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Republic of the Philippines

BATANGAS STATE UNIVERSITY


Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

MECHANICAL ENGINEERING DEPARTMENT


GEd 105 – Readings in Philippine History
Research Paper
President Rodrigo Duterte's 2018 State of the Nation Address

The Filipino’s Health under Duterte’s Administration

ABSTRACT

The Republic of the Philippines is characterized due to the serious social and economic

inequalities, with 26% of the population in poverty. Government health services and access

expenditure have been limited. Collecting the vote of numerous poor Filipinos, Rodrigo Duterte

was chosen to the Presidency of the Republic of the Philippines on May 9 and inaugurated on

June 30, 2016. In the Western media, he has been denounced for his statements as the "Trump

of the Philippines" and for the legal and orderly policies of his term as Mayor of Davao City, He

was called "The Punisher" or "Harry Duterte.". In reality, be that as it may, he is a more intricate

figure, who made peace with Muslims and Communists while filling in as Mayor. Since the

election, he has taken liberals in his cabinet and declared a unilateral ceasefire with the

communist uprising. He has promised to set up social policies to lift the poor, including

improvements in access to health services. However, oligarchy will not give up its privileges and

its holdings easily, nonetheless. The health of the Filipinos will be influenced by what Duterte

manages to achieve during his six-year period.


Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

INTRODUCTION

The election of Rodrigo Duterte to the presidency of the Republic of the

Philippines on 9th of May of 2016 represented a deviation from the common political

landscape of the nation. Elected on June 30, 2016, Duterte took over the management

of Benigno S. Aquino III. Will the Duterte’s government be able to lead changes in the

social and economic order? Will the administration lead changes in the health aspect

that will lead to an improvement in the health of the Filipinos? For 22 years he has been

mayor of Davao City, the third most populated municipality in the country, located on

Mindanao, the southernmost island of the archipelago. The legal provisions for his

mayor's administration led to a fall in crime figures. Duterte’s peace with armed

insurgencies between Muslims and communists and accorded representation to the

Muslims and indigenous peoples in the municipal administration. Since his presidency,

out-of-court killings or popularly known as extrajudicial killings have led to allegations of

vigilance and human rights violations.

During the presidential campaign, Duterte vowed to improve the poor system of

our country. In February 2016, he promised that if he is elected as president, he would

require all private hospitals to reserve 20 to 30 beds for the poor, with their expenses

paid by the government. Even though it is contrary to the Catholic Doctrine, Duterte still

pledged to make family planning more accessible to families who struggle to raise their

children - to curb population growth.


Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

In his State of the Nation Address last July 25, 2016, Duterte state that. Social

justice will be pursued, as will the rule of law. “My administration must implement a

more effective approach to the development and governance, while improving the

welfare of our people in terms of health, education, adequate food and water, housing,

environmental protection and respect for culture.”

President Rodrigo Duterte called on Congress to prioritize the implementation of

the Universal Health Bill during his 3rd State of the Nation Address (SONA) Monday,

July 23, 2018.

During his speech, Duterte said that there is a lot of room for improving the

country's health system. He cited a difference in the results among people who can and

can not afford current healthcare.

"There is a lot of work to improve our healthcare system, which is still very

fragmented, leading to a difference in health outcomes among the rich and the poor,

urban and rural," says Duterte.

The president also noted that "different operational bottlenecks and policies"

have limited universal health services in that country. He added that the administration

intends to "ensure that all Filipinos get the right affordable and quality health services at

the right facilities" and that citizens are also "protected from financial burden due to

illness".
Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

Duterte, through his spokesman, Harry Roque, had earlier noted the urgency of the

passage of the said bill.

The issue of the House of the Universal Health Law, approved in September last

year, states that all Filipinos will be covered by a national health insurance. He also

mentions that the current PhilHealth will be transformed into the Philippine Health

Security Corporation, which would pay medical fees and products.

FILIPINO’S CURRENT HEALTH STATUS

Classified by the World Bank as a lower middle class country, life expectancy is

expected at birth in the Philippines as 65 for men and 72 for women (2015). In the

United States life expectancy is 77 for men and 82 for women. Total healthcare costs

per capita are $ 287 (2013); 3 US spend $ 9146 per capita.

HEALTH SERVICES AND HEALTH WORKER DISTRIBUTION

The low cost per capita is reflected in the general lack of accessibility of health

services. Moreover, the existing services are unevenly distributed, with many poor, rural

and mountain areas lacking health workers and therefore health care. Some social

groups such as Muslims and indigenous people experience exclusion. Progressives

claim that seven out of ten Filipinos die without receiving medical assistance. In

addition, many of those who have received medical attention cannot afford drugs or

procedures that fit their condition.


Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

The salaries of health professionals in the public sector are low. In 2012,

professional nurses earned average monthly wages of 11,488 Philippine pesos (Php),

about US $ 250. Doctors earned an average monthly salary of PHP 22,870 (about US $

497). Wages that are too low in relation to the cost of education and the cost of living,

causes the health professionals to work abroad. The International Organization for

Migration reported that in 2012 15,655 Filipino nurses were taken over the border. The

Philippines is the country that contributes the largest number of nurses to the rest of the

world. It is the third after India and the U.K. in the number of doctors that it contributes

to the rest of the world.

HEALTHCARE FINANCING

The Philippine Society for Health Insurance (PhilHealth) was created by law in

1994. And revised in 2013, Enrollees provides contributions to health insurance

companies.

To qualify for benefits,

 Members had to make three monthly payments in the last six months. Phil-Health

pays health care workers and facilities for medical costs incurred. For indigent

patients who have previously received medical assistance at nominal cost or at

no charge at state-owned facilities, and whose care was therefore funded by the

government, PhilHealth changes part of the cost of the user who has to pay a
Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

membership fee. As more and more patients use private facilities, public funding

that was previously transferred to public facilities has been returned to private

suppliers.

HOSPITAL CORPORATIZATION AND PRIVATIZATION

Under the administration of Aquino, there are a number of hospitals that were

previously owned and managed by corporate or privatized public-private partnerships

(PPP). Because corporate organizations are responsible for their own funding; even the

poor are charged with user charges. For example Filipino Heart Center has been

transformed to attract private patients. National Kidney and Transplant Institute aims to

transfer patients to PhilHealth. This means that patients must face pocket expenses on

hemodialysis, medicines and hospital admissions. Patients with small hemodialysis are

encouraged to switch to peritoneal dialysis, which is difficult to perform. While the above

institutions are national reference centers, regional centers also undergo a process of

corporatization and privatization

SOCIAL DETERMINANTS OF HEALTH

Among the social determinants of health that affect the Philippine people are poverty,

unemployment, land shortages, geographical distance, environmental degradation,

vulnerability to disasters and social exclusion. While the Philippine economy achieved a

growth rate of 6%. In 2015, 26.3% of Filipinos (26.5 million of 100.7 million) lived below
Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

the poverty threshold, defined by the Statistical Authority of the Philippines as a

minimum income to meet basic needs, including food. In addition, 12.1% (12.2 million)

lived in extreme poverty, defined as inability to pay three meals per day. Certain regions

are more impoverished. In the Autonomous Community Muslim region of Mindanao

59% of the people live below the poverty threshold and 30.1% in extreme poverty.16 In

2015, official unemployment. The rate was 6.3%, and the unemployment rate was

18.5%.

POTENTIAL FOR CHANGING THE SOCIAL DETERMINANTS OF HEALTH

With portfolios such as social welfare, agrarian reform and work assigned to the

left, the administration of Duterte offers a possibility of opening up to changes in the

social determinants of health. On the day of its inauguration, Duterte invited the leaders

of Bagong Alyansang Makabayan (BAYAN), who were celebrating a concentration on

the street, at the Malacañang Palace, where they presented fifteen points "Popular

Agenda for Change" covering the five areas economic, social policy, governance, peace

and human rights, national sovereignty and foreign policy. A central issue is real land

reform, with the free distribution of land to landless peasants. When he was a member

of the House of Representatives of Anakpawis (peasant and labor party), the new

Secretary of Agrarian Reform, Rafael Mariano, proposed this legislation. By breaking

down the capture of large landowners and decreasing practices, such as land retention,
Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

one can expect to increase living standards and, therefore, the nutrition and health of

rural poor people. Without a doubt, the interests obtained are opposed to this agrarian

reform. The economic team at Duterte is not capable of planning drastic measures.

CONCLUSION

Will changes in the determinants of health lead to an improvement in the health

of the people of the Philippines?

The answers will depend on whether the Administration of Duterte has a political

mandate and power to continue the proposed reforms. The Democratic Party of the Bay

of Pilipino-Lakas Bay (PDP-Laban) controls the Senate and the House of

Representatives. Their legislative agendas will do so. They have an online approach

with the left-wing agenda, how to get peace conventions with the CPP-NDF and end the

work contract where workers are permanent temporary workers. However, other issues

of the Duterte program include the establishment of a federal form of Government and

restore the death penalty. Duterte also receives support from the right, which hopes to

continue many of the neoliberal economic policies of its predecessors.


Republic of the Philippines
BATANGAS STATE UNIVERSITY
Pablo Borbon Main II, Batangas City
College of Engineering, Architecture & Fine Arts
www.batstate-u.edu.ph Tel. No. (043) 425-0139 loc. 118

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