Tag Archives: Philhealth

Filipino PWDs this March 2019

Amidst the current government measure providing mandatory health coverage1 to persons with disabilities (PWDs), the US State Department has reported in its annual human rights report2 that the latter “continued to face discrimination” in 2018 since the policy crafted by the National Council for Disability Affairs that same year to help them “was not effectively enforced”.

It pointed the inaccessibility of public buildings, limited transportation access, separate education centers, lack of a clear system to inform parents of PWDs with their educational rights, lack of a well-defined procedure for reporting discrimination in education, lack of offices dedicated for PWDs in 40% local government units, and discrimination in hiring and employment.

The US State Department seemed to forget to note, though, about the Mental Health Law (Republic Act 11036) signed into law in June 20, 2018. It will integrate mental health services, promote mental health services, protect the people who availed those services, establish a mental health council in the country, and prohibit discrimination against PWDs.

In any case, this month, the province of Camarines Norte has drafted its “Local Disaster Risk Reduction and Management Plan (LDRRMP)” for the next five years. The Toyota Motor Philippines (TMP) has also donated a 29-seater Toyota Coaster to the Philippine Paralympic Committee (PPC). Novels, textbooks, and other printed materials currently limited in distribution and production by copyright law were secured by the Intellectual Property Office of the Philippines (IPOPHL) for more than three million visually-impaired Filipinos.

Occupational therapy was also legislated recently. Entitled “Philippine Occupational Therapy Law of 2018” (Republic Act 11241), it has sought to create the Professional Regulatory Board of Occupational Therapy, which will issue or cancel registration and licenses for the practice of occupational therapy.

“It’s the repetition of affirmations that leads to belief. And once that belief becomes a deep conviction, things begin to happen.” ~ Muhammad Ali

Video taken from the YouTube Channel of the CNN Philippines

1The health coverage—mandated in the Republic Act 11228—will be under the Philippine Health Insurance Corp. (PhilHealth) National Health Insurance Program.

2The “Country Reports on Human Rights Practices for 2018” was produced by the US State Department on all countries receiving assistance and all United Nations member states since 1977.

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Mental health in the Philippines

After more or less 28 years, the law that could provide affordable mental health services for Filipinos has been signed.

Referred to as the Mental Health Law, the Republic Act 11036 would secure the rights and welfare of persons with mental health needs, provide services for them even in barangays, improve mental healthcare facilities, and promote mental health education in schools and workplaces.

It also aims to (1) provide psychiatric, neurologic and psychosocial services to the regional and other tertiary level hospitals, (2) add mental health service providers, and (3) introduce anti-stigma or anti-discrimination programs in schools and workplaces. Mental healthcare would not just be concentrated in urban areas anymore and would highlight the importance of research required to formulate and develop culturally-relevant national mental health programs.

The Mental Health Law has been signed by Senate President Vicente Sotto III and Senators Loren Legarda, Antonio Trillanes IV, Paolo Bengino Aquino IV, Juan Edgardo Angara, and Joel Villanueva.

A Human Right

Before the Mental Health Law was legislated, there have been at least 16 other bills focusing on mental health.

Former senator Orlando Mercado was the first one to file an act about it in 1989. The next year, another version was filed by Senator Jose Lina. Then in 2000, Executive Order 470 was issued, creating a council for mental health attached to the Department of Health (DOH).

The Philippine Mental Health Policy came into being in 2001, signed by former health secretary Manuel M. Dayrit. But it was revised four years after over 4.5 million cases of depression had been reported.

The figures went down as a result but the cases of anxiety and alcoholism have gone up in the succeeding years. Suicide, too, which was “seriously contemplated” by Filipino students as young as 13 years old. By 2012, 2,558 Filipinos died by suicide (World Health Organization) and 1 in 5 Filipino adults has some form of mental illness (Department of Health).

The destruction wrought by Typhoon Yolanda (Haiyan) across the central Philippines—particularly in Marabut, Samar, Carles, and Estancia—led the government to scale up its community mental health programs and train city and municipal health officers in identifying mental health problems. It spearheaded the first public health convention on PWDs in order to improve their access to health and wellness services.

Then it signed an administrative order in 2016 for the nationwide implementation of its mental health program. It also created a national hotline for mental health assistance in 2017. That same year, the Senate passed the Senate Bill 1354 or the Mental Health Act of 2017 that enable affordable and accessible mental health services to Filipinos.

Globally, more than 300 million people are living with depression so, in the Philippines,  the DOH together with the WHO and the Natasha Goulbourn Foundation launched Hopeline, a 24-hour phone-based counseling service for individuals who suffer from that. Other organizations that are helping are the Youth for Mental Health Coalition, Incorporated, Silakbo PH, Isanliyab Servant Leaders’ Union, and Where There Is Hope (WTIH).

Mental health is important because all aspects of people’s lives is affected by it. Depression, suicidal ideation, and bipolar disorder are currently the most common mental health problems in the country, and one in every three Filipinos has a mental health problem1. There is only one psychiatrist for every 250,000 mentally ill patients, though, and the fund set aside for mental health is just five percent of the health department’s total annual budget2.

Furthermore, most of the mental health facilities and institutions are within the National Capital Region3. Most of the victims are overseas Filipino workers, residents of typhoon-prone areas, families that have abusive parents, and those that lived through disasters and violence.

With these in mind, The PWD Forum cannot but echo a Philippine senator’s hope for mental health in the country: that it will be eventually accepted as a genuine public concern that requires accessible medical care, consistent government support, and compassionate social understanding.

“Help is finally here. The Mental Health Law cements the government’s commitment to a more holistic approach to healthcare: without sound mental health there can be no genuine physical health.” ~ Sen. Risa Hontiveros

Video taken from the YouTube Channel of the GMA News

1This estimate was from a population survey conducted by the UP-Philippine General Hospital in Western Visayas more than 20 years ago. It was shared by Dr. Lourdes Ignacio, professor emeritus at the University of the Philippines College of Medicine, during her lecture on “Reaching the unreached: Integrating mental health care in general health care” before national academicians and national scientists of the National Academy of Science and Technology.

2From the allotment, 95% goes to the maintenance of mental health institutions and personnel’s salary.

3They are the National Center for Mental Health in Mandaluyong, Cavite Center for Mental Health in Trece Martires, Mariveles Mental Ward in Bataan, and psychiatric wards in the Philippine General Hospital, Makati Medical Center, University of Santo Tomas Hospital, University of the East Ramon Magsaysay Memorial Medical Center, and Metro Psychotherapy Facility.

Notes:

  1. Depression is a common and serious medical illness that can cause feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to suicidal ideation, which means thinking about or planning suicide.

Bipolar disorder, on the other hand, is an illness that causes unusual shifts in mood. Schizophrenia is a mental disorder characterized by failure to understand reality. Anxiety causes nervousness, fear, apprehension, and worrying. All of them—depression, suicidal ideation, bipolar disorder, schizophrenia, and anxiety—can be treated through medication, counselling, and social rehabilitation.

  1. In rural areas: mental disorders are a result of other-worldly spirits or witchcraft.
  2. The state-run insurance firm, Philippine Health Insurance Corporation (Philhealth) recently added mental illness under its coverage but for severe disorders and short- duration of confinement only.

Cancer in PhilHealth

Even though cervical cancer screening has been included in a diagnostic package three years ago, the Senate of the Philippines still sought to establish a Philippine Cancer Center as well as a national control program.

In the “Tamang Serbisyo sa Kalusugan ng Pamilya” (Tsekap), cervical cancer was among the medical conditions included in the Enhanced Primary Care Package by the Philippine Health Insurance Corporation (PhilHealth). A total of 15, 068, 028 indigent and sponsored members of the health company can go to either a private or a public hospital that is a Tsekap provider.

But there are still gaps in cancer care, Senator Joseph Victor Ejercito reasoned, so he filed Senate Bill 1850 or the “National Integrated Cancer Control Act”. It was approved on third and final reading to be able to, as its title implies, integrate policies for the prevention, detection, correct diagnosis, treatment, and management of cancer.

“Through the National Integrated Cancer Control Act, we can give cancer patients a choice, we can give them hope – hope that they will have an equitable and affordable cancer treatment and care especially for the underprivileged and marginalized Filipinos,” Sen. Ejercito was quoted saying in an article.

Under the bill, it will not only be cervical cancer that the PhilHealth can sponsor for but all types and stages of cancer in both adults and children. All member employees and voluntary members shall be covered and compensated by the sickness benefits of the Social Security System and the disability benefits of the Government Service Insurance System.

All health maintenance organizations would be required, too, to cover genetic counseling and testing, cancer screening, and diagnostic and palliative care. The University of the Philippines-Philippine General Hospital should establish the Philippine Cancer Center and a fund—the Cancer Assistance Fund—to ensure a steady supply of cancer drugs and cancer control related vaccines to patients.

Cancer is the third leading cause of adult death and the 4th for child morbidity in the country. There are an estimated 8 deaths per day for child cancer and up to 11 new cases and 7 deaths per hour for adult cancer based on the record of the Department of Health. This translates to almost 110,000 new cancer cases and over 66,000 cancer deaths every year.

“Through the National Integrated Cancer Control Act, we can give cancer patients a choice, we can give them hope – hope that they will have an equitable and affordable cancer treatment and care especially for the underprivileged and marginalized Filipinos,” Sen. Joseph Victor Ejercito

Video taken from the YouTube Channel of the Medical Observer

Job hunting for Filipino PWDs

Persons with disabilities in the Philippines have been given a chance to prove their worth.

In Makati, its deaf-mute residents have been invited in a job fair held at the Activity Center of the Ayala Malls in Circuit Makati. Among of the 26 companies that have been “intent of hiring persons with disability (PWDs)” are the George Optical, China Bank, Regalong Pambahay, Nail-A-Holics, Group Perspective Incorporated, CNT, Guill-Berns, BFL Bookstore, Market Place Christian Church Transport & Multi-Purpose Coooperative, Philippine Survey Research Center, and Receivers and Liquidators. There were also food establishments such as the Samjin Amook, The Burgery, Torch Circuit Lane, Fox Box, Dunkin Donuts, Andok’s Lechon, Rackshaack Circuit, Serenitea, and Mesa Restaurant; shopping centers such as the Mi Department Store, Rustans Super Center, Uniqlo, and Bench; and recruitment agencies Mirof Resources Incorporated and More Than Jobs. The Department of Labor and Employment (DOLE), Government Service Insurance System (GSIS), Home Mutual Development Fund (Pag-Ibig), and Philippine Health Insurance Corporation (Philhealth) were in the job fair, too.

In Quezon City, the Department of Labor and Employment (DOLE) has partnered with the 30 Rotary Clubs of District 3830 to conduct a one-day job fair where private companies and government agencies in Metro Manila have participated. Job-seeking PWDs or employers just have to register at philjobnet.gov.ph. The Department of Trade and Industry (DTI) and the Technical Education and Skills Development Authority (TESDA) will also provide livelihood and skills training during the event.

“The special activity will highlight compliance with the law mandating offices of government to set aside one percent of the positions to persons with disabilities. The same law, Republic Act 10524, encourages private enterprises with more than 100 employees to reserve one percent of their workforce to the disadvantaged persons,” the labor department stated in an article.

In Iloilo, seven PWDs have grabbed the chance for a possible employment in a two-day job fair facilitated by the Public Employment Service Office (PESO). A total of 124 companies offered more than around 60,000 job vacancies—most of which are for overseas employment—in malls as service crew and cashiers, in drug stores as sales clerk and pharmacy assistant, and in supermarkets as bagger and cashiers, among others. The Bureau of Fire Protection (BFP), Bureau of Jail Management and Penology (BJMP), Bureau of Internal Revenue (BIR) and Professional Regulation Commission (PRC) also joined the event.

While this is a welcome event, The PWD Forum hopes that the private companies that joined the job fair haven’t done so to exempt themselves from labor law compliance inspection for one year. Labor Secretary Silvestre Bello III has promised that immunity in an interview at the Jobs and Opportunities Fair for PWDs at the covered walk of Quezon City Hall.

“The law mandates that employer or business establishments to hire PWDs of at least 1 percent of their business compliment. If there’s a company that will hire more than one percent or will reach 10 percent, I will give immunity from inspection for one year.” ~ Silvestre Bello III

Video taken from the YouTube Channel of the International Labour Organization

Transporting healthcare

Aside from having to afford healthcare, persons with disabilities in the Philippines also have to struggle with transportation expenses to experience it.

The Senate has passed on third and final reading the Senate Bill No. 1391 last July 30. It sought to amend Republic Act No. 7277, otherwise known as the Magna Carta for Persons with Disability, and provide mandatory coverage from the Philippine Health Insurance Corporation. The House of Representatives, on the other hand, has approved on second reading its own version—the House Bill No. 8014–on September 5.

If finally signed into law, the PhilHealth will be required to develop exclusive packages for PWDs, taking into account their specific health and development needs. The 1.6 million PWDs in the country today won’t have to worry when they have to go to hospitals.

That is, if they could go to hospitals.

The mininum fare in public utility jeepneys (PUJs) as of February 8, 2017 is P6.50 while the minimum fare in public utility buses (PUBs) varies: P8.00 is the minimum for the ordinary buses since March 29, 2011 while P9.50 is the minimum fare for the air-conditioned ones. Both groups of transport vehicles are clamoring for a fare hike, though, citing the continuous increase of oil prices.

But “running mostly on diesel engines, [PUJs] are polluting and inefficient for city transportation,” cited in a report. “Passengers have little comfort and virtually no security or safety,” it was further noted, and “there is probably not a single jeepney plying the streets of Metro Manila that can pass even a fraction of safety necessities that every automobile must follow.”

So would the bills really help PWDs? The PWD Forum thinks it would if the current transportation woes would be addressed. Most PWDs come from the low-income class that the means to go to a hospital is important, too.

“Currently, only P2P buses are considered accessible to us. There is also a limited number and limited time for us to avail of such services. This is unfair compared to those without disabilities.” ~ Abner Manlapaz

Video taken from the YouTube Channel of the ABS-CBN News

Note: Currently, PWDs can avail medicine and hospitalization discounts at the same level as senior citizens for as long as they are certified as such and carry PWD cards issued by local governments.

Healthcare in the Philippines

“We are currently institutionalizing the unified implementation of the “No Balance Billing Policy” through which the government and our private healthcare providers can work out a system that will provide an order of charging of medical expenses.”

A year ago, President Rodrigo Roa Duterte signed into law the Anti-Hospital Deposit Law. No hospital shall “request, solicit, demand or accept any deposit” for any medical treatment starting then, and any violator would be punished by either imprisonment, fine, or both. The Philippine Health Insurance Corporation (PhilHealth) and the Philippine Charity Sweepstakes Office (PCSO) were also called upon for the implementation of this law: the first to reimburse the hospital or clinic for the medical costs and transportation services given to poor and indigent patients, while the second to provide medical assistance for the basic emergency care needs of poor and marginalized groups.

Much needs to be done to improve our healthcare system, which remains highly fragmented, resulting in disparity in health outcomes between the rich and the poor in the urban areas and rural. While investments in health have increased over the years, several policy and operational bottlenecks have constrained universal health care for this country.”

But the Private Hospitals Association of the Philippines, Inc. (PHAPi) was against it. As soon as the implementing rules and regulations of the law were released, they filed a petition to the Supreme Court to nullify the Act Strengthening the Anti-Hospital Deposit Law by Increasing the Penalties for the Refusal of Hospitals and Medical Clinics to Administer Appropriate Initial Treatment and Support in Emergency or Serious Cases. The penalties1  for health facilities that refuse to take in emergency patients who cannot pay in advance is “unconstitutional,” “unreasonable,” and “amounts to denial of due process.” Directing the PhilHealth and the PCSO to reimburse basic emergency care costs to “poor and indigent patients” is violative of the equal protection clause, too, amounting to involuntary servitude.

“We shall pool all our resources for health services under the [PhilHealth]; institutionalize primary care as a prerequisite to access higher level of healthcare; and supplement human resource gaps of the LGUs through a National Health Workforce Support System.”

So, as of now, the PhilHealth covers Filipinos regardless of their social status. An amount—termed as the “case rate amount”—would be deducted from the member’s total bill, which would include the professional fees of attending physicians, prior to discharge2. Filipinos can also turn to the Department of Social Welfare and Development (DSWD) to get free prescription medicine through its Assistance to Individuals in Crisis Situations (AICS) program3.

“These will ensure that every Filipino family gets the appropriate, affordable, and quality health services in appropriate facilities and will be protected from financial burden due to sickness.”

Indigents, government employees, services workers, and those “determined by DSWD social workers” can benefit from the program through referral letters to the department’s partner-drugstores and hospital pharmacies. They must just submit their medical certificate, doctor’s prescription, indigent card, and valid ID to the DSWD Crisis Intervention Unit (CIU) located at the Central Office, field offices, and satellite offices in the provinces.

“To this end, I urge the speedy passage of the Universal Health Care Bill authored by Former Representative Harry Roque. Strong political determination, not political ambition, is the guiding light.”

The Universal Health Care bill will automatically include Filipinos into the National Health Insurance Program (NHIP). The House of Representatives has already passed its third and final reading on this in September 2017, while the Senate’s counterpart measure is still pending at its committee on health. It will be most beneficial to PWDs and tobacco victims, Emer Rojas, president of the New Vois Association of the Philippines (NVAP) was quoted as saying in a report, since it will ensure that they are especially provided for with their respective healthcare needs.

One of the most important thrusts of this administration’s medium-term development plan is to cover all Filipinos against financial health risks. That is why I have directed concerned agencies to streamline the various sources of financial assistance for people with health-related needs.” ~ Pres. Rodrigo Roa Duterte 

1The Republic Act No. 10932 further notes imprisonment from four to six years, or a fine from P500,000 to P1,000,000, to directors or officers of hospitals or clinics, or both. The facility’s license to operate will also be revoked after three repeated violations, and a presumption of liability shall arise against the hospital and its employees. 

2 Filipinos must just go to any PhilHealth office to register, fill out two copies of the PhilHealth Member Registration Form (PMRF), submit the PMRF to the human resources department, then await the member data record and PhilHealth ID card from employer. The contributions are shared by the employee and the employer, and could be paid monthly, quarterly, semi-annually or annually.

Filipino senior citizens can apply as well as those who are unemployed or self-employed. Overseas Filipino workers (OFWs)—documented or undocumented—can register, too. They only have to pay ₱2,400.00 annually or in two increments (₱1,200 every six months). Members could then have 45 days hospitalization allowance after paying at least 3 months’ worth of premiums within the immediate 6 months of confinement. Nine months’ worth of contributions in the last 12 months is needed, on the other hand, for pregnancies, the new born care package, dialysis, chemotherapy, radiotherapy and selected surgical procedures. The attending physician(s) and the health care institutions (HCI) must also be PhilHealth-accredited.

Video taken from the YouTube Channel of Rappler