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DRIVING HOSPITALS OUT OF BUSINESS
The Philippine Star As if the dwindling number of highly skilled doctors, nurses and other health care personnel is not enough, here comes a new law that practically allows a hospital patient to merely give a promissory note in lieu of paying the bill. In essence, the law – Republic Act 9439 or the Hospital Detention Law – seems prone to abuse by sending out the message to private hospital “charity” patients that if you cannot pay the bills, just leave the hospital a promissory note, and yes, please attach a thank you note as well. Now, members of the Private Hospitals Association of the Philippines (PHAP), after suspending its plans last May, are bent on staging a hospital holiday twice a month in protest of the law which threatens the viability of hundreds of private medical facilities. One wonders whether the bill, sponsored by presidential candidate Sen. Manny Villar, is actually meant to protect the interests of both hospitals and patients or just a political investment-cum-stunt with expected dividends in three years time. Let's face it, while hospitals are mandated to deliver care and medical attention to patients, private hospitals are also business enterprises that need to get a return on their investment to avoid going bankrupt. A businessman before entering politics, Villar should know all about this. Under RA 9439, private hospital administrators/owners face penalties for detaining patients (except those treated in private rooms) who cannot pay their bills upon discharge. This new law may seem to be all heart, except that it overlooks the fact that, as hospital administrators have pointed out, out of every ten patients who submits a promissory note, only one would actually return to settle his or her bill. With the new law, what would prevent anyone from asking to be confined to charity wards of private hospitals, knowing that they could leave with only a promissory note? I'm not saying all types of patients, whether indigent or well-to-do, will or should try this, but reality dictates that with the new law, such a ploy opens a Pandora's Box. In fact, PHAP is saying that a growing number of patients are already refusing to pay up by invoking the law. What about hospital owners' bills? While hospital owners under the law are prohibited from detaining patients who cannot pay their bills, hospital owners certainly cannot get equipment, supplies, medicines and hospital staff services with simply a promissory note, especially when a mounting number of non-paying, promissory note-wielding patients have left them cash strapped. Surely, the thousands of homeowners did not present promissory notes to Villar's real estate company to pay for the houses that earned the good senator billions. The law may have addressed the woes of indigent patients, but disregarded a bigger problem: When private hospitals are led to near bankruptcy, would over-crowded but grossly under-funded and ill-equipped government hospitals take up the load? With a measly budget of around P12 billion this year out of the total national budget of P126 trillion, it is easy to explain why the public healthcare system cannot be as effective as it should be. The government, therefore, needs the assistance of privately-owned hospitals to take care of increasing number of charity patients. Philhealth? PhilHELP! There is a better way to ease the financial burden and assist patients unable to meet their hospital bills. This is by improving coverage and financial assistance by PhilHealth. For example, a simple procedure such a child delivery or an appendectomy in a private hospital may cost around P30,000 to P40,000. Yet Philhealth only covers around 10 percent of the bill, and only after a lot of paper work. A more significant and comprehensive coverage from Philhealth, minimal increase in contributions and a transparent and judicious handling of Philhealth funds, plus a significant increase in the budget allocated for public health are things that need to be done if we are to protect both indigent and paying patients and the private hospitals. Granting tax incentives to hospitals was also brought up by some quarters during discussion held between private hospital owners and the health department. Recent developments, however, point to the DOH as turning down most of the private hospital owners' recommendations and proposals during conferences to tackle the implementing rules and regulations of the law. With this impasse, we may just have to prepare for more problems in the health sector – the dwindling number of healthcare professionals, the threat of driving our private hospitals to bankruptcy, and public hospitals forever struggling to service millions of our poor countrymen. 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