges for the storing and distribution of medicines.
Healthcare workers in the Philippines face issues such as low pay, job insecurity, and delayed allowances, driving many to seek jobs abroad.
The government's long-term plan includes encouraging local drug manufacturing by creating economic zones for pharmaceutical companies.
Healthcare workers in rural areas face additional challenges, including the risks associated with transporting medical supplies.
The government plans to build at least 28 primary and urgent care multipurpose centers by 2028 to prevent overloading hospitals.
Public healthcare in the Philippines is financed through various sources, including the Health Department's yearly national allocation and patients' out-of-pocket spending.
The Philippine General Hospital (PGH) serves as a training ground for the country's best doctors and treats the most complex medical cases.
Dr. Gerardo Legaspi, the director of PGH, is working to expand the hospital and establish similar facilities in the provinces to improve healthcare access.
The COVID-19 pandemic has exposed health inequities in the Philippines, with many patients unable to afford necessary treatments.
The government is considering imposing 'sin taxes' on products like cigarettes and alcohol to fund the health department and state health insurance.
Transcripts
[Music]
Filipino mother of four amilita depra
was diagnosed with guer an enlarged
thyroid gland 2 months ago at under $4 a
day she works at a salon in Metro Manila
as a freelance manicurist it's supposed
to be a temporary job amalita is hoping
to secure an overseas job opportunity to
work as a domestic worker in the Middle
[Music]
East like many Filipinos she could
barely save up for the future much less
byy all of her prescribed
medication on this day after work she
brings me to her home and shares this
news with
[Music]
me like many Filipinos Amita rarely goes
for medical checkups until a friend
noticed a lump on her neck unable to
afford medications for her condition she
turns to supplements that are cheaper
but these were not prescribed by her
doctor essential medicines in the
Philippines cost at least three times
more than International prices according
to the Department of
Health with such steep medicine prices
in the country supplements not
registered with the Local Food and Drug
Administration are openly sold to
Filipinos and they're marketed as cures
to various ailments the World Health
Organization says substandard and
falsified Medical Products may cause
harm to patients and fail to treat
[Applause]
diseases we're here in bomang Street
which is famous in Manila for pharmacies
lined up selling cheap med medicines and
medical supplies let's find out why that
is so I'll ask about prices here using
my medical prescription issued by my
doctor
p50
M Advocates say the government should
create a national pool of medicines
through bulk procurements to lower costs
instead of having each locality and
medical facility buying medicines
separately at different volumes and
various price
points but the pharmaceutical sector in
the Philippines argues that cheap does
not always mean good for the patient
it's urging government to evaluate
previous medicine suppliers to state run
medical
facilities number one is patient safety
right so patient safety how how have the
patients experienced these drugs
purchased by the government and how they
have they adhered to the patient safety
regulations that have been set for set
forth by the Philippine
FDA the pharmaceutical sector in the
Philippines also argues that revenues
from pricier drugs of so-called
innovator Brands would help fund
research for new
medicin some big pharmaceutical
companies have started selling drugs at
a low cost in countries with a greater
need to make access to medicines more
Equitable we group our countries into
different
tiering and these tiering is determined
um with regards to the economical
dynamics of a country so the GDP the
healthcare infrastructure framework of a
country the outof pocket segment as well
as the policies and enabling access to
specific um therapeutic areas so pricing
is determined on these economical
factors and the Dynamics of these
countries still medicine prices in the
Philippines affect both the rich and the
poor according to the World Health
Organization as high as 75% of out
of-pocket Health spending for the
poorest Filipinos and 58% for the
richest goes to
medicines experts say the country's
geography with over 7,000 Islands also
make the storing and distribution of
medicines more
challenging I think a lot of issues in
the health department stems from expired
medicines because of uh Logistics and uh
management issues we have really a huge
problem if we buy a huge amount of
drugs and then there's just blanket
distribution the government's long-term
plan is to encourage local drug
manufacturing by creating economic zones
for pharmaceutical
companies we have to promote competition
there has to be many more Brands many
more companies coming in so not only do
we allow products from the outside but
if we can actually manufacture those
products locally then why
not but until then many f Filipino
patients are forgoing life saving cures
as they can't afford them and choosing
non-medicinal food supplements that are
unlikely to treat their medical
[Music]
conditions
Rene capito heads the Philippines
largest Union of healthcare workers
employed in private hospitals he says
the government still owes their members
an average of over
$2,400 us each in allowances promised to
them for service rendered during the
pandemic an amount that he says could
pay their fam's medical
expenses
kidney chronic disease
C even as they care for others health
workers like Renee say there is little
care for them but the Philippines
Department of Health says the allocated
budget for payment of these allowances
this 2024 is over 50% short of what is
needed to pay off all the filed claims
at least $480 million us more are needed
to pay pending allowance claims Beyond
delayed allowances low pay and job
insecurity are driving many Filipino
health workers to see jobs abroad over
350,000 doctors nurses and midwives have
left the Philippines to work abroad
between 1990 and 2017 health workers
rights activist Robert Mendoza points to
a host of factors that's driving low
morale among healthare
workers
workast Asia
workers to patient is
12 dep
ofth public health specialist Dr Michael
CED says healthcare workers deployed to
rural areas and areas with high crime
rates likewise face the risks linked to
those communities he says healthcare
workers are often blamed by patients and
their families for inadequately equipped
Health
Facilities patients have an expectation
especially the ones that are when you
are faced with a person that uh a family
with uh dying patient they wouldn't care
if you're the nicest doctor I know if if
if their life or their son's life is on
the line they will they will really
demand something that not that might not
be there because that's part of the
grief no they they're trying to find
someone to
blame to know more about healthcare
workers conditions on island communities
in the Philippines I join Community
nurse Rose De La Cruz on her journey to
Thim Island a 2-hour boat ride from the
mainland more or less 30,000 residents
live on this island in the middle of the
Philippines largest lake there is only
one twoed capacity birthing facility
catering to all 17 Villages here so the
local government is constructing the
so-called Infirmary Hospital to expand
the range of services offered to
patients for free the expansion includes
plans for an emergency area and some
laboratory
services on this day a town doctor from
the mainland came on a visit but this
happens only 1 to two days a month due
to the work commitments he has in the
mainland
this means nurse Rose and other midwives
here are left to run the rural health
unit where she has worked for the past
30
[Music]
years8
247 healthcare workers also face dangers
related to transport R in 2023 a midwife
deployed to the island died as the boat
she was on
capsized Midwife family OKO was working
towards securing her nursing license so
she can provide better quality of care
as she was living in another town she
had to stay at least 3 days a week on TM
Island where she was deployed to avoid
long travel each
day Fe Marie's dedication has inspired
those who knew
[Music]
her
for despite the Perils of healthcare
work in rural areas nurse Rose finds
moments of pure
joy
for for as long as there is a patient in
need there will be healthcare workers
like nurse
Rose no matter the
hardship no matter the pain finding joy
in every life saved
and every baby
[Music]
delivered the world on a standstill has
gone back to its Daily Grind once empty
roads now a city that came back to life
the Philippines continues to battle
Health inequities exposed by the
outbreak one year onun since the end of
the covid-19 global Health Emergency the
family of 17-year-old Cyrus leano knows
this all too well they spent months at a
metr manila hospital after Cyrus got
infected with leptos pyrosis a zoonotic
disease that's endemic in the
Philippines the state health insurance
covered only 2% of their 20 $2,000 us
hospital bill for which they are now
deep in
debt to pay off the loan his father clad
is working as a house painter the land
title for his relative's home served as
collateral for the loan a common story
among many Filipinos faced with health
[Music]
emergency a
[Music]
day experts admit a lower middle-income
country like the Philippines can only
afford to cover health care expenses of
the poorest
population the government
must structure the health system in such
a way that the poor are really given the
necessary subsidy or assistance
including or in conjunction with the
private sector the private sector is
willing to
help it cannot be equal for everybody in
terms of the financial uh return or the
uh or assistance that you give to the
patient State Health Insurance firm Phil
Health however has drawn Flack for
delayed payments of its Financial
Obligations to private hospitals public
Health experts say premiums remitted to
fill Health should be treated as your
contribution to fund health care for
those in need and a reflection of the
values you hold as a nation to prevent
overloading hospitals doctors say
preventive care and early diagnosis are
key the government's plan is to build by
2028 at least 28 primary and Urgent Care
multip specialty centers
bukas to sound like the filipino word
for open they're meant for the 28
million poorest Filipinos the first such
facility opened in early
March doctors I spoke to say this
socalled bkas facility closes the
healthc care gap between village-based
Health Centers and tertiary hospitals it
has equipment and offers services not
typically done in rural Health Centers
such as minor surgeries for patient
patients not needing hospital
admission but reforms require funding in
the Philippines public healthare is
financed through the Health Department's
yearly National allocation a locality's
budget for health other social welfare
programs and a patients out of pocket
spending revenue from betting centers
managed by state run firm Philippine
charity sweep Stakes office are also
used to help pay hospital bills of indig
patients in 2012 the Philippine
government imposed so-called Sy taxes on
products like cigarettes the taxes help
fund the health department and state
health insurance firm fill Health Sy
taxes are also imposed on alcohol and
Advocates hope electronic cigarettes or
Vapes can be included in the future a
senate panel is probing some local
officials for allegedly blocking the
passage of an International Convention
calling for disclosures in the product
labels of Vapes among the direct
beneficiaries of syntaxes is this
Hospital the country's best and
brightest doctors train here at the
Philippine General Hospital the
country's largest tertiary government
hospital with less equipped medical
facilities and infrastructure gaps in
the provinces the most complex of
medical cases and are treated here at
the hospital of Last Resort
Dr Gerardo legaspi a surgeon popularly
known as Dr Gap is the hospital's
director he is Shoring up support from
funders and legislators to expand
Philippine General Hospital or PGH and
to set up more such hospitals in the
provinces the role of PGH in training uh
is probably one aside from the service
one of its biggest contribution to
society uh and to the health care in
general so uh we'd like to spread out
those centers so that we can not only
provide the service that we're providing
here but also to provide that training
and research opportunities the expansion
to cater to more patients is ongoing Dr
Gap says PGH whose emergency room serves
patients numbering over twice its
capacity is about giving patients their
last Ray of Hope former PJ doctors would
Resort to pulling in their allowances
each month to buy medicines for their
patients who can't afford them indeed
under privileged patients benefit most
from
PGH I spoke to those who for months have
been sleeping on the hospital sidewalks
waiting for their turn to receive free
painkillers or for a follow-up checkup
for an ailment all other hospitals they
went to could not treat the patients
needs are
overwhelming but the doctors are
pressing
on in the first place there was no plan
to leave at all so because my belief is
that you know all my needs in life uh I
I can have in the Philippines and in PJ
in up as a teacher as a surgeon as a
member of the community in mid-march a
fire broke out at the hospital briefly
displacing patients doctors went on
overtime but it was just a other days
work for
them Dr Gap the hospital director once
said that in order to survive PGH one
must Envision what PGH could be in the
[Music]
future what
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