Saturday, April 19, 2008

Is There Really A System?

I was again invited to participate in the blog rounds. This is actually the 6th edition and my fourth time to contribute. The topic chosen by the host, Merrycherry is very interesting indeed for it concerns the Philippine healthcare system which we doctors are a part of.

When I received her invitation to participate, I sarcastically commented on her blog post that the Philippines has no "system" of healthcare at all. That was purely sarcasm... yes our "poor" (pun intentional) country has a healthcare system but sad to say it sucks!

First and foremost, like what has been lamented by each and every Health Secretaries, past and present, health was, is, and will never be one of the Philippine government's top priorities (not in Arroyo's time anyway). I don't reckon they care about the nation's health at all. The total appropriations for the Department of Health for 2007, according to the Department of Budget and Management is Php 11,562,704,000.00. At first glance... WOW that's a lot of moolah but in reality that's only a booger comparing to more than 1 TRILLION peso annual budget. Well, in case you do not know, Mrs. Arroyo... health is wealth. So the next time you check-in at St. Lukes' suite room for a check-up, think about the millions of your kababayans in dire need of being healthly as well. I cannot compare the Philippine Healthcare system with Australia's Medicare. There is no point of comparing... ang layo talaga at ang laki ng kaibahan! All I know is that Australia's health is being take cared of very meticulously by the Federal Government and the State Government as well.

Secondly, corruption will always be a stigma to the Philippines. Hell, it runs through the veins of many public and private officials already. What more can we do about it? (unless we execute them all ;) ). The lagayans, SOP's, padulas, 10%'s... these will NEVER stop. I am not saying all officials are like that but almost all are! What will you do to a very small budget and part of that budget goes to the pocket of hungry corrupt crocodiles and personnel. Whew, I can't imagine the headache, Secretary Duque is having everyday. I pity the good man.

Thirdly, my personal opinion is that doctors are not taken cared of in our country. I can only shake my head in disgust! Why do you think doctors leave the country and work as nurses, pathology collectors, AIN's? Just answer that question yourselves. Which reminds me of my salary when I was a Paediatric resident in 1998, its a meager Php 2,500 per month. Doctors are being damn abused and used! And what is the lame excuse of these so called training hospitals and university hospitals? Oh, its because you are still under training...that's bull$h!t isn't it? Interns, resident doctors and fellows man your hospitals while your arses are snoring at home, don't you think it is unfair? I say, doctors in training should be given what they truly deserve. Good living quarters, free decent food, free uniforms, good salaries and most of all put an end to the bull$h!t thing of making them work on a 24 hour shifts, hell that is a no, no! Here in Australia, doctors in training work 10 or 12 hours,max, per day and they surely earn heaps

Another thing is that the dispensing of medicines and drugs is very, very, very, very, very, very, very, very, very, very lax in the Philippines. Medicines are being sold to the public even without prescriptions. Mercury Drug is the only winner with regards to this problem. People no longer go to doctors, all they need to do is go to the nearest Mercury drug outlet and ask the saleslady or salesman there what is the medicine for this and that. I experienced it myself. I still can recall how I scolded a woman and a Mercury Drug saleslady. I was buying my anti-hypertensive maintenance drugs when a woman besides me started asking the saleslady for a cough medicine for a child, as if she was consulting a doctor. This good for nothing idiot saleslady asked, "how old?" and the woman replied 2 years old. She said "ahh, Dimetapp po" I couldn't helped it so I butted in. I introduced myself as a doctor, not that I want her child to be my patient, I told her not to consult a saleslady who obviously has no idea what she is talking about and instead bring her child to a doctor.

Another problem related to the drug dispensing thing is that our Barangay health centres are not manned by doctors. Instead they are mostly manned by "know-it-all" midwives who almost always prescribe and give "Cephalexin" left and right. Good if they know the correct dosage and duration of treatment but most if not all the time they do not. For me that is a major reason for drug resistance! Again it boils down to lack of doctors... secondary to lack of funding, secondary to poor government prioritisation, etc, etc.

Lastly we Filipinos do not value our own health. Many are guilty of that and that is a fact. We do not eat right, we do not exercise regularly, we do vices. These are small things that should be first in our priorities as individuals. For we cannot do anything anymore if we are already 6 feet under the ground.


Anonymous Anonymous said...

You should also look into the health budgets of local government units, which I believe is MUCH MUCH MORE relevant to the country's present health situation than the DOH's budget because most healthcare services have been devolved since over a decade ago. As far as I know, the DOH has been advocating for increased local health spending (~20% of the local budget should be allotted for health) but some local chief executives (mayors, governors) aren't just prioritizing the health of their constituents. Hindi naman puwedeng diktahan ng DOH ang mga opisyal na ito.

3:52 AM  
Blogger Ness said...

You hit it right on the head, Abner!

12:50 PM  
Blogger MerryCherry, MD said...

The Blog Rounds 6th Edition here. Thanks!

Doc Abner, to the defense of my midwives, in a set-up where there is no MD most of the times, people expect them to KNOW-IT-ALL. That's why when an MD comes, they act like they do know it all. You'd be surprised at what is expected of them. :)

12:09 AM  
Anonymous Anonymous said...

I agree with you 100% Doc Abner. Alas, the problem is not only with the healthcare system. The entire nation is adrift, no direction.

That is the problem when there is no governance, leadership, direction.

3:20 PM  

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