Philippines Battles Health Inequities: From Medical Costs To Worker Shortage | CNA Correspondent

Summary

The 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

00:00

💼 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.

05:00

🏥 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.

10:02

🛑 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.

15:03

🏥📈 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.

20:04

🌆 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.

Keywords

💡Guer

Guer, short for goiter, is an enlargement of the thyroid gland. In the video, it is mentioned as the medical condition of the Filipino mother of four, Amita Depra, which she was diagnosed with two months prior. The condition is significant as it affects her ability to afford medication and highlights the broader issue of healthcare affordability in the Philippines.

💡Manicurist

A manicurist is a professional who performs nail care services, such as applying polish, shaping nails, and providing nail art. Amita Depra works as a freelance manicurist in Metro Manila, which is her temporary job while she hopes to secure an overseas job opportunity. This reflects the economic situation where many Filipinos seek work abroad due to better opportunities.

💡Out-of-pocket health spending

Out-of-pocket health spending refers to the costs borne directly by the patient for healthcare services, without insurance reimbursement. The video mentions that a significant portion of the poorest and richest Filipinos' healthcare expenses are out-of-pocket, indicating the financial burden on individuals due to high medication costs.

💡Supplements

Supplements in the context of the video are non-medicinal products marketed as alternative cures for various ailments. Amita Depra turns to cheaper supplements due to her inability to afford prescribed medication, which raises concerns about the efficacy and safety of such unregulated products as highlighted by the World Health Organization.

💡National pool of medicines

A national pool of medicines is a centralized system for procuring and distributing essential drugs in bulk to reduce costs. Advocates in the video suggest this approach to lower medicine prices in the Philippines, which are currently high due to separate purchases by localities and medical facilities at varying prices.

💡Innovator Brands

Innovator Brands refer to pharmaceutical companies that create and market new, patented drugs. The video discusses the argument from the pharmaceutical sector that revenues from these brands are crucial for funding research and development of new medicines, implying a balance between affordability and innovation.

💡Healthcare workers

Healthcare workers encompass a broad category of professionals involved in providing health services, including doctors, nurses, and midwives. The video discusses the challenges faced by these workers in the Philippines, such as low pay, job insecurity, and the risk of working in rural areas, which contributes to the migration of health professionals abroad.

💡Health equity

Health equity refers to the fair distribution of healthcare resources and opportunities, ensuring that everyone has access to quality healthcare regardless of their social or economic status. The video highlights the disparities in healthcare access and affordability in the Philippines, particularly the struggle faced by the poor to afford necessary treatments.

💡Sy taxes

Sy taxes, or sin taxes, are levied on products deemed harmful to health, such as tobacco and alcohol. The video mentions these taxes as a funding source for the health department and state health insurance in the Philippines, suggesting a strategy to finance public health initiatives.

💡Primary and Urgent Care multip specialty centers

These centers, referred to as 'bukas' in the video, are part of the government's plan to provide healthcare services to the poorest Filipinos. They are designed to bridge the gap between village-based health centers and tertiary hospitals by offering a range of services, including minor surgeries and laboratory services, which are not typically available in rural areas.

💡Philippine General Hospital (PGH)

The Philippine General Hospital is the country's largest tertiary government hospital, often referred to as the 'hospital of last resort.' The video discusses the hospital's role in training medical professionals, treating complex medical cases, and providing free services to underprivileged patients, illustrating the critical importance of such institutions in addressing healthcare inequities.

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