Health Policy Network

No medicine for poorest Pinoys

CLD.HPN — Wed, 21 Apr 2010 07:39:00 GMT

(From Manila Times, Tuesday, 09 March 2010)

THE banner of the Inquirer on Monday “More Pinoys poor, GMA adviser admits” did not surprise anyone.

For the fact reiterated in the banner is known to most Filipinos.

It is personally known especially by those who make up more than 50 percent of the population who live below, on and just barely above the poverty line, and even those who used to belong to the shrinking middle class and have become poor but are still maintaining, painfully, their better-than-poverty-stricken lifestyle.

It was also not a surprise that the statement that gave the banner a bite had come from Gov. Jose Salceda of Albay. Salceda is he who had said of the President, in connection with the streak of economic expansion that makes banks and international agencies respect the Arroyo administration, that she is “one lucky bitch.”

Salceda said, according to the Inquirer, that his biggest frustration was seeing that the 34 quarters of uninterrupted economic growth in the nine years that Mrs. Gloria Macapagal Arroyo has been president “did little to reduce poverty and the number of poor people.”

New medicine policy not helping poor

Newly released findings of an Asian Institute of Management center confirms the depth of poverty in our country in respect to poor people and the medicine they need but cannot afford to have.

The study finds that the newly introduced medicines policy—just like the Gross Domestic Product growth or economic expansion the Philippines (or rather the Filipino rich) has enjoyed these past nine years—has not benefited the poor of our country.

The Center for Legislative Development (CLD), an independent policy research center, finds that the latest government drug policy that sets price ceilings on some essential medicines has been ineffective.

The new cheaper medicines law and policy have failed to improve the poor’s access to medicine. Why? Simply because the sick who are poor don’t have money to buy these medicines even at the current reduced prices.

The study involved surveys in known poor barangays in Manila, Caloocan and Quezon City. It found that even with the substantial reduction in prices of medicines, the poor still find it difficult to buy the number and quality of drugs they need to cure or control their illnesses.

The survey was done a month after the initial implementation of the Access to Cheaper and Quality Medicines Law.

Most respondents in the surveys reported that they only sporadically or even rarely purchased maintenance drugs prescribed by their physicians. A key finding in the study confirmed that access to medical care, i.e., the availability of a doctor, is a key factor in determining access to medicine.

Without regular consultations, respondents resorted to relying on other sources for information such as drugstore clerks, neighbors or relatives, to determine their medicine purchases. Physicians warn that consumption of prescription medicines should be under the supervision of a qualified medical practitioner.

This is because the most common illnesses—such as hypertension, diabetes, and arthritis—are long-term, chronic illnesses. Irregular consumption or consumption of the wrong medicines means most of these poor patients are in fact putting their lives at greater risk.

The study concludes that the Filipino poor are so poor that price cuts would not result in their greater access to medicines and that the policy to mediate access to medicines through pricing intervention would benefit mainly middle-class poeple who already have access to medicines.

Prof. Emmanuel Leyco, CLD’s Executive Director who specializes on health care financing, reiterated a conclusion found in many earlier studies: “If the government wishes to reach the poorest sector, it may have to explore other means, like adopting a drug subsidy program for the poor, financed and administered by the national health insurance program.“

Prof. Leyco said the current price reduction policy could only result in broader access by the poor if it is combined with a drug procurement program by government that targets priority diseases and population segments in known poor geographical areas.

The poor are too poor, price cuts do not result in greater access to medicines

CLD.HPN — Wed, 21 Apr 2010 07:19:13 GMT

MAKING MEDICINES ACCESSIBLE to the poor is essential in attaining the policy goal of health equity for all.

A recurring policy theme that the government has adopted towards this goal focused on the prices of medicines that many considered were beyond the reach of the poor majority. Towards this end, the government has, by way of legislation and executive orders, sought to bring medicines, especially those used to cure or control the most common diseases, within the reach of even the poorest households. Among the measures that have been adopted was the Generic Drugs Law that mandated the use of generic names in prescribing, labeling and marketing of drugs to give consumers more choices and discretion in their purchase of drugs, other than relying on more expensive “branded” drugs. Recently, the government took more unprecedented steps to bring down the price of the most essential drugs. These included the importation of cheaper medicines from neighboring countries, the establishment of small neighborhood pharmacies selling medicines at subsidized prices, and the outright imposition of a price ceiling on medicines most in demand.

The expectation is that, with the prices of the most essential medicines brought down to at least half of their previous cost, the Filipino people, but especially those living below the poverty line, would have greater access to the medicines they need to maintain their health.

To examine its impact, CLD's Health Policy Network surveyed the residents of six barangays in three cities in Metro Manila: Manila City, Caloocan and Quezon City. While the samples were too small to stand for the national population, the findings of the survey do give a picture of the health behavior of the poorest sector, and their attitudes towards seeking to cure or control their illnesses.

A major finding is that, even with the price ceiling on medicines lowered considerably, the poor still find it difficult to buy the number and quality of drugs they need to cure or control their illnesses. Most of the respondents reported sporadic or even rare consumption of medicines. Another finding is that access to medical care, i.e., the availability of a doctor, is a key factor in determining access to medicine. Without regular consultations, respondents reported relying on other sources for information such as drugstore clerks, neighbors or relatives, to determine their medicine purchases. Since the most common illnesses, such as hypertension, diabetes, and arthritis are long-term, chronic illnesses, irregular consumption or consumption of the wrong medicines means most of them are in fact putting their lives at greater risk.

The study concludes that the Filipino poor are so poor that price cuts would not result in greater access to medicines and that the policy to mediate access to medicines through pricing intervention would benefit mainly the middle-class who already have access to medicines. If the government wishes to reach the poorest sector, it may have to explore other means, like adopting a drug subsidy program for the poor, financed and administered by the national health insurance program.

HPN study finds Philippine healthcare financing system seriously underfunded, inequitable

CLD.HPN — Sun, 06 Sep 2009 04:17:00 GMT

A recent study by the Center for Legislative Development and the Health Policy Network finds the Philippine health care system seriously underfunded and characterized by acute inequities that leavethe poor without reliable access to the health care system.

Despite recent policy moves that seek to address such inequities, the poor remain vulnerable and questions remain whether they will be actually benefited with increased access or merely reinforce the access of those who already enjoy them.

Over 15 years since Congress passed the National Health Insurance Act of 1995, inequities pervade notwithstanding the over all improvement in health outcomes. The Act established the National Health Insurance Program (NHIP) and created the Philippine Health Insurance Corporation (PhilHealth) as its financing vehicle with a clear constitutional mandate that “the State shall adopt an integrated and comprehensive approach to health development which shall endeavour to make essential goods, health and other social services available to all the people at affordable costs.”

The NHIP has set2015 as goal for providing coverage for all Filipinos as mandated by the law. Just a few more years before its goal,studies suggest that a vast majority of Filipinos still remain inadequately covered by the national health insurance program.

The CLD-HPN study is available at CLD's website: http: cld.org

Quality issues in delivery of health care services: A policy perspective

CLD.HPN — Fri, 15 May 2009 01:42:00 GMT

As a paramount national concern, access to health care has mobilized policy makers and stakeholders to consider urgent steps to bridge the glaring gap between access to health care by the poor and the rich. But access is just one of the indicators of health care inequities that policy makers must address now.

Depending on one's ability to pay, Filipino patients may enjoy the best state-of-the-art care that is comparable to the best there is in highly advanced countries. But a much larger portion of the population has to do with improvised health care technology like the fabled makeshift incubators used by cash-strapped health care facilities in remote health care facilities.

How do we ensure that policy initiatives address health care inequities rather than perpetuate them? How do we distinguish policies that were pushed in the name of the poor but does very little for them?

To explore these issues, we would like to invite you to a policy discussion on "Quality issues in delivery of health care services: A Policy perspective on May 27, 2009, Wednesday, 9 am to 11 am at the AIM Conference Center, Benavidez corner Trasierra Streets Legazpi Village Makati City.

To reserve a seat for the forum, please call Netsky at 750-1010 local 2072 or email us at healthpolicy@cld.org.

Media forum on softening the impact of the global economic crisis on the health sector, March 19 at the AIM Conference Center in Makati City

CLD.HPN — Tue, 10 Mar 2009 15:01:00 GMT

On March 19, the Center for Legislative Development International (CLD) and the Health Policy Network will hold another roundtable discussion aimed exclusively for media professionals to discuss policy options to soften impact of the global financial crisis on the health sector.

Without much fanfare, the global economic crisis landed on our shores when the first batch of displaced Filipino overseas workers in Taiwan returned jobless. This was immediately followed with the closure of Intel processor company and the last flight of FedEx from Subic a few weeks ago.

In fact, the International Labor Organization has warned that the crisis could push more than 140 million people in Asia into extreme poverty this year due to widespread unemployment. Locally, social analysts have aired their concern that the combined effects of extreme poverty and unemployment could lead to a catastrophe for millions of Filipinos who are dependent on the private and government health insurance system.

The media forum will be held March 19, from 10 am to 12 noon at the AIM Conference Center in Makati City. For further details, please call Ms. Netski Pinili at 750-1010 local 2072 or 703-1245.

Reducing prices not enough to help the poor

CLD.HPN — Wed, 25 Feb 2009 01:36:00 GMT

By Cris G. Odronia, Reporter
The Manila Times, February 25, 2009

Reducing the prices of medicine is not enough to improve health care in the Philippines, an executive director of the Center for Legislative Development International said Tuesday.

According to Prof. Emmanuel Leyco, “a pricing policy response is not going to work” because even if medicine prices are reduced, only those who can afford to buy them will benefit.

In his presentation at the Kapihan para sa Kalusugan forum held at the Asian Institute of Management, Leyco said some of the factors that impede access to health care services are availability, affordability and accessibility.

Citing the recent Family Income and Expenditures Survey, Leyco said about 70 percent of the population do not have access to health care services not only because of the prevailing market prices of medical care but also because of their low income.

He pointed out that among the top 10 expenditures of the Filipinos, medical care has ranked No. 8. The No. 1 expenditure is food, followed by house rent and transportation and communication.

He said government’s attempt to keep a tighter control on health care facilities and price levels of medicines in the Philippines through the passage of the Anti-Hospital Detention Law and the Cheaper Medicines Law, will have little impact on the medical needs of the poor.

“It [Cheaper Medicines Law] was a very sincere effort. [However], what was not considered was the people purchasing power profile and spending pattern,” he said. “These are the two major aspects [that need to be considered."

Leyco argued that even if the government would reduce the prices of the medicines, the poor ones, especially those who have no savings, “particularly the bottom 50 percent of the population, would not be able to benefit from it.”

For the poor ones to have access to health care, the government has to give it for free, Leyco said. But if they are given medicines, the poor have other things to worry about such as access to hospital facilities.

“We need to have a focused targeted health policy,” Leyco said, adding the government has to focus on rural areas.

Citing the figures from the National Statistics Office and the Department of Health, he said there is an uneven distribution of healthcare resources and physicians and nurses in the country. Majority of the nurses and doctors are operating in the National Capital Region.

Kapihan Para sa Kalusugan

CLD.HPN — Wed, 18 Feb 2009 13:18:00 GMT

CLD, through its Health Policy Network project will launch its first Kapihan Para sa Kalusugan, a media forum to tackle policy issues of the day. The first Kapihan will be held on Tuesday, February 24, 2009 from 9 am to 11 am at the Duet's Bistro, located on the 5th Fl of the AIM Conference Center, Benavidez corner Trasierra Streets, Legazpi Village Makati City .

Rationale: Lack of access to health care services by millions of Filipinos has prompted the country's lawmakers to adopt new laws to address the perceived financial barriers that prevent access by the poor to health care services.

CLD's research team, however, examined the issues and found that the barriers to health care access are deeply entrenched in the country's socio-economic structure and that drug price control policy will only have limited effects.

CLD's study shows that such will benefit mostly those who can already afford to buy their medicines. CLD recommends that a comprehensive health care reform, anchored on a health care financing reform be pursued to ensure the Filipinos� access to affordable and quality health care services.

For more details, please call Netsky Pinili, CLD Secretariat, Telephone Nos. +6..., local 2072 , Direct line: +6...

HPN as Stakeholders' Forum for Health Care Reform

CLD.HPN — Tue, 27 Jan 2009 14:05:54 GMT

Lack of access to health care services by millions of Filipinos have prompted the country's lawmakers to take major steps to address this issue while pinning down health care cost as the major culprit. Bills and new laws were adopted to address the perceived financial barriers that prevent access by the poor to health care services.

A law, oddly known as the "Anti-Hospital Detention Law," was passed that now explicitly mandates hospitals to treat patients without requiring "deposits" or be discharged from the facility even prior to fully settling their accounts.

Last year, an encompassing legislation was also passed to control drug prices, allow importation of lower priced medicines and early development of generics for patented drugs.

To help sustain the momentum on health care reform, the Center for Legislative Development (CLD) initiated the Health Policy Network (HPN) as a forum in further exploring options to enhance access and delivery of quality health care to Filipinos, especially the marginalized poor.

CLD is a Philippine-based non governmental organization that assists in the capacity development of national and local legislatures and promotes broad citizen participation in the legislative process.

As a virtual forum, this blogsite is intended to stimulate health policy discussions among stakeholders by making their views known regarding issues that affect access, affordability and delivery of quality health care services.

CLD will also post event announcements and results of its studies on relevant health care issues and invite comments and suggestions from readers.

The CLD-HPN Secretariat