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Inclusive health care

Ike Señeres . 

IN a manner of speaking, “inclusive growth” could just be a meaningless buzzword that could eventually lose its meaning in a sea of slogans. Maybe it’s just me who is saying it now, but the term could either be an oxymoron or a non sequitur, depending on who is talking. I say that it is an oxymoron, because by my own definition, “growth” is not planned as opposed to “development” that is supposed to be planned. Given that definition, I would say that there is no way to plan ahead to make “growth” inclusive, because growth could not be planned. On the other hand, it would be correct to use the term “inclusive development”, being a result of planned development. For whatever it is worth, “inclusive society” seems to be coming out of that sea of slogans, if it is not planned how the marginalized sectors (those who are now excluded) could be “included”.

For the lack of a better understanding, we could perhaps say that Universal Health Care (UHC) could be, or should be synonymous to “inclusive healthcare”. In my mind, it is really that simple because logically, if it is not “inclusive”, then it is not “universal”. By definition, “inclusive” means “everybody”, and that goes the same for “universal”. For the lack of a better term, I would say that “access” is the common denominator between inclusivity and universality. What I mean is gaining access to healthcare or to be more precise, “full access”. Perhaps that is what is meant by “no balance billing” (NBB), as in all hospital charges will be paid for by the government on behalf of indigent patients. If that is going to be the case, then it would really mean “universal access”, and it would really mean “inclusive”.

It would be fair to assume that rich people would be able to pay for 100 percent of their hospital bills, not unless they have become “needy”, at least so to speak. That is not the case when it comes to poor people, who would always have a balance to pay, not unless the government would pay for it on their behalf. That is actually one of the UHC law; for the government to pay for the PHILHEALTH premiums of the poor people so that they could have health insurance coverage just like the rich people. As I understand, that is where NBB would become useful, because as it should happen, the government should still pay for the rest of the balance, even if it has already paid for the premium that enabled the poor people to have health insurance coverage in the first place. As it actually happens however, even the large health insurance coverage of the rich people would not be enough if they fall victim to major medical expenses.

In theory, it could be said that if only there is no graft and corruption in the Philippines, we would have enough money to fund our own version of UHC, perhaps patterned after the Canadian and the Cuban models. As of now however, that would seem to be water under the bridge, because graft and corruption here may not disappear as fast as we want it, therefore socialized medicine may not appear here as fast as we want it to. However, there is one way to actually realize the goal of universality, by way of playing a numbers game. Towards that goal, we could say that if universality is synonymous to accessibility, then all we have to do is provide more access to more people, something that could be done through telemedicine, for example. The other way to increase the numbers is to provide access to more people with minor medical needs.

Perhaps very few people have noticed it, but a charity ward inside a government hospital is an aberration, actually an oxymoron also at the very least. That is so because a government hospital is supposed to be a charity hospital in its entirety. That is not simply a theory, because that is how it is supposed to be in the first place. On the other hand, as it is supposed to be, there is supposed to be a charity ward in every private hospital. Well, I say that is only how it is supposed to be, because the requirement is for private hospitals to make sure that 10% of their patients are charity cases. How else could that be interpreted? It could just be a play of words, but why not convince the private hospitals to put up charity wards. I do not know how and why it happened, but as of now, there are very few charity hospitals left standing. Perhaps we should really examine ourselves, and then try to bring back what ought to be.



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