Need to prioritize health services in 2021 budget

Think tank IBON says proposed 2021 national budget neglects public health

MANILA – Health care will remain inaccessible and expensive for many Filipinos with the lower budget for public health in the proposed 2021 national budget.

According to research group IBON, the pandemic underscored the lack of capacity in the privatized health system. However, the group expressed concern over fleeting increase in health spending and cuts next year in important health areas.

The Department of Health’s (DOH) budget is at least P171.5 billion in 2020 with P104.5 billion under the General Appropriations Act (GAA) 2020, P49 billion under Bayanihan 1 law, and at least P18 billion under the recently passed Bayanihan 2 or Republic Act 11494. Meanwhile the proposed P131.7 billion DOH budget for 2021 is P39.8 billion or 23.2% less than this year’s appropriation.

In a statement, IBON said the proposed 2021 budget for Health Facilities Enhancement Program (HFEP) covering the building of health infrastructure and purchase of medical equipment is just P4.8 billion. This is 62.9% less than this year’s P12.9 billion composed of P8.4 billion under GAA 2020 and P4.5 billion under Bayanihan 2.

The research group said the HFEP budget is actually been falling steeply under the Duterte administration in the regular GAAs even before the pandemic. It was P30.3 billion in 2018, P15.9 billion in 2019 and P8.4 billion in 2020. From the P1.1 trillion infrstructure program for 2021 only allots P2.3 billion or one-fifth of one percent (0.2%) to the DOH, which h is also a 36.7% cut from the GAA 2020.

Health privatization-driven budget cuts for public health facilities like this have already cause public hospitals numbering to 730 in 2010 to fall to just 433 in 2018.

It was also learned the proposed 2021 budget for health workers and supporting the operation of DOH hospitals also falls by P1.7 billion or a 2.6% cut, from P64.3 billion in 2020 to P62.6 billion next year. This is because the P12.6 billion increase in Human Resource for Health (HRH) and DOH hospital budgets in the GAA 2021 from GAA 2020 is off-set by the discounting of P13.5 billion in fleeting support under Bayanihan 2.

The government has played up how the 2021 budget for Human Resources for Health (HRH) Deployment increases to P16.6 billion form P10 billion in 2020 to hire 26,035 health workers. This, according to IBON, seems urgent because the government doctor-to-population and government nurse-to-population ratios have been worsening under the Duterte administration, between 2016 and 2018, from 1:32,644 to 1:33,909 doctors and from 1:17,269 o 1:17,769 nurses.

According to Alliance of Health Workers (AHW), the increase is only temporary and does not indicate a sustained increase in health workers for the public health system. They said that 14,553 DOH plantilla positions will remain vacant in 2021 with public hospitals remaining understaffed and government health personnel still overworked over the long-term.

It was also projected that 23 out of 66 DOH hospitals, most of which serve the poor, will see their maintenance and other operating expenses (MOOE) budgets cut P4 million to as much as P209 million. IBON noted how the budget of two COVID-19 referral government owned-and-controlled (GOCC) hospitals will also be cut next year. The Lung Center of the Philippines sees a 2.9% budget vit to just P405 million in 2021 and the Philippine Children’s Medical Center (PCMC) a 13% cut to just P1 billion.

The budgets for the National Reference Laboratories (NRL) and Health Information Technology (HIT), which are important in detecting, testing, databasing and reporting coronavirus cases and other emerging diseases, ae also slashed. The proposed allocations for NRL decreased from P326 million to P289 million while the and HIT budget decreased from P1.2 billion to P97 million,

According to IBON, the second biggest chunk of the proposed 2021 health budget or P71.4 billion, still goes to PhilHealth. While noting recent corruption controversies in the agency, IBON said it is difficult to reconcile the unchanged budget with increase health expenses of Filipinos. At the same time, the group said government resources are better spend on expanding and improving the public health system rather than subsidizing private health sector profits.

Finally, IBON said the Duterte government should increase funding for health infrastructure, personnel and operations. Filipinos right to health and affordable health care cannot be realized if, as is happening today, more and more of the country’s health system is being turned over to the profit-driven private sector. The current arrangements will result in expensive health care with shortage in capacity, which the pandemic has shown and revealed its insufficiency for public health emergencies. (Melo M. Acuña)

Philippine Heart Center is one of the country's top hospitals. (File photo/Melo M. Acuna)