Bernardo M. Villegas
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Greater Focus on Health Sector

          One blessing in disguise of the COVID-19 pandemic is the greater focus that Philippine society is now giving to the health sector.  On the part of the Government, there is a greater allocation of both operating and capital budgets to health-oriented services and projects.  In fact, part of the capital budget for the Build Build Build program is actually being shifted to more hospital and other health-related facilities.  Because of the perceived increase in market demand for both health-related products and services, businesses—both large and small—are expanding their exposure to the health sector.  We expect to see more business conglomerates following the examples of the First Pacific Group, the Ayala Corporation and the UNILAB group in investing in hospitals, clinics, and other related investments.  Since there is the general awareness that COVID-19 is here to stay, even if a vaccine is finally developed, private citizens will continue indefinitely into the future to practise the safety measures of washing their hands frequently, using all types of disinfectants on surfaces, wearing masks and social distancing.  These more or less permanent habits will surely create a bigger market for alcohol and all types of disinfectants, face masks and other Personal Protective Equipment (PPE) items.  There is a great probability that consumer expenditures on health-related items, which would include all types of products and services (like fitness gyms)  that increase immunity against all types of diseases,  will compete with what used to be spent on fashion goods, luxury items,  entertainment and even tourism.  To address this threat to their markets, products like Nike shoes are no longer positioning themselves as part of fashion goods but as indispensable for physical fitness programs!

         It is hoped that this greater awareness of the importance of promoting health for the general population will also trickle down to the the local government units (LGUs).  That is why, I would like to present the specific case of the Batangas province’s Health Integrated Management as a possible model for other LGUs.  This health integrated management was created as a response to the current implementation of the Universal Health Care Law.  The objective is “to optimise an economic enterprise modality of service that will deliver a health care model that provides all Filipinos access to a comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative and palliative health services without causing  financial hardship, and prioritizes the need of the population who cannot afford such services.”

         The vision of this Health Integrated Management of the Province of Batangas is to make available free quality health care services to the poor who will not incur any balance billing in the entire provincial hospital system which comprises all the provincial and accredited private hospitals/clinics in the entire province of Batangas.  The mission is the full implementation of the Universal Health Care Law (UHC Law), including the full activation of the Special Health Fund under the Provincial Health Board.   The strategy to be followed in attaining the mission is made up of the following :  1)Upgrade to Level 2 at least 5 of the 12 hospitals of the provincial government, i.e. Tanauan, Lipa, San Juan, Lemery and Nasugbu, and establish a new provincial hospital with 100 beds in a 3-hectare property in Salong, Calaca.  2) Establish state of the art Diagnostic Centre and a complete Medical Laboratory in the Capitol Site in Batangas City close to the Batangas Medical Centre.  3)  Improve the General Administration and staffing by operating the Provincial Health Care facilities as economic enterprises. 

         As regards the schedule, implementation is immediate, taking advantage of the COVID-19 crisis.  There is an obvious need for Levels 2 and 3 hospitals in the province of Batangas, as in most provinces in the Philippines.  The implementation of the Universal Health Care Law has already begun.  The Economic Enterprise Ordinance has already been passed, covering the operations of the provincial hospitals.  Funds for healthcare have already been secured through a P4 billion loan from the Development Bank of the Philippines (DBP).  The National Government has also provided funding through the Department of Energy, Bayanihan Grant for Provinces and Department of Health.   Ample appropriations have been included in the 2020 General Fund Budget.  In addition, there are offers for a turn key establishment of the proposed new Provincial Hospital to be located in Calaca, Batangas.

           Batangas could lead the way for the more than 70 provinces in the country to have their respective health integrated management.  This is an outstanding example of the principle of subsidiarity applied to the state sector:  what can be better accomplished efficiently and competently at a lower level of government  should not be taken over by a higher authority.  The principle of subsidiarity can even be better implemented if private hospitals can partner with the LGUs to deliver better health services.  The case of Batangas presents a strong argument for the National Government to strictly implement what Governor Hermilando Mandanas was able to obtain from a final judgment of the Supreme Court:  that the National Government should strictly comply with the requirement that the Internal Revenue Allotment (IRA) should be wholly and promptly released to local governments from the tax collections of the National Government.   Governor Mandanas is determined to make Batangas a model for such devolution of financial resources from the national to the local governments.   For comments, my email address is bernardo.villegas@uap.asia